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	<title type="text">Oshan Jarow | Vox</title>
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	<updated>2025-01-07T18:58:25+00:00</updated>

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				<name>Oshan Jarow</name>
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			<title type="html"><![CDATA[How long should you meditate?]]></title>
			<link rel="alternate" type="text/html" href="https://www.vox.com/future-perfect/392636/how-to-meditate-time-yoga-sitting-long-movement" />
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			<updated>2025-01-07T13:58:25-05:00</updated>
			<published>2025-01-09T08:00:00-05:00</published>
			<category scheme="https://www.vox.com" term="Future Perfect" /><category scheme="https://www.vox.com" term="Health" /><category scheme="https://www.vox.com" term="Mental Health" /><category scheme="https://www.vox.com" term="Psychology" /><category scheme="https://www.vox.com" term="The Future of the Mind" />
							<summary type="html"><![CDATA[A scientific narrative about what meditation does can offer a helpful lens on what is happening when you take your seat on the cushion. But no matter the story, there’s no substitute for actually doing the practice. Which raises the question: If you’re interested in exploring deeper meditation, how long will it take you to [&#8230;]]]></summary>
			
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<p class="has-text-align-none">A scientific narrative about what meditation does can offer a helpful lens on what is happening when you take your seat on the cushion. But no matter the story, there’s no substitute for actually doing the practice. Which raises the question: If you’re interested in exploring deeper meditation, how long will it take you to actually get somewhere?&nbsp;</p>

<p class="has-text-align-none">There’s no fixed relationship between how much time you put in and how much progress you get out. And even thinking about meditation in these terms — time you spend meditating as an investment in particular outcomes —&nbsp;will earn you smirks from some meditation teachers. But there <em>are</em> clear trends and useful benchmarks to help you think through how much daily meditation might actually deepen your practice.</p>

<h2 class="wp-block-heading">Meditation is more like learning physics than exercising&nbsp;</h2>

<p class="has-text-align-none">Meditation is often compared to <a href="https://www.mindful.org/meditation-mental-fitness-way/">exercise</a>, where the relationship between effort and outcomes is usually clear. The more time you put in, the more results you get. But it’s not quite as straightforward as that, whether in exercise or meditation.</p>

<div class="wp-block-vox-media-highlight vox-media-highlight">
<h2 class="wp-block-heading">This was first published in More to Meditation</h2>



<p class="has-text-align-none">More to Meditation is Vox’s five-day course on deepening your meditation practice. <a href="https://www.vox.com/pages/more-to-meditation-newsletter-signup" data-type="link" data-id="https://www.vox.com/pages/more-to-meditation-newsletter-signup">Sign up here</a>!</p>
</div>

<p class="has-text-align-none">Take the Buddhist idea of “<a href="https://www.lionsroar.com/right-effort/">Right Effort</a>,” which is kind of like learning proper weightlifting form. “If you want to lift more weight, but your form is bad, the only thing your weightlifting actually measures is how close you are to injury,” said <a href="https://meditatewithtucker.com/">Tucker Peck</a>, a meditation teacher and clinical psychologist who specializes in working with advanced meditators.&nbsp;&nbsp;</p>

<p class="has-text-align-none">Given proper form, you might then expect a consistent relationship between how often you work out and the bulge of your biceps. But meditation outcomes can be jagged and unpredictable. As cognitive scientist and meditator <a href="https://rubenlaukkonen.com/">Ruben Laukkonen</a> explained to me last year, the amount of time you spend practicing isn’t a reliable indicator of how much progress you’ve made.</p>

<p class="has-text-align-none">Instead, he suggested thinking of meditation like learning physics. There’s a lot to learn that does just require putting in the work —&nbsp;memorizing all those equations and theories, mastering the math that underpins it. And you want to make sure you’re learning correct ideas, rather than wasting your time on fake equations or disproved hypotheses.</p>

<p class="has-text-align-none">But there’s also intuition at play, and flashes of insight can erupt at any point in the learning process. Meditation, too, can be quick and intuitive for some, or a long slog for others.&nbsp;</p>

<p class="has-text-align-none">Consider the Indian sage Ramana Maharshi (1879–1950). Among the hordes of gurus out there, he’s widely considered one of the least assailable cases of being the spiritual real deal.</p>

<p class="has-text-align-none">At the age of 16 while hanging out at his uncle’s house, with no particular interest or commitment to meditation, Maharshi got the sudden feeling that he was going to die. So he laid down, observed the process, and a few minutes later, stood up, permanently enlightened, as <a href="https://www.davidgodman.org/an-introduction-to-sri-ramanas-life-and-teachings/">the story</a> goes.&nbsp;</p>

<p class="has-text-align-none">Now, I’m not sure what that actually means, and I’m skeptical of anyone who says they do. But the point is that some people can spend their entire lives meditating in search of some big psychological transformation, only for nothing much to happen. Others, like Maharshi, can get hit with what some traditions call “<a href="https://www.mctb.org/mctb2/table-of-contents/part-v-awakening/37-models-of-the-stages-of-awakening/the-sudden-schools-of-awakening/">sudden awakening</a>,” without any real prior meditation practice to speak of.</p>

<p class="has-text-align-none">And making progress in meditation, at least traditionally speaking, depends on more than just doing the actual meditation. Across almost every school of both Buddhism and Hinduism, getting your ethics in order — <a href="https://www.accesstoinsight.org/ptf/dhamma/sila/index.html">sīla</a>, or “moral conduct” in Buddhism — comes before sitting down to practice.&nbsp;</p>

<p class="has-text-align-none">According to Buddhist scripture, no matter how long you sit for, you won’t be able to access <a href="https://www.vox.com/future-perfect/354069/what-if-you-could-have-a-panic-attack-but-for-joy">the jhānas</a> —&nbsp;states of deep meditative absorption — unless your mind is relatively free from <a href="https://www.accesstoinsight.org/lib/authors/nyanaponika/wheel026.html">the five hindrances</a> (which are obstacles to deep concentration like ill will, sloth, or restlessness). And as the Buddha’s teaching of the <a href="https://tricycle.org/magazine/noble-eightfold-path/">Eightfold Path</a> holds, establishing moral thought, speech, action, and livelihood all come <em>before</em> getting to mindfulness practice.</p>

<p class="has-text-align-none">All of which is to say, there’s no obvious formula here, and a lot of moving parts. Still, whether you’re looking to drop every ounce of tension you’ve stored up in your muscles, deconstruct some harmful mental habits, or embark upon a first-person investigation into the nature of mind, we can flesh out a bit more detail on different approaches to daily meditation.&nbsp;&nbsp;</p>

<h2 class="wp-block-heading">How much of my day will I have to sink into advanced meditation practices?</h2>

<p class="has-text-align-none">Let’s assume you won’t spontaneously launch into the deep end of meditation experiences with a Ramana-style sudden awakening (but you never know). There’s no blanket answer to how long you should meditate, of course. But if you’re interested in deepening your meditation practice, there are at least two general principles to follow:</p>

<ul class="wp-block-list">
<li><strong>It’s more important to practice </strong><strong><em>regularly</em></strong><strong> than to sporadically do longer sessions. 20 minutes a day is a better bet than 60 minutes once a week.</strong><strong><br></strong></li>



<li><strong>Therefore, you should do the most meditation </strong><strong><em>that you will actually do</em></strong><strong> every day (within reason, which we’ll get to).</strong></li>
</ul>

<p class="has-text-align-none">As mindfulness has gone mainstream, though, much shorter sessions have become the vogue. Many of the stress-relief meditations on popular apps like <a href="https://www.headspace.com/">Headspace</a> or <a href="https://www.calm.com/">Calm</a> cluster around <a href="https://link.springer.com/article/10.1007/s12671-018-0905-4">10-minute sessions</a>.</p>

<p class="has-text-align-none">Some teachers&nbsp;— especially those coming from <a href="https://iep.utm.edu/advaita-vedanta/">non-dual traditions</a> that believe we’re all already enlightened but just don’t know it — say that even short, 5- or 10-minute meditations can be powerful stuff. Nondual meditation teacher Loch Kelly teaches “<a href="https://lochkelly.org/mindful-glimpses">mindful glimpses</a>” that take no more than a few minutes, but, he told me, can give a real peek into deep states of meditation. Though he added that it then takes about three years of practice to stabilize those glimpses.&nbsp;</p>

<p class="has-text-align-none">Glimpses, stress relief, and sudden awakenings aside, most meditation teachers I spoke with agree that you’ll have to sit for more than 10 minutes per day to really get acquainted with meditation’s deeper practices.&nbsp;</p>

<p class="has-text-align-none">Even the formal method of <a href="https://www.sciencedirect.com/science/article/abs/pii/S0022399903005737?via%3Dihub">mindfulness-based stress reduction</a> (MBSR), which trojan-horsed mindfulness into Western science more than 40 years ago, is an eight-week course that <a href="https://www.sciencedirect.com/science/article/pii/S0005796717300979?via%3Dihub">recommends 45 minutes</a> of daily meditation. <a href="https://www.vox.com/the-gray-area/23999825/mindfulness-meditation-jon-kabat-zinn-the-gray-area">Jon Kabat-Zinn</a> — meditation teacher, former biologist, and MBSR’s creator — settled on 45 minutes as a middle ground between longer sessions that could get you past the initial fidgety phases of meditation, while being somewhat realistic for people to actually do on their own (though a <a href="https://www.sciencedirect.com/science/article/pii/S0005796717300979?via%3Dihub">2017 review</a> found that people wind up doing more like 30 minutes).&nbsp;</p>

<p class="has-text-align-none">MBSR’s timeframe is pretty close to that of <a href="https://www.nytimes.com/2019/02/12/style/transcendental-meditation.html">Transcendental Meditation</a>, a technique based on silently repeating a personal mantra that’s been practiced by a range of celebrities, from the Beatles to David Lynch, which <a href="https://my.clevelandclinic.org/health/treatments/22292-transcendental-meditation">prescribes</a> two 20-minute sessions per day. And meditation teacher Leigh Brasington, who we’ll hear from later in this course, recommends a minimum of 45 minutes per day if you want to get into states of deep concentration like the jhānas.</p>

<p class="has-text-align-none">So if you’re used to shorter meditations, or none at all, work upwards incrementally. Try starting with at least a 20-minute session per day. Jack Kerouac, a writer who <a href="https://tricycle.org/magazine/negative-capability-kerouacs-buddhist-ethic/">introduced</a> much of the 20th-century Beat Generation to Buddhism, <a href="https://citylights.com/beat-literature-poetry-history/jack-kerouac-allen-ginsberg-letters/">wrote</a> to his fellow poet Allen Ginsberg that “it takes twenty minutes to quiet the machine motor of the mind.” Despite his competing infatuation with benzos and wine, I think he was on to something.</p>

<p class="has-text-align-none">If you think back to yesterday’s newsletter, quieting the motor of the mind is equivalent to doing enough focused attention practice to release the mind’s first layer of priors —&nbsp;or habits. A quiet mind is one where attention no longer gets snagged on mental activity, clearing the path to deeper open-monitoring or nondual practices. And 20 minutes can be a helpful benchmark for getting there.</p>

<p class="has-text-align-none">But instead of using a timer, try using a stopwatch, and practicing to intuitively stop around the time you’re shooting for. This might be tricky at first, but it gets easier. And that way, if you find yourself in the midst of a particularly spacious and comfortable meditation, you can stretch it a bit longer without being jolted out by a timer. Or, if your “sit” is getting particularly tortuous, or your back hurts, you can just stop with less grief about not lasting the whole time.</p>

<p class="has-text-align-none">As an added bonus, you’ll begin to develop an internal clock for meditation duration, which is actually something advanced practitioners <a href="https://x.com/WystanTBS/status/1852207025134112975">train</a> to do anyway.</p>

<p class="has-text-align-none">Peck, the meditation teacher and psychologist, suggests that if you’re doing anything more than 45 minutes, you should be checking in with a teacher every now and then. Longer sessions are more likely to send you into deeper states, where meditation shifts from relaxing to potentially transformative. But there’s no guarantee that things change for the better, which is where experienced teachers can help steer your practice. “I’ve seen quite a number of people become psychotic from meditating six hours a day in their room without talking to anybody,” he said.&nbsp;</p>

<h2 class="wp-block-heading">A word on the under-studied risks of meditation</h2>

<p class="has-text-align-none">Research on the risks of meditation is unsurprisingly <a href="https://journals.sagepub.com/doi/10.1177/2167702621996340">lagging behind</a> the benefits. A <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/acps.13225">2020 systematic review</a> of 83 meditation studies found that the prevalence of “meditation adverse events,” which can include anything from anxiety and depression to suicidal behaviors, hovered around 8.3 percent. But experts I spoke with are all over the map on whether that number looks too high or too low.&nbsp;&nbsp;</p>

<p class="has-text-align-none">The relative lack of knowledge about the risks has given rise to various organizations trying to fill in the gaps. <a href="https://theeprc.org/executive-summary/">Networks of scholars and practitioners</a> are looking to educate healthcare professionals on how to support people going through challenging meditation experiences. Communities like <a href="https://www.cheetahhouse.org/meditator-consultations-1?gad_source=1&amp;gclid=Cj0KCQiAsOq6BhDuARIsAGQ4-zj7An_aLLpSKShUCkfVICpQm_BsQn3rQwwHcvVnV8Eaj2iPKlpHzuUaAj8aEALw_wcB">Cheetah House </a>offer direct support, alongside training meditation teachers to better handle difficult experiences. And resources like psychotherapist David Treleaven’s book, <a href="https://psycnet.apa.org/record/2018-02486-000"><em>Trauma-Sensitive Mindfulness</em></a><em>, </em>can help guide people through a more supported approach to meditation.</p>

<h2 class="wp-block-heading">The goals and benefits of meditation change over time</h2>

<p class="has-text-align-none">According to the original framework for meditative development presented in Buddhist scripture — the <a href="https://www.dharma.org/the-four-levels-of-awakening/">four-path model</a> —&nbsp;as your practice develops, real, durable changes to your psychology set in. Different traditions have their own maps of what making “progress” in your contemplative practice looks like —&nbsp;and yes, some teachers will ridicule the idea of spiritual progress as precisely the goal-oriented approach that <em>undermines</em> development — but most share the idea that if you keep up your practice over time, deeper stages begin to unfold.&nbsp;</p>

<p class="has-text-align-none">So instead of thinking about meditation as just a daily practice, then, we can also think about what it means to make progress over time. Are there benchmarks of progress in meditation? If you spent 30 minutes a day meditating over the next decade, you’d rack up about 1,800 hours of practice. Would the benefits of that much effort justify the opportunity cost of other things you might’ve done with about 75 days of your life?</p>

<p class="has-text-align-none">One of the few studies to explore the relationship between lifetime hours spent meditating and benefits was <a href="https://link.springer.com/article/10.1007/s12671-022-01977-6#Abs1">published in 2022</a> by psychologists from the University of Melbourne’s <a href="https://psychologicalsciences.unimelb.edu.au/CSC">Contemplative Studies Centre</a>. They surveyed 1,668 English-speaking adult meditators with an average of 1,095 lifetime meditation hours. (On the spectrum of expertise, this is still fairly low. For comparison, when Harvard neuroscientist Matthew Sacchet studied an advanced meditator in his lab <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10793575/">earlier this year</a>, they had roughly 23,000 hours of lifetime practice).</p>

<p class="has-text-align-none">The psychologists looked at the correlation between lifetime meditation hours and four variables: life satisfaction, positive affect, negative affect, and psychological distress. Across all four cases, two things immediately jumped out.</p>

<p class="has-text-align-none">First, steeper benefits show up in the first 500 hours of practice. In the cases of life satisfaction and positive affect (basically, pleasure), the sharpest gains registered within the first 200 hours.&nbsp;</p>

<p class="has-text-align-none">The authors point out a range of limitations to their study, from sampling bias to basing lifetime practice hours on an extrapolation of prior-month self-reported meditation time. But overall, they come away with two conclusions: Meditation outcomes appear non-linear with time spent practicing, and the strongest gains seem to show up in the first 500 hours of practice.</p>

<p class="has-text-align-none">I found that strange. If you look at the range of claims people make about their meditation practice, my read is that they get more intense, not less, as someone’s practice develops.</p>

<p class="has-text-align-none">So I reached out to Nicholas Bowles, PhD student in psychology and lead author of the study, to ask if he really thought the beginning stages of meditation are more potent than the later ones. He explained that in his more recent research, he’s finding that as meditators practice more, their goals and motivations change. “People who have practiced less tend to value mental health, improving relationships, etc, while people who have practiced more tend to value spiritual growth,” he said via email.</p>

<p class="has-text-align-none">Peck said that he sees this pattern of changing motivations with almost every student. “That people’s motivations change is universal. When you first start meditating, your mind is just wasting most of its energy on this idiotic, circular rambling. You have no sensory clarity, you don’t really understand what’s going on deeper in your mind.”&nbsp;</p>

<p class="has-text-align-none">Which means that there’s no single metric that can capture the thrust of meditation’s effects from 0 hours of practice out to 1,000, let alone 23,000. If you find major improvements to life satisfaction in the first 200 hours that level off afterward, that could be because the category of “life satisfaction” no longer captures the sort of benefits you’re getting out of sustained practice. “Overall then,” Bowles added, “the gains from practice for experienced practitioners probably continue to be quite impactful, but perhaps they’re impactful in different ways.”</p>
<img src="https://platform.vox.com/wp-content/uploads/sites/2/2024/12/gettyimages-2185100556.jpg?quality=90&#038;strip=all&#038;crop=0.011405109489054,0,99.977189781022,100" alt="Practicing yoga" title="Practicing yoga" data-has-syndication-rights="1" data-caption="Guests practice yoga at Team Milk&#039;s Every Woman&#039;s Marathon Wellness Fair &amp; Expo on November 15, 2024, in Savannah, Georgia. | Carol Lee Rose/Getty Images for Every Woman&#039;s Marathon" data-portal-copyright="Carol Lee Rose/Getty Images for Every Woman&#039;s Marathon" />
<h2 class="wp-block-heading">How do movement and meditation fit together? Q+A with Tibetan Buddhist meditation teacher Chandra Easton</h2>

<p class="has-text-align-none">In my early 20s, I spent some time at a Zendo in southern India. During sesshins, which are like Zen’s form of silent meditation retreats, our daily schedule would mostly alternate between periods of sitting meditation (zazen) and walking meditation (kinhin).</p>

<p class="has-text-align-none">After sitting for something like 10 hours a day, walking was obviously crucial for my Western joints, as well as my sanity. But kinhin isn’t supposed to be just a respite from the tyranny of crossed legs —&nbsp;it’s meditation, too. But I struggled to really believe that.</p>

<p class="has-text-align-none">To my mind, the “real” meditation was sitting still, and walking was mostly a concession we make on account of having bodies that need movement. If you think back to our framework for how meditation deconstructs the predictive mind, I saw movement as just a part of the first layer of “focused attention” practices. The deeper stuff requires sitting still.</p>

<p class="has-text-align-none">Now, I think of sitting still in meditation as training wheels for the <em>real</em> practice, which is finding the same states of deeper awareness while your mind is thrashing around and navigating the stuff of daily life, whether the subway in Manhattan, the grocery store aisles the day before Thanksgiving, or while your kids are screaming. That’s when you find out if your meditation practice is actually working. Ram Dass has another good <a href="https://www.ramdass.org/ram-dass-quotes/">quip</a>: “If you think you’re enlightened, go spend a week with your family.”</p>

<p class="has-text-align-none">But moving engages the mind, so if meditative depth is about shutting down the predictive mind, and moving triggers it, aren’t these opposing forces? How’s it possible to progress into deeper open-monitoring and non-dual states while doing yoga poses, walking, or dancing?</p>

<p class="has-text-align-none">To explore these questions, I spoke with <a href="https://chandraeaston.com/">Chandra Easton</a>, a meditation teacher, yoga instructor, and translator of Tibetan Buddhist texts. This excerpt of our conversation has been edited for length and clarity.</p>

<p class="has-text-align-none"><strong>You’ve been teaching a </strong><a href="https://chandraeaston.com/ongoing-classes/#:~:text=Releasing%20Into%20Presence&amp;text=Classes%20will%20be%20relaxing%2C%20rejuvenating,presence%20with%20ease%20and%20comfort."><strong>class</strong></a><strong> that combines meditation, mantra, and movement. How do these three fit together?</strong></p>

<p class="has-text-align-none">In Buddhism, the body, speech, and mind are called the <a href="https://chandraeaston.com/body-speech-mind/">three doors</a>, or gates. We can work through each of those different doorways into the same space. There’s one big room: presence.</p>

<p class="has-text-align-none">Sitting in stillness is the ultimate body door. But that’s not easy for a lot of us to do. So in my class, I designed it to touch on those three doors and give people different access points into awareness or presence.</p>

<p class="has-text-align-none"><strong>Can you go as deep into meditation during movement as you can when you’re sitting still?</strong></p>

<p class="has-text-align-none">It’s true that stillness allows us to access very deep states of attention. When we move, the mind moves. So we tell people don’t move if you don’t have to, because you’re just stirring up the dust again. But one’s not better than the other, it just depends where you are in the arc of your own practice.</p>

<p class="has-text-align-none">For me, I’ve had some challenging chronic pain issues. So sitting still in traditional meditation posture is not always an option. It’s forced me to find other ways to practice, and it’s been really liberating and helpful.</p>

<p class="has-text-align-none">I’ve practiced through walking meditation, and supine [lying on your back] meditation. I was in such bad shape that I had to lie down while teaching meditation. And that was a really good thing for me to do in public. People would come up and say thank you for teaching us how to tend to our bodies.</p>

<p class="has-text-align-none">A lot of people deal with chronic pain, which can be a boundary for people to get into meditation. There were periods when I was in so much pain that I had to do moving meditation, like yoga, qi gong, or tai chi. For many years, I taught a style called shadow yoga, which is based on Hatha Yoga and South Indian dance and martial arts. There’s a quality of slow, mindful movement.&nbsp; Currently, I practice Tibetan yoga and shadow yoga adapted for my situation, and I teach elements of these in my courses to help prepare people for meditation. So for people who are facing illness or chronic pain, moving meditation options are really important.&nbsp;&nbsp;&nbsp;</p>

<p class="has-text-align-none">That’s also why working with a skillful teacher is very important, somebody who can help the student navigate different phases of their lives in different circumstances.</p>

<p class="has-text-align-none"><strong>I think I’ve been a little biased against movement meditation because when I think of meditation, I picture the Buddha sitting quietly under the Bodhi tree.&nbsp;</strong></p>

<p class="has-text-align-none">A lot of people don’t know that after the Buddha sat under the Bodhi tree and got liberated from the roots of suffering, he got up and he walked. He taught for 45 years, and he spent more time walking than sitting. And that doesn’t get communicated to a lot of us Westerners.&nbsp;</p>

<p class="has-text-align-none">So we get this perception that seated meditation is the most important thing. And there are times in our life when that should be the case… so we can train the mind to go into deep concentration.&nbsp;</p>

<p class="has-text-align-none">But then, the advanced practice is getting up from that and blending the meditative state with the post-meditative state. The true advanced practice is to blend the awareness that we steep in and touch during [still] meditation with all our life, our movement or driving or parenting or cooking. All the mundane things.</p>

<div class="wp-block-vox-media-highlight vox-media-highlight">
<h2 class="wp-block-heading">Want to dive deeper into meditation?</h2>



<p class="has-text-align-none">Check out Vox’s free meditation course. For five days, staff reporter Oshan Jarow breaks down what you need to know to fit meditation into your everyday life, features exclusive interviews with different meditation experts, and offers bite-size meditation practice exercises. <a href="https://www.vox.com/pages/more-to-meditation-newsletter-signup">Sign up here</a>!</p>
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			<entry>
			
			<author>
				<name>Oshan Jarow</name>
			</author>
			
			<title type="html"><![CDATA[How meditation deconstructs your mind]]></title>
			<link rel="alternate" type="text/html" href="https://www.vox.com/future-perfect/392634/how-meditation-works-new-science-consciousness" />
			<id>https://www.vox.com/?p=392634</id>
			<updated>2025-01-07T12:19:35-05:00</updated>
			<published>2025-01-08T08:30:00-05:00</published>
			<category scheme="https://www.vox.com" term="Future Perfect" /><category scheme="https://www.vox.com" term="Health" /><category scheme="https://www.vox.com" term="Mental Health" /><category scheme="https://www.vox.com" term="Psychology" /><category scheme="https://www.vox.com" term="The Future of the Mind" />
							<summary type="html"><![CDATA[We’re laying out the latest science of what meditation does to your mind. The better we understand the common mechanisms across how different meditation practices affect the mind, the more meditation science can contribute to broader understandings of human psychology. More relevant for us non-scientists, we’ll get better at developing and fine-tuning styles of practice [&#8230;]]]></summary>
			
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<p class="has-text-align-none">We’re laying out the latest science of what meditation does to your mind. The better we understand the common mechanisms across how different meditation practices affect the mind, the more meditation science can contribute to broader understandings of human psychology.</p>

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<h2 class="wp-block-heading">This was first published in More to Meditation</h2>



<p class="has-text-align-none">More to Meditation is Vox’s five-day course on deepening your meditation practice. <a href="https://www.vox.com/pages/more-to-meditation-newsletter-signup" data-type="link" data-id="https://www.vox.com/pages/more-to-meditation-newsletter-signup">Sign up here</a>!</p>
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<p class="has-text-align-none">More relevant for us non-scientists, we’ll get better at developing and fine-tuning styles of practice that can help us get the most out of whatever we’re looking for in taking up meditation. (It’s possible, after all, that there are improvements to be made on the instructions we received a few thousand years ago.)&nbsp;</p>

<p class="has-text-align-none">There’s a lot to get into here, but if you walk away from this with anything, it should be that in the past few years, a breakthrough has begun <a href="https://www.vox.com/future-perfect/23836358/meditation-mindfulness-enlightenment-science-contemplative-buddhism-spirituality">sweeping across meditation research</a>, delivering science’s first “general theory of meditation.” That means very exciting days —&nbsp;and more to the point, scientifically refined meditation frameworks and practices — are not too far ahead.&nbsp;</p>

<h2 class="wp-block-heading">Don’t we already know what meditation is?</h2>

<p class="has-text-align-none">Over the last decade or two, the rise of mindfulness-related practices as a <a href="https://www.huffpost.com/entry/beyond-mcmindfulness_b_3519289">profitable industry</a> has spread the most accessible forms of meditation —&nbsp;like short, guided <a href="https://www.headspace.com/meditation/stress">stress-relief meditations</a>, or <a href="https://www.mindful.org/a-simple-weekly-mindfulness-practice-keep-a-gratitude-journal/">gratitude journals</a> —&nbsp;to <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC11217305/">millions</a> of Americans.</p>

<p class="has-text-align-none">Which is great —&nbsp;basic mindfulness practices that help us concentrate on the present are both relaxing and useful. But as psychotherapist Miles Neale, who coined the term “McMindfulness,” <a href="https://insighttimer.com/blog/mcmindfulness-frozen-yoga-miles-neale/">writes</a>, if stress relief is all we take meditation to be, it’s “like using a rocket launcher to light a candle.” Some meditation practices can help ease the anxious edges of modern life. Others can change your mind forever.</p>

<p class="has-text-align-none">One way to pursue happiness is to try and fill your experience with things that make you happy — loving relationships, prestige, kittens, whatever. Another is to change the way your mind generates experience in the first place. This is where more advanced meditation focuses. It operates on our deep mental habits so that well-being can more naturally arise in how we experience anything at all, kittens or not.</p>

<p class="has-text-align-none">But the deeper terrain of meditation is often shrouded in hazy platitudes. You may hear that meditation is about “<a href="https://insighttimer.com/meditation-topics/awakening#:~:text=Awakening%20Meditation,a%20powerful%20tool%20for%20awakening.">awakening</a>,” “<a href="https://adyashanti.opengatesangha.org/teachings/intro-teachings#tf_the-way-of-liberation-excerpt-3">liberation</a>,” or jubilantly realizing the inherent emptiness of all phenomena, at which point you’d be forgiven for tuning out. Descriptions of more advanced meditation often sound … weird, and therefore, inaccessible or irrelevant to most people.</p>

<p class="has-text-align-none">Part of my hope for this course is to change that. Even if you don’t want to join a monastery (I do not), there’s still a huge range of more “advanced meditation” practices to explore that go beyond the mainstream basic mindfulness stuff. Some can feel like melting into “<a href="https://sashachapin.substack.com/p/pure-pleasure-isnt-what-you-want">a laser beam of intense tingly pleasurably electricity</a>,” and ultimately change the way you relate to pleasure, <a href="https://www.vox.com/future-perfect/354069/what-if-you-could-have-a-panic-attack-but-for-joy">like the jhānas</a>. Others, like <a href="https://deconstructingyourself.com/nondual-awareness-meditation-series">non-dual practices</a> (which I’ll get into later), can plunge you into strange modes of consciousness full of wonder and insight that you might never have known were there.&nbsp;</p>

<p class="has-text-align-none">Which might leave you wondering why it’s mindful relaxation that gets all the attention. For one thing, there’s how much time we imagine deeper meditation practices will take —&nbsp;we’ll get into that later in this course. Another obstacle blocking advanced meditation’s path into the mainstream is that a critical mass of Americans aren’t exactly itching to become full-on Buddhists. But if you turned to science instead of religion for guidance on these meditation practices in the past few decades, you’d mostly find a bunch of scattered neuroscience jargon that doesn’t all hang together.</p>

<p class="has-text-align-none">Buddhism can paint a really elaborate picture of what’s going on with meditation, with ancient models of meditative development still being used today, like the <a href="https://www.mctb.org/mctb2/table-of-contents/part-v-awakening/37-models-of-the-stages-of-awakening/the-theravada-four-path-model/">four-path model</a>. Science has struggled to do the same. We know some interesting but scattered things: Meditation makes parts of your brain <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC1361002/">grow thicker</a>. It <a href="https://academic.oup.com/nc/article/2022/1/niac013/6758320#418874162">changes patterns</a> of electrical activity in key brain networks. It <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC5261734/">raises</a> the baseline of gamma wave activity. It <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6302143/">shrinks</a> your amygdala.&nbsp;</p>

<p class="has-text-align-none">The problem, as Shamil Chandaria, a senior research fellow at the University of Oxford’s Center for Eudaimonia and Human Flourishing, put it to me, is weaving it all together into a story that shows us the big picture. “In terms of all these neuroscience results,” Chandaria said, “there’s this problem of what does it all mean?”</p>

<p class="has-text-align-none">In <a href="https://www.sciencedirect.com/science/article/pii/S014976342100261X">a pivotal 2021 paper</a> by cognitive scientists Ruben Laukkonen and Heleen Slagter, that big picture — a model of how meditation affects the mind that can explain the effects of simple breathing practices and the most advanced transformations of consciousness alike — finally began coming together.</p>

<h2 class="wp-block-heading">A general theory of meditation</h2>

<p class="has-text-align-none">Let’s start with plain language. Think of meditation as having four stages of depth, each with a corresponding style of practice: focused attention, open-monitoring, non-dual, and cessation.</p>

<p class="has-text-align-none">Near the surface,“focused attention” practices help settle the mind. By default, our minds are usually snow globes in constant frenzy. Our attention constantly jumps from one flittering speck to the next, and the storm of activity blocks our view of the whole sphere. By focusing attention on an object —&nbsp;the breath, repeating a mantra, the back of your thigh, how a movement feels in the body —&nbsp;we can train the mind to stop getting yanked around. With the mind settled on just one thing, it’s easier to see through the storm.&nbsp;</p>

<p class="has-text-align-none">“Open-monitoring” practices help us get untangled from focusing on any particular thing happening in the mind, opening the aperture of our attention to notice the wider field of awareness that all those thoughts, feelings, and ideas all arise and fall within.</p>

<p class="has-text-align-none">Once you’ve settled the mind and gotten acquainted with the more spacious awareness beneath it, “non-dual” practices help you shift your mental center of gravity so that you identify with that expansive field of awareness itself, rather than everything that arises within it, as we normally do. (I know this probably sounds weird, we’ll get more into it later. Some things in meditation are irreducibly weird, which is part of what makes me think it’s worth paying attention to.)</p>

<p class="has-text-align-none">And finally, for practitioners with serious meditation chops, you can go one step deeper, where even the field of non-dual awareness disappears. If you sink deep enough into the mind, you’ll find that it just extinguishes, like a candle flame blown out by a sudden gust of wind. That can happen for seconds at a time, called nirodhas in Theravada Buddhism, or it can last for days at a time, called nirodha-sammapati, or cessation attainment.</p>
<img src="https://platform.vox.com/wp-content/uploads/sites/2/2024/12/meditation-spot.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" alt="An illustration shows a ladder with four rungs, labeled “Focused attention, open monitoring, non-dual, and cessation”" title="An illustration shows a ladder with four rungs, labeled “Focused attention, open monitoring, non-dual, and cessation”" data-has-syndication-rights="1" data-caption="" data-portal-copyright="Pete Gamlen for Vox" />
<p class="has-text-align-none">You can think of this progression as four rungs on a ladder that lead from the surface of the mind all the way down to the bottom. Or, from the beginner stages of meditation, all the way through to the very advanced. You can place a huge variety of meditative practices — though not all — somewhere along this spectrum.</p>

<p class="has-text-align-none">And just about everything that’s grown popular under the label of mindfulness is in that first group of focused-attention practices. The idea that meditation can make you “<a href="https://www.meditatehappier.com/podcast">10 percent happier</a>” is talking about these introductory practices that settle the mind.</p>

<p class="has-text-align-none">But the idea that meditation can make you 10 times happier, like meditation teacher Shinzen Young <a href="https://www.youtube.com/watch?v=8P7q2MW5upg">claims</a>, references the next stages: practices that open up once the mind begins to settle.</p>

<h2 class="wp-block-heading">Once more, with science</h2>

<p class="has-text-align-none">Now, bear with me. We’re going to retell that story, but using Laukkonen and Slagter’s innovation —&nbsp;the general theory of meditation. The key to this framework is a theory that’s risen to dominate cognitive science in the past decade or so: <a href="https://link.springer.com/article/10.1007/s13164-022-00666-6">predictive processing</a>.&nbsp;</p>

<p class="has-text-align-none">Predictive processing says that we don’t experience the world as it <em>is</em>, but as we <em>predict</em> it to be. Our conscious experience <a href="http://slehar.com/wwwRel//cartoonepist/cartoonepist.html">is a construction</a> of layered mental habits acquired through past experiences. We don’t see the world through our eye sockets; we don’t hear the world through our ear canals. These all feed information into our brains, which conjure our experience of the world from scratch — like when we dream — only that in waking consciousness, they’re at least trying to match what they whip up in our experience to what might actually be going on in the world outside our skulls.&nbsp;</p>

<p class="has-text-align-none">The building blocks for these conjured models of the world we experience — the predictive mind —&nbsp;are called “priors,” those beliefs or expectations based on the past. Priors run a spectrum from deep and ancestral to superficial and personal.</p>

<p class="has-text-align-none">For example, say you ventured an opinion in front of your third grade class and everyone laughed. You might have formed a prior that assumes sharing your thoughts leads to ridicule. If that experience was particularly meaningful to you, it could embed deep in your predictive mind, shaping your behavior, and even perception of the world, for the rest of your life.</p>

<p class="has-text-align-none">Similarly, our bodies know how to do some of their most basic functions — like maintaining body temperature around <a href="https://www.cell.com/trends/cognitive-sciences/abstract/S1364-6613(18)30239-0?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1364661318302390%3Fshowall%3Dtrue">98.6 degrees</a> Fahrenheit —&nbsp;because we’ve <a href="https://www.sciencedirect.com/science/article/pii/S1571064519300028?via%3Dihub">inherited priors</a> from our evolutionary history that holding our body in that range will keep us alive. According to predictive processing, consciousness is constructed via this hierarchy of priors like a house of cards.</p>

<p class="has-text-align-none"><strong>With all that in place, science’s new meditation story can be put nice and short: Meditation deconstructs the predictive mind.</strong></p>

<p class="has-text-align-none">But hold on. It took billions of years for evolution to slowly, patiently build us these predictive minds. They’re one of the great marvels of biology. Why would we want to deconstruct them?&nbsp;</p>

<p class="has-text-align-none">Well, evolution doesn’t care whether survival feels good. Conscious experience — as we know it — might be a really useful trick for adapting to our environments and achieving the goals that further <a href="https://www.vox.com/the-gray-area/376839/creativity-predictive-processing-chaos-mark-miller">life’s crusade against entropy</a> and death. But natural selection cares about ensuring our bodies survive, not that we achieve happiness and well-being.&nbsp;</p>

<p class="has-text-align-none">Which is why you often hear meditation teachers talking about “reprogramming” the mind. We don’t want to just leave the predictive mind in pieces. Again, it’s one of the most useful adaptations life on Earth has ever mustered. But in some departments, we might want to kindly thank evolution, while taking the reins and revising a bit of its work to make this whole business of living feel better.</p>

<h2 class="wp-block-heading">“Precision weighting” is the volume knob on the predictive mind</h2>

<p class="has-text-align-none">Each step, from focused attention through to cessation, is a deeper deconstruction of the predictive mind. But “deconstructing” doesn’t mean, like, breaking it.</p>

<p class="has-text-align-none">Instead, the key idea is “precision weighting,” which you can think of as the volume knob on each of the priors that make up your predictive mind. The higher the precision — or volume — assigned to something, the more focus your mind pays to it. The more your experience warps around it.</p>

<p class="has-text-align-none">Deconstructing the mind is to progressively turn down the volume on each layer of stacked priors, releasing the grip they ordinarily hold on awareness. By definition, then, the deeper meditation goes, the stranger (as in, further from ordinary) the resulting experience will be.</p>

<h2 class="wp-block-heading">How meditation deconstructs the predictive mind</h2>

<p class="has-text-align-none">So let’s go back to our four-step model of meditative depth. We said the first step, focused attention practices, “settle the mind.”&nbsp;</p>

<p class="has-text-align-none">Now, we can say that with a bit more detail. By focusing on one particular thing, like the breath, you’re cranking up the precision weighting assigned to it. You’re holding up the volume knob so that your experience settles around it.</p>

<p class="has-text-align-none">By doing so, you also turn <em>down</em> the volume on everything else. You can see this happen in real time pretty easily — just try picking out one specific thing in your current experience. Like your left earlobe — how does it feel right now?</p>

<p class="has-text-align-none">Really, take five seconds and tune into it.</p>

<p class="has-text-align-none">Looking back, you might notice that the more you tuned into that earlobe, the more everything else began to fade into the background. That helps explain why focused attention practices like basic mindfulness can be so relaxing. You’re turning down the volume on everything that’s stressing you out.</p>

<p class="has-text-align-none">Next, in open-monitoring practices, you drop that object of attention and release the volume knob. But it doesn’t twist back to its normal resting position. Since your focusing practice turned down the volume on everything else, the default setting across your mind at large is now lower.&nbsp;</p>

<p class="has-text-align-none">Focused attention settles your mind onto one object of attention. In open-monitoring, you drop into a more settled mind across the board.</p>

<p class="has-text-align-none">It’s not that you no longer have thoughts springing up. But as those thoughts do, your mind reacts less to them. They’re muted, less sticky, so attention clings to them less. They just come and go more easily.&nbsp;</p>

<p class="has-text-align-none">That’s why during the open-monitoring stage, you begin to see the entire snow globe that mental activity is happening inside of. The idea of a “field” of awareness is no longer a metaphor; you can see it directly.</p>

<p class="has-text-align-none">“Advanced practitioners are said to be able to effortlessly observe experience as a whole,” <a href="https://www.sciencedirect.com/science/article/pii/S014976342100261X#bib0025">write</a> Laukkonen and Slagter, without being ‘caught’ by thoughts, emotions, or anything else that arises in one’s sensorium.”</p>

<p class="has-text-align-none">Focused attention practices are an important step in meditation — it helps to calm your mind before trying to see through it. But on their own, they don’t usually lead to big revelations about how your mind works. Open monitoring is where this “seeing through” process really kicks in.</p>

<p class="has-text-align-none">“There is a space of awareness that’s different from the contents of awareness,” said Chandaria, who’s been meditating for about 37 years. “And that’s something that most people aren’t even aware of. The first time we see that, it’s like, oh, I never knew that there was actually an ocean on which these waves were arising. I never knew the ocean.”</p>

<h2 class="wp-block-heading">And then there’s non-dual experience</h2>

<p class="has-text-align-none">As you sink into open-monitoring practice, the predictive mind has loosened its grip on experience. But there are still deep priors at play.</p>

<p class="has-text-align-none">For example, in open-monitoring practice, it probably still feels like there’s a “you” doing the meditating. And that “you” is experiencing “your” awareness. There’s a subject — you — aware of an object, the field of experience.&nbsp;</p>

<p class="has-text-align-none">But according to <a href="https://www.amazon.com/Perennial-Philosophy-Aldous-Huxley/dp/0061724947">heaps of meditators and mystics</a> through the millennia, this, too, can be deconstructed.&nbsp;&nbsp;</p>

<p class="has-text-align-none">Non-dual meditation aims at turning down even those deep priors that construct distinctions between subject and object altogether. As well as basically every other possible distinction. During <a href="https://digitalcommons.ciis.edu/cgi/viewcontent.cgi?article=1031&amp;context=conscjournal">non-dual experiences</a>, there’s no self/other, good/bad, here/there, now/later. All these dualities that underlie ordinary cognition basically melt into a big soup of the Now.</p>

<p class="has-text-align-none">This is the thing — the big soupy Now —&nbsp;that you’ll quickly hear a ton of platitudes about in meditation circles. The illusion of separation, the truth of universal oneness.</p>

<p class="has-text-align-none">That’s because there’s just no great way to describe it — it’s either incredibly weird, or incredibly trite. But if you’re after more descriptions anyway, philosopher and meditator Thomas Metzinger recently <a href="https://mitpress.mit.edu/9780262547109/the-elephant-and-the-blind/">published a book</a> containing over 500 different accounts of non-duality, or “minimal phenomenal experience” as he calls it, from advanced meditators across 57 countries. Metzinger is usually at least a decade ahead of the field, so it’s worth a read.</p>

<p class="has-text-align-none">If open-monitoring practice is where meditation’s hefty insights begin kicking into gear, non-duality is where they ramp up. It’s often described as “coming home.” One meditator from Metzinger’s research described it as: “the realization of having finally found home after an eternal search. The pathological searching, the agony of control, comes to an abrupt end, and for the first time you realize what it means to be alive.”</p>

<p class="has-text-align-none">According to Laukkonen and Slagter’s framework, non-duality is the baseline of all experience. It’s always beneath our ordinary experiences —&nbsp;awareness in its least constructed form. Non-dual meditation practice is about “creating the conditions that reduce ordinary cognition that normally ‘hides’ non-dual awareness.”</p>

<p class="has-text-align-none">But even non-duality isn’t the end of the road. It’s still a mode of consciousness. And according to predictive processing, wherever there’s conscious experience, there’s an underlying prior, or expectation, that’s holding it up. This, too, can be deconstructed.</p>

<h2 class="wp-block-heading">When the mind has no priors left: Cessation</h2>

<p class="has-text-align-none">In the past year, meditation researchers have begun to <a href="https://link.springer.com/article/10.1007/s10548-024-01052-4">corroborate</a> long-standing claims from Buddhist scripture that if your meditation goes deep enough, the whole show of consciousness can be extinguished —&nbsp;temporarily, that is — altogether.</p>

<p class="has-text-align-none">Nirodha-samāpatti, or “cessation of thought and feeling,” is a summit of <a href="https://academic.oup.com/jaar/article-abstract/XLV/2/226/832348">meditative attainment</a> in Theravada Buddhism, the oldest surviving form of Buddhism most commonly practiced in Southeast Asia. Cessation is like going under general anesthesia, but without any drugs. Consciousness can be <a href="https://psyche.co/ideas/what-happens-to-the-brain-during-consciousness-ending-meditation">switched off</a> from the inside, for —&nbsp;according to the scriptures — up to seven days at a time (though the first <a href="https://www.sciencedirect.com/science/article/abs/pii/S0079612322001984?via%3Dihub">lab data</a> on cessation looked at a more modest 90-minute stretch).</p>

<p class="has-text-align-none">Cessation is a bonafide advanced meditation thing — I’ll make zero effort to convince you it’s accessible to us non-monastic folks. But <a href="https://www.scientificamerican.com/article/advanced-meditation-alters-consciousness-and-our-basic-sense-of-self/">according</a> to neuroscientist Matthew Sacchet, who leads the Meditation Research Program at Harvard Medical School and Massachusetts General Hospital, the early data collected from studying cessations with neuroscience gizmos supports the idea that meditation deconstructs the predictive mind.&nbsp;</p>

<p class="has-text-align-none">“Cessation could thus reflect a final release of the expectation to be aware or alert,” Luakkonen and Slagter <a href="https://www.sciencedirect.com/science/article/abs/pii/S0079612322001984?via%3Dihub">write</a>. It’s like a bottoming-out of the predictive mind.</p>

<p class="has-text-align-none">Coming out of cessation, meditators can observe the reconstruction of the predictive mind, prior by prior. “That puts us in a special state,” Chandaria said. “You can call it reprogramming mode. And in reprogramming mode, we can start to reprogram ourselves in ways that could be more conducive to human flourishing.”</p>

<h2 class="wp-block-heading">Why does this matter?</h2>

<p class="has-text-align-none">For those of us who aren’t neuroscientists, or don’t care about “predictive processing,” what good does this model of meditation do?</p>

<p class="has-text-align-none">It’s not the objective truth about what meditation <em>actually</em> does. It’s just a story. It’s not comprehensive —&nbsp;there are styles of meditation that wouldn’t fit neatly onto this framework. And meditation doesn’t always follow this trajectory —&nbsp;you can go straight into non-dual practices, or try out open-monitoring before focused attention.</p>

<p class="has-text-align-none">On a personal note, I find this framework really helpful. Immediately after reading Laukkonen and Slagter’s paper, it gave me a way to see my own practice that clicked with my experience better than other stories — which stem from other cultures — about what meditation does.</p>

<p class="has-text-align-none">Now, I usually spend the beginning of my meditation sessions doing focused attention practice to settle the mind. And when I notice my concentration is stable enough, I release the focus and drop into open-monitoring practices. And when my mind falls into an especially weird place that words don’t really capture, I figure, maybe that’s leaning into this non-dual stuff? Just having the labels helped kindle my interest in playing around with things.</p>

<p class="has-text-align-none">And as a scientific framework, this model is generating all sorts of <a href="https://osf.io/preprints/psyarxiv/c7naw">new hypotheses</a> to test. More broadly, it also gives us a way to think through how it’s possible that so many people are trying meditation, but so few are having the big transformative experiences that more advanced practitioners talk about.</p>

<p class="has-text-align-none">Even if some <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC11217305/">60 million</a> Americans tried meditation in 2022, if most of them only do some sort of focused attention practice, they’re never trying anything beyond the first step. That’s like concluding that running probably won’t make you significantly healthier because you laced up your sneakers and nothing transformative happened.</p>

<p class="has-text-align-none">When I asked Chandaria how this new scientific model compares to religious models that have been around for ages, like Theravada Buddhism’s&nbsp;<a href="https://link.vox.com/click/676c0fe1a72e65368187b036/aHR0cHM6Ly93d3cuZGhhcm1hLm9yZy90aGUtZm91ci1sZXZlbHMtb2YtYXdha2VuaW5nLz91ZWlkPWEzZjdmY2NkYzc5OTM2NzNkMWZkZjBkZGQ3ZTM4YTM4/63892b0e972cc9d3ca0c43a7Ba1cddcc4" target="_blank" rel="noreferrer noopener">four-path model</a>, he said that “Ultimately…all these stories are pointing to the moon. But [contemplative traditions] were pointing with their fingers. Now, we have laser pointers.” And as science progresses, “we’ll be able to work with what we’re finding out about the brain,” he added. “It’s actually about making progress, and by progress, I mean more useful stories.”</p>

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<h2 class="wp-block-heading">Want to dive deeper into meditation?</h2>



<p class="has-text-align-none">Check out Vox’s free meditation course. For five days, staff reporter Oshan Jarow breaks down what you need to know to fit meditation into your everyday life, features exclusive interviews with different meditation experts, and offers bite-size meditation practice exercises. <a href="https://www.vox.com/pages/more-to-meditation-newsletter-signup" data-type="link" data-id="https://www.vox.com/pages/more-to-meditation-newsletter-signup">Sign up here</a>!</p>
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			<entry>
			
			<author>
				<name>Oshan Jarow</name>
			</author>
			
			<title type="html"><![CDATA[The world’s most mysterious psychedelic is already inside your brain]]></title>
			<link rel="alternate" type="text/html" href="https://www.vox.com/the-highlight/379914/dmt-psychedelics-drug-neuroscience-consciousness-ayahuasca" />
			<id>https://www.vox.com/?p=379914</id>
			<updated>2024-12-30T14:30:00-05:00</updated>
			<published>2024-12-07T07:22:00-05:00</published>
			<category scheme="https://www.vox.com" term="Future Perfect" /><category scheme="https://www.vox.com" term="Health" /><category scheme="https://www.vox.com" term="Mental Health" /><category scheme="https://www.vox.com" term="Neuroscience" /><category scheme="https://www.vox.com" term="Psychology" /><category scheme="https://www.vox.com" term="Science" /><category scheme="https://www.vox.com" term="The Highlight" />
							<summary type="html"><![CDATA[There’s often a threshold for how weird something can sound beyond which most people stop taking it seriously. One of the quickest ways to kill a conversation, for example, is to start telling someone about that strange dream you had. Perhaps an even more surefire way to land on the far side of that threshold [&#8230;]]]></summary>
			
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<p class="has-text-align-none">There’s often a threshold for how weird something can sound beyond which most people stop taking it seriously. One of the quickest ways to kill a conversation, for example, is to start telling someone about that strange dream you had. Perhaps an even more surefire way to land on the far side of that threshold is to tell them about your trip on one of the most bizarre, powerful, and under-studied psychedelic drugs: DMT, or, if you speak chemistry, N,N-dimethyltryptamine.</p>

<p class="has-text-align-none">Tales of hyperdimensional worlds populated by various intelligent creatures —&nbsp;tiny <a href="https://realitysandwich.com/dmt-research-from-1956-to-the-edge-of-time/">machine elves</a> eager to teach you the universe’s secrets or <a href="https://www.iflscience.com/why-do-people-see-elves-and-other-entities-when-they-smoke-dmt-62234">giant praying mantises</a> that seem to harvest human emotions —&nbsp;are commonplace in DMT trip reports.&nbsp;</p>

<p class="has-text-align-none">Because these trips are so bizarre, even compared to other psychedelics, DMT has largely lived on the fringes of the <a href="https://www.vox.com/future-perfect/23721486/ketamine-dmt-lsd-psychedelics-magic-mushrooms-legalization-recreation-psilocybin">ongoing revival in psychedelic research</a> and therapy. Ketamine clinics are spawning left and right. MDMA therapy teeters <a href="https://www.vox.com/future-perfect/365820/mdma-therapy-lykos-therapeutics-maps-psychedelics-ecstasy">on the brink</a> of government approval. Legal psilocybin centers are set to open across multiple states. But DMT, once <a href="https://maps.org/srv/htdocs/wp-content/uploads/2007/11/01883lea.pdf">called</a> &#8220;the nuclear bomb of the psychedelic family” by Harvard psychologist and psychedelic hype-man Timothy Leary, has lagged pretty far behind in mainstream attention and scientific interest.</p>

<p class="has-text-align-none">That’s slowly starting to change. “We unashamedly think there’s value here, beyond the weird stuff,” neuroscientist <a href="https://profiles.imperial.ac.uk/c.timmermann-slater15">Chris Timmermann</a>, who leads the DMT Research Group at Imperial College London, told me. Like its more conventional psychedelic counterparts, DMT <a href="https://cybin.com/development-pipeline/">could play</a> a role in psychedelic therapy, offering a new treatment for conditions ranging from <a href="https://www.forbes.com/sites/benjaminadams/2022/08/17/small-pharmas-patented-injectable-dmt-formulation-could-help-battle-depression/?sh=77645ccd641a">depression</a> to <a href="https://www.mdpi.com/2076-3425/14/4/348">cluster headaches</a> — and it could even serve as a kind of <a href="https://newrepublic.com/article/169525/psychonauts-training-psychedelics-dmt-extended-state">rocket fuel</a> for the science of consciousness.&nbsp;</p>

<p class="has-text-align-none">The compound naturally occurs in a variety of mammals and plants. “DMT is everywhere,” wrote chemist Alexander Shulgin, who created nearly <a href="https://www.nytimes.com/2005/01/30/magazine/dr-ecstasy.html">200 psychedelics</a> through the late 20th century. Humans have been ingesting a slow-acting form of it for at least a few hundred, and perhaps <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6561276/">thousands</a> of years by boiling DMT-containing vines and leaves to make the psychoactive brew <a href="https://www.sup.org/books/anthropology/global-ayahuasca/excerpt/introduction-excerpt">ayahuasca</a>. But scientists didn’t figure out how to isolate, extract, and ingest pure DMT on its own <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6088236/">until 1956</a>, which branched the drug off from ayahuasca into its own history.</p>

<figure class="wp-block-pullquote"><blockquote><p>On high doses of DMT, the self does not disappear. Instead, the self feels largely intact, but transported to alternate worlds reconstructed out of the chaos.&nbsp;</p></blockquote></figure>

<p class="has-text-align-none">If Timothy Leary <a href="https://www.npr.org/2018/01/05/575392333/nixons-manhunt-for-the-high-priest-of-lsd-in-the-most-dangerous-man-in-america">was</a> the “high priest of LSD” in the 1960s, the eccentric philosopher <a href="https://www.nytimes.com/2000/04/09/us/terence-mckenna-53-dies-patron-of-psychedelic-drugs.html">Terrence McKenna</a> became DMT’s rhapsodic bard a generation later. “My entire expectation of the nature of the world was just being shredded in front of me,” McKenna <a href="https://chacruna.net/terence-mckenna-first-smoked-dmt/">recalled</a> of his first trip. “All this stuff was just so weird and so alien and so un-English-able that it was a complete shock — I mean, the literal turning inside out of my intellectual universe.”</p>
<img src="https://platform.vox.com/wp-content/uploads/sites/2/2024/10/GettyImages-1322408018.jpg?quality=90&#038;strip=all&#038;crop=0.071428571428569,0,99.857142857143,100" alt="Terrence McKenna sits in a stairwell looking at the camera." title="Terrence McKenna sits in a stairwell looking at the camera." data-has-syndication-rights="1" data-caption="Terrence McKenna. | San Francisco Chronicle/Getty Images" data-portal-copyright="San Francisco Chronicle/Getty Images" />
<p class="has-text-align-none">Like other psychedelics, DMT was pushed underground when President Richard Nixon outlawed it in 1970. Well before today’s psychedelic renaissance, it was <a href="https://pubmed.ncbi.nlm.nih.gov/1941365/">research</a> on DMT’s hallucinogenic <a href="https://jamanetwork.com/journals/jamapsychiatry/article-abstract/496497?casa_token=TMQ_XApNlkMAAAAA:uISolFyl-t7E-re-mNS7Bi0GCFbWyMBO58pWXyaNryWgIBeJ-Hha6LymsCOvrwNHeAjdJkJSww">effects</a> led by psychiatrist Rick Strassman in the early 1990s that marked the first return of legal psychedelic research.</p>

<p class="has-text-align-none">In the decades since, other psychedelics have claimed the spotlight, but in the last few years, DMT research has shown hints of a resurgence. The drug’s unique properties may make it both a more convenient therapy and a more powerful tool for studying the mind than its trippy counterparts: While psilocybin or LSD trips run for <a href="https://www.nature.com/articles/s41586-023-06204-3">several hours</a>, a DMT trip winds down after just <a href="https://www.nature.com/articles/s41598-024-53363-y">20 minutes</a>, and <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10411500/">unlike</a> with other psychedelics, users <a href="https://www.biologicalpsychiatryjournal.com/article/0006-3223(95)00200-6/abstract">don’t build up</a> a tolerance to DMT that diminishes its impact.</p>

<p class="has-text-align-none">DMT’s propensity to construct rich alternate realities in the minds of its users can also help push the study of consciousness into new terrain. The drug puts the mind’s ability to create immersive, convincing models of the world on full display — the very same thing our minds do <a href="https://www.vox.com/the-gray-area/376839/creativity-predictive-processing-chaos-mark-miller">during ordinary consciousness</a> (and dreams). And if DMT can simulate that process in a quick and controllable way, then studying the mechanics of DMT trips could help us learn more about the construction of our sober minds, too.&nbsp;</p>

<p class="has-text-align-none">Still, even with all the world’s research funding and best scientific minds, we may never be able to truly “explain” what happens under the influence of this peculiar molecule — but there’s certainly more to know than we do now. So to the woefully incomplete degree that’s currently possible, here’s the news on DMT as we know it today, in not-quite-all of its curious and under-studied glory.</p>

<h2 class="wp-block-heading has-text-align-none">When pure DMT hit the scene</h2>

<p class="has-text-align-none">Pure DMT was first synthesized in <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6088236/">1931</a> but was set aside, leaving its effects unknown. It wasn’t until 1956 that the first straight DMT hit was reported. Hungarian pharmacologist Stephen Szára had wanted to study LSD, but upon requesting some from the Swiss Sandoz Laboratories, which had been supplying to psychiatrists in the 1950s, he was denied. Communist governments scared them enough, but communists with acid? That was too risky.</p>

<p class="has-text-align-none">No matter, thought Szára. He pored over the existing psychedelic literature, found research identifying DMT as an active ingredient in longstanding psychedelic drinks of the Amazon, extracted it from the Mimosa hostilis plant, and became the first person to describe what happens when you take a hit.</p>
<img src="https://platform.vox.com/wp-content/uploads/sites/2/2024/10/GettyImages-1417906279.jpg?quality=90&#038;strip=all&#038;crop=0,0.0091877986034561,100,99.981624402793" alt="A black and white drawing of the DMT molecule" title="A black and white drawing of the DMT molecule" data-has-syndication-rights="1" data-caption="The DMT molecule, in all of its mundane molecular  glory | Lena Gadanski/Getty Images" data-portal-copyright="Lena Gadanski/Getty Images" />
<p class="has-text-align-none">From his Budapest laboratory, Szára <a href="https://realitysandwich.com/dmt-research-from-1956-to-the-edge-of-time/">reported</a> “brilliantly coloured oriental motifs and, later, wonderful scenes altering very rapidly.” Immediately after, he recruited volunteers from his hospital to try the strange drug. In these first DMT trials throughout the late 1950s, participants <a href="https://pubmed.ncbi.nlm.nih.gov/13554710/">reported</a> rooms “full of spirits” and “curious objects.”</p>

<figure class="wp-block-pullquote"><blockquote><p>“DMT is the most efficient reality-switching molecule currently known to exist”</p><cite>Andrew Gallimore</cite></blockquote></figure>

<p class="has-text-align-none">Rumors of the immensely powerful, conveniently short-lasting psychedelic began to spread through the 1960s counterculture (famously, they were pretty into mind-altering drugs). By 1962, word of DMT <a href="https://psychology.fas.harvard.edu/people/timothy-leary">reached Timothy Leary</a>, who was then researching psychedelics at Harvard. He ran experiments that applied his idea of carefully crafting the “<a href="https://journals.sagepub.com/doi/full/10.1177/2050324516683325#:~:text=The%20set%20and%20setting%20hypothesis,which%20the%20experience%20takes%20place)%20(">set and setting</a>” of a trip — focusing on how everything from a room’s lighting to one’s preexisting cultural ideals shape the psychedelic experience — to DMT. Though Leary’s experiments successfully nudged them toward increasingly positive experiences, DMT trips remained indelibly weird and never rose to the level of LSD among the counterculture’s preferred vehicles for exploring altered states of consciousness. When it was outlawed under the 1970 <a href="https://www.dea.gov/drug-information/csa">Controlled Substances Act</a>, the modest interest that remained was largely put on ice.</p>

<p class="has-text-align-none">The freeze lasted until the early 1990s, when Strassman managed to jump through the heap of <a href="https://pubmed.ncbi.nlm.nih.gov/1941365/">regulatory hoops</a> to carry out legal <a href="https://pubmed.ncbi.nlm.nih.gov/8297216/">DMT research</a> at the University of New Mexico, making DMT the origin of today’s revival in psychedelic science. He went on to publish a <a href="https://www.google.com/books/edition/DMT_The_Spirit_Molecule/J14oDwAAQBAJ?hl=en">book</a> in 2000 that dubbed DMT “the spirit molecule,” which was later adapted into one of the <a href="https://web.archive.org/web/20180724025758/https://variety.com/2018/film/news/dermot-mulroney-melora-walters-hard-luck-love-song-1202882056/">most-viewed</a> documentaries on Netflix, starring podcaster Joe Rogan.&nbsp;</p>

<p class="has-text-align-none">Still, DMT remained concentrated more on podcasts and internet forums than in the medical and therapeutic highways toward mainstream acceptance like MDMA and psilocybin. High-profile psychedelics research —&nbsp;like much of neuroscientist Roland Griffiths’s <a href="https://pubmed.ncbi.nlm.nih.gov/16826400/">work</a> at Johns Hopkins or studies funded by the Multidisciplinary Association for Psychedelic Studies (<a href="https://maps.org/">MAPS</a>) —&nbsp;has tended to focus on psilocybin or MDMA. By 2019, the world’s first <a href="https://www.imperial.ac.uk/news/190994/imperial-launches-worlds-first-centre-psychedelics/#:~:text=Funded%20by%20more%20than%20%C2%A3,into%20a%20licensed%20treatment%20for">dedicated academic center</a> for psychedelic science opened at Imperial College London, where Timmermann was finishing up his PhD on the neuroscience of DMT. After advising a few PhD students also working on DMT, he figured, “Let’s make this into a group and focus our energies into understanding [DMT] from a consciousness perspective,” launching the university’s DMT Research Group in 2022.</p>

<p class="has-text-align-none">Now, Timmermann said, “there’s definitely traction here. And the way to develop that is by doing good science.”&nbsp;&nbsp;&nbsp;&nbsp;</p>

<h2 class="wp-block-heading has-text-align-none">What it’s like to take DMT</h2>

<p class="has-text-align-none">Now, the fun stuff. Neurobiologist Andrew Gallimore, author of a <a href="https://www.amazon.com/Death-Astonishment-Confronting-Mystery-Strangest/dp/1250357756">forthcoming book</a> on the history and science of DMT, <em>Death by Astonishment</em>, has <a href="https://www.amazon.com/Reality-Switch-Technologies-Psychedelics-Exploration/dp/1739110102">called</a> it “the most efficient reality-switching molecule currently known to exist, almost instantaneously transporting the tripper from the Consensus Reality Space to a bizarre hyperdimensional omniverse teeming with superintelligent entities of every (un)imaginable form and character.”</p>

<p class="has-text-align-none">We’ll get to all that, but let’s move slowly.</p>

<p class="has-text-align-none">Recreationally, most people smoke DMT either from a pipe or, especially nowadays, a vape pen. The effects kick in within a few seconds, before you can even exhale the first hit. All psychedelic experiences are dose dependent — a gram and a half of dried mushrooms might as well be a different drug than 5 grams — and with DMT in particular, ascending doses lead not just to more intense experiences, but to different kinds altogether.</p>

<p class="has-text-align-none">There’s no agreed upon “map” of what <a href="https://yalebooks.yale.edu/book/9780300276091/psychonauts/">psychonauts</a> (self-experimenters who explore altered states of consciousness) call the “DMT space.” Different people slice it up in different ways, with varying <a href="https://x.com/FatherMcKennaa/status/1582107818848837634">degrees of detail</a>. Some taxonomies <a href="https://qri.org/blog/hyperbolic-geometry-dmt">have six levels</a>, with names like “The Magic Eye Level” and “The Waiting Room.” Others have mapped out <a href="https://smoothbrains.net/posts/2023-02-19-dmt-with-two-eyes-open-part-i.html">four-step ladders</a>. For brevity’s sake, I’m going to zoom out as much as possible and cram the weirdness of DMT trips into three simple categories: low, medium, and high doses.&nbsp;</p>

<p class="has-text-align-none">At low doses, the onset of DMT feels similar to other psychedelics. Colors grow more vivid, your body may tingle, the world appears a bit crisper, as though the contrast and saturation have been dialed up. A portentous, ambient sense of meaning begins to set in, what’s been called the “<a href="https://www.vox.com/future-perfect/23972716/psychedelics-meaning-science-psychedelic-mushrooms-ketamine-psilocybin-mysticism">noetic quality</a>” of psychedelic trips.</p>

<div class="wp-block-vox-media-highlight vox-media-highlight">
<h2 class="wp-block-heading">Read more about the mystery of psychedelics</h2>



<ul class="wp-block-list">
<li><a href="https://www.vox.com/future-perfect/355687/fda-mdma-therapy-maps-lykos-cult">The biggest unknown in psychedelic therapy is not the psychedelics</a></li>



<li><a href="https://www.vox.com/future-perfect/23972716/psychedelics-meaning-science-psychedelic-mushrooms-ketamine-psilocybin-mysticism">Why psychedelics produce some of the most meaningful experiences in people’s lives</a></li>



<li><a href="https://www.vox.com/future-perfect/2024/5/15/24156372/psychedelics-chronic-pain-cluster-headache-medicine-lsd-psilocybin">Psychedelics could treat some of the worst chronic pain in the world</a></li>
</ul>



<p class="has-text-align-none"><strong>Have questions, comments, or ideas?&nbsp;</strong>Email me: oshan.jarow@voxmedia.com.</p>
</div>

<p class="has-text-align-none">At medium doses, that vivid picture of the world begins to dissolve into classically psychedelic imagery: swirling geometric patterns, flashing colors and shapes, and a general deconstruction of ordinary perception into chaos. Your ordinary sense of self, too, while not obliterated or dissolved, will likely begin to lose its familiar anchors in space and time.</p>

<p class="has-text-align-none">Then there are high, or “breakthrough,” doses (around 20–30 milligrams and up), where the distinctly DMT-flavored weird stuff starts to happen. The incoherent imagery of a medium dose snaps into a new kind of coherence, reconstructing a very high-definition world, albeit one that looks entirely different from what we’re familiar with. When people talk about exploring <a href="https://newrepublic.com/article/169525/psychonauts-training-psychedelics-dmt-extended-state">other dimensions</a> on DMT, it’s this dose they’re talking about.</p>

<p class="has-text-align-none">“If the dose is sufficient … the user bursts through a kind of membrane into an entirely novel domain unlike anything within this universe,” as Gallimore <a href="https://www.amazon.com/gp/product/1739110102/">put it</a>. “The most striking feature of this ‘DMT space’ is its structure, often described as ‘hyperdimensional.’” In our normal states of consciousness, human perception tends to see space as flat, even though, ever since Einstein’s theory of relativity, we’ve known that mass bends space and time. <a href="https://qri.org/blog/hyperbolic-geometry-dmt">Some consciousness researchers</a> believe that on high doses of DMT, perception takes on this kind of <a href="https://www.discovermagazine.com/the-sciences/an-obscure-field-of-math-might-help-unlock-mysteries-of-human-perception">curvy geometry</a>. That could help explain why the experiences are so strikingly unusual, and why it’s so hard to describe them back in our sober minds.&nbsp;</p>

<p class="has-text-align-none">But since DMT trips only last a few minutes, people often feel that they’re pulled out of the oddly curved DMT worlds right as they begin to find their bearings, or, as we should probably now get into, before they can finish their conversations with the entities.</p>

<h2 class="wp-block-heading has-text-align-none">We do need to talk a bit about the DMT entities</h2>

<p class="has-text-align-none">One of the strangest things about these breakthrough doses are the entities. “I was neither intellectually nor emotionally prepared for the frequency with which contact with beings occurred in our studies, nor the often utterly bizarre nature of these experiences,” Strassman wrote of his DMT experiments in the ’90s.&nbsp;</p>

<p class="has-text-align-none">Not everyone meets entities on DMT, but it happens often enough that it seems like more than a random quirk. A 2022 <a href="https://www.nature.com/articles/s41598-022-11999-8">analysis</a> of 10 years worth of trip reports posted on the r/DMT subreddit, totalling 3,778 DMT experiences, 45.5 percent included “entity encounters,” including: deities, aliens, “creature-based entities” like reptilian and insect beings, mythological beings, “machine elves,” and “jesters.”&nbsp;</p>
<img src="https://platform.vox.com/wp-content/uploads/sites/2/2024/10/GettyImages-1468272759.gif?quality=90&#038;strip=all&#038;crop=0,0,100,100" alt="A moving image of a psychedelic face, colored purple and blue with psychedelic geometry and shapes." title="A moving image of a psychedelic face, colored purple and blue with psychedelic geometry and shapes." data-has-syndication-rights="1" data-caption="An artistic rendition of a DMT entity. | Spencer Whalen/Getty Images" data-portal-copyright="Spencer Whalen/Getty Images" />
<p class="has-text-align-none">While McKenna, who succeeded Leary as <a href="https://www.google.com/books/edition/The_Re_Enchantment_of_the_West_Vol_2/iIfdkgicKhIC?hl=en&amp;gbpv=1&amp;pg=PA113&amp;printsec=frontcover">the voice</a> of the psychedelic counterculture, is often credited with <a href="https://www.harpercollins.com/products/the-archaic-revival-terence-mckenna?variant=32117983543330">spreading the idea</a> and expectation of encountering “self-transforming machine elves” in DMT space, humans have been encountering other seemingly intelligent beings while under the influence of DMT since well before he <a href="https://chacruna.net/terence-mckenna-first-smoked-dmt/">had his first trip</a> in 1965. One of the hallmarks of ayahuasca is encountering other spirits and beings, so much so that ayahuasca is often personified as “<a href="https://www.facebook.com/watch/?v=358273108267284">Mother Aya</a>.”</p>

<p class="has-text-align-none">Even among the early pure DMT users in Szára’s experiments in the 1950s, people <a href="https://www.cambridge.org/core/journals/journal-of-mental-science/article/abs/dimethyltryptamine-experiments-with-psychotics/1AAE2E0411B8CE878FA80D9F67E9CB13">reported</a> seeing “strange creatures, dwarfs or something.” A young physician <a href="https://pubmed.ncbi.nlm.nih.gov/13554710/">recalled</a> that “The whole room is filled with spirits.” Another stated, “In front of me are two quiet, sunlit Gods … I think they are welcoming me into this new world.”</p>

<p class="has-text-align-none">A whole scientific <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0214377#sec008">literature</a> <a href="https://www.nature.com/articles/s41598-022-11999-8">is</a> <a href="https://journals.sagepub.com/doi/full/10.1177/0269881120916143">emerging</a> to document the different kinds of entities people meet in DMT spaces. (And outside of peer review, there’s <a href="https://go.gale.com/ps/i.do?id=GALE%7CA667306437&amp;sid=googleScholar&amp;v=2.1&amp;it=r&amp;linkaccess=abs&amp;issn=10639330&amp;p=AONE&amp;sw=w&amp;userGroupName=nysl_oweb&amp;isGeoAuthType=true&amp;aty=geo">a debate</a> over whether these entities and alternate dimensions are “real.” Gallimore, for example, has argued for conducting <a href="https://www.youtube.com/watch?v=ba5pAjM8HZM">diplomacy with the DMT entities</a>, since we can’t rule out their existence.)&nbsp;&nbsp;&nbsp;</p>

<p class="has-text-align-none">Either way, the full-on construction of novel worlds and beings gives scientists an opportunity to study the mind in the midst of one of its most dazzling abilities: creating worlds of experience. “You can track the brain as it’s dissolving the habitual model of the world and generating a novel one that has equal or even deeper feelings of immersion,&#8221; Timmerman told me.</p>

<h2 class="wp-block-heading has-text-align-none">What DMT could mean for the science of consciousness</h2>

<p class="has-text-align-none">DMT, along with the other classical psychedelics — psilocybin, LSD, and mescaline — share a primary mechanism of action, binding to the serotonin 2A receptor and <a href="https://www.pnas.org/doi/10.1073/pnas.2218949120">scrambling activity</a> across both the brain’s default-mode and salience networks (brain regions responsible for self-referential thinking and helping our brains choose what information is worth paying attention to). DMT also binds to the <a href="https://www.sciencedirect.com/science/article/pii/S0028390821001660?dgcid=raven_sd_recommender_email#">sigma-1 receptor</a>, which a team of Hungarian <a href="https://www.sciencedirect.com/science/article/pii/S0028390821001660?dgcid=raven_sd_recommender_email#!">researchers recently found</a> helps protect brain cells when they lack oxygen, as in a stroke. At least one neuroscientist thinks that <a href="https://doubleblindmag.com/no-dmt-entities-arent-real/">could help explain</a> the whole entities thing.</p>

<p class="has-text-align-none">Also like other classical psychedelics, DMT is neither physiologically addictive (though any drug carries <a href="https://journals.sagepub.com/doi/10.1177/0269881113513852">abuse potential</a>) nor <a href="https://pubmed.ncbi.nlm.nih.gov/23619992/">toxic</a> to the brain (per that sigma-1 research, it could actually be neuroprotective). Still, DMT experiences can be destabilizing. One of the main risks is sometimes called “<a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4817368">ontological shock</a>,” where someone’s worldview is undermined in a way that causes lasting distress. One <a href="https://journals.sagepub.com/doi/full/10.1177/0269881120916143">survey of 2,561 DMT users</a> found that more than half who identified as atheists before their DMT trips no longer identified as atheist afterward. There’s nothing wrong with abandoning atheism per se, but upending worldviews should always be handled with care, caution, and available support.</p>

<p class="has-text-align-none">That said, upending worldviews in reliable, controlled, and targeted ways could also help advance our understanding of how minds construct worldviews in the first place.&nbsp;</p>

<p class="has-text-align-none">So far, though, psychedelics <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8378075/">haven’t quite lived up</a> to their <a href="https://www.google.com/books/edition/LSD_Psychotherapy/DYU3AQAAIAAJ?hl=en&amp;gbpv=0&amp;bsq=microscope">promise</a> of revolutionizing the science of consciousness. “The big limitation on the use of psychedelics to understand the mind and brain concerns how difficult it is to isolate components of the psychedelic experience that we’re interested in,” said Timmermann. His hope is that short trips associated with DMT, which can be repeated in quick succession without diminishing in intensity, will prove more easily interpretable to scientists working in lab settings. For example, DMT research is already turning up a curious pattern that hasn’t emerged with other psychedelics.&nbsp;</p>

<p class="has-text-align-none">One of the major findings in psychedelic science has been that the entropy —&nbsp;or randomness, complexity, and disorder —&nbsp;of brain activity is a kind of signature of a trip’s intensity. Stronger trips are associated with higher levels of entropy in the brain, all the way to reports of “<a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC6007152/">ego dissolution</a>,” dubbed the “<a href="https://www.sciencedirect.com/science/article/abs/pii/S0028390818301175#:~:text=The%20entropic%20brain%20hypothesis%20proposes,informational%20richness%20of%20conscious%20states.">entropic brain” hypothesis</a> by neuroscientist <a href="https://www.vox.com/23896208/robin-carhart-harris-professor-neurology-psychedelics-ucsf-future-perfect-50-2023">Robin Carhart-Harris</a>. Most psychedelics push our minds from <a href="https://www.frontiersin.org/journals/human-neuroscience/articles/10.3389/fnhum.2014.00020/full">order to disorder</a>.&nbsp;</p>

<div class="wp-block-vox-media-highlight vox-media-highlight">
<h2 class="wp-block-heading">One surprising thing</h2>



<p class="has-text-align-none">A 2006 study found that two months after taking&nbsp;<a href="https://www.vox.com/future-perfect/2020/10/9/21506664/psychedelics-mental-health-depression-ptsd-psilocybin-mdma">psilocybin</a>, the active ingredient in magic mushrooms, two-thirds out of 30 volunteers rated their trip as one of the five most meaningful experiences of their lives.</p>



<p class="has-text-align-none">Read Vox’s reporting on <a href="https://www.vox.com/future-perfect/23972716/psychedelics-meaning-science-psychedelic-mushrooms-ketamine-psilocybin-mysticism">the science of how psychedelics crank up the dial of meaningful experiences here</a>.</p>
</div>

<p class="has-text-align-none">DMT fits this mold, up to a point. Low to medium doses show a reduction in the alpha frequency of brain waves (which <a href="https://www.sciencedirect.com/topics/neuroscience/alpha-wave">correspond</a> to relaxed and wakeful states), along with rising entropy, a <a href="https://www.nature.com/articles/s41598-019-51974-4">signature finding</a> of sober brains sinking deeper into a trip.</p>

<p class="has-text-align-none">But in high doses of DMT, that trend flips. The self does not disappear. Instead, the self feels largely intact, but transported to alternate worlds reconstructed out of the chaos. The rising entropy gives way to new neural signatures of order. “We’re starting to see the emergence of low-frequency brain waves in the breakthrough state, usually called delta or theta waves,” Timmermann said. “What’s intriguing about them is that these brain waves are very much present when people are asleep and dreaming. And there’s a resonance between dreams and the DMT state, the deconstruction of the assumptions about external waking life and the reconstruction of a novel world of experience.”</p>

<p class="has-text-align-none">These “contractions” in brain entropy, as Timmermann called them, tend to happen when his team asks tripping study participants to pay attention to a single, salient feature of their experience, like an entity. “Our perceptual systems are finding a way to make sense out of this chaos,” he said.&nbsp;&nbsp;&nbsp;&nbsp;</p>

<p class="has-text-align-none">Researchers hope that probing how DMT deconstructs and reconstructs our experiences of the world can make at least some progress on psychedelic science’s original promise of a major leap in our understanding of consciousness. “Our scientists are interested in how world-modeling actually comes about, and whether something like DMT can simulate that for us,” said Timmermann. That, in turn, can help us understand “how we generate a model of the world in our habitual, daily lives.”&nbsp;</p>

<p class="has-text-align-none">Next year, Timmermann’s research group is moving to University College London, where they’ll add DMT’s molecular relative, 5-MeO-DMT (bufo), to their research agenda, which, I kid you not, is considered <a href="https://www.youtube.com/watch?v=0RonFMPnZq8">even stronger</a> than DMT. If DMT can help scientists study how brains model worlds, bufo can show what happens when the brain stops modeling everything altogether and a bare form of consciousness without content remains.</p>

<p class="has-text-align-none">“5-MeO-DMT is like the modeler of no-worlds … it’s like a canvas without the paint on it. If we can have that experience, then you can look into the more fundamental, core workings of the mind and brain,” said Timmermann. Together, DMT and bufo could make for a hell of a one-two punch in the future of consciousness science.</p>

<h2 class="wp-block-heading has-text-align-none">What the heck is DMT doing in the human body?</h2>

<p class="has-text-align-none">Another mystery sets DMT apart from just about every other psychedelic: It’s <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC4149582/">naturally produced</a> by the human body, and no one knows why.&nbsp;&nbsp;</p>

<p class="has-text-align-none">Research <a href="https://www.nature.com/articles/s41598-019-45812-w">published in 2019</a> led by a team at the University of Michigan found that some parts of the mammalian brain can have similar levels of DMT as they do serotonin, a neurotransmitter that regulates a huge variety of important <a href="https://www.ncbi.nlm.nih.gov/books/NBK545168/">functions</a>, from behavior and mood to memory.</p>

<p class="has-text-align-none">When trace amounts of naturally occurring DMT were first <a href="https://www.nature.com/articles/2061052a0">found in humans</a> in 1965, scientists <a href="https://journals.sagepub.com/doi/10.1177/02698811221104054">speculated</a> that it may underlie mental illness, like schizophrenia. Further research found that DMT might actually mitigate symptoms of psychosis, which <a href="https://mcb.berkeley.edu/labs2/presti/sites/mcb.berkeley.edu.labs2.presti/files/u3/2005%20DMT%20Jacob%20Presti.pdf">tanked</a> that idea pretty quickly.</p>

<p class="has-text-align-none">Next, in 1976, it was <a href="https://pubmed.ncbi.nlm.nih.gov/4987/">proposed</a> that DMT might be a neurotransmitter, akin to serotonin and <a href="https://www.vox.com/future-perfect/24159087/what-is-dopamine-hacking-fasting-does-it-work-science">dopamine</a>, that has a functional role in the body. Serotonin is popularly associated with happiness, dopamine with motivation and pleasure — but what the heck would DMT be doing in the neurochemistry of our minds?</p>

<p class="has-text-align-none">A <a href="https://journals.sagepub.com/doi/10.1177/02698811221104054">2022 review</a> of the last 60 years of debate over DMT’s function concluded that DMT is likely doing <em>something</em> in the brain. But in the two years since, <a href="https://www.nature.com/articles/s41598-023-27538-y">new research</a> has turned up more questions than answers.&nbsp;</p>

<p class="has-text-align-none">It’s tempting to speculate. When Strassman called DMT “the spirit molecule,” he meant it rather literally: Its function in the brain, he argued, is simply to elicit psychological states that we call spiritual. Research <a href="https://www.nature.com/articles/s41598-019-45812-w#Abs1">published in 2019</a> showed that levels of DMT in rat brains spike during cardiac arrest, lending some substance to <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2018.01424/full">a link</a> between DMT and near-death experiences.&nbsp;</p>

<p class="has-text-align-none">But neuroscientist Jimo Borjigin, lead author of that study and <a href="https://dmtquest.org/dr-jimo-borjigin/">considered</a> one of the world’s leading experts on the puzzle of DMT in the human body, put it bluntly: “We know nothing — seriously! — about the role of endogenous DMT.”</p>

<h2 class="wp-block-heading has-text-align-none">Mainstreaming DMT</h2>

<p class="has-text-align-none">For all the far-out ridiculousness of DMT — the curvy geometry, the mischievous but <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0214377">generally benevolent</a> elves, the prospect of hidden dimensions — it could have remarkably practical applications. <a href="https://www.mdpi.com/2076-3425/14/4/348">Studies</a> are beginning to corroborate <a href="https://clusterbusters.org/forums/topic/1016-anyone-tried-dmt-for-ch/">anecdotes</a>, for example, that DMT could <a href="https://forum-bots.effectivealtruism.org/posts/4dppcsbcbHZxyBC56/treating-cluster-headaches-using-n-n-dmt-and-other-1">treat cluster headaches</a>, one of the most <a href="https://www.vox.com/future-perfect/2024/5/15/24156372/psychedelics-chronic-pain-cluster-headache-medicine-lsd-psilocybin">painful conditions</a> known to humankind.&nbsp;</p>

<p class="has-text-align-none">DMT could also offer a few advantages over the current generation of psychedelic therapy treatments that rely on MDMA or psilocybin. The big one is money: Psychedelic therapy is incredibly expensive. A few months of MDMA therapy recently tested in clinical trials cost about $<a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8880875/">11,537</a> per patient, nearly half of which came from paying two therapists to stay with each patient for a full eight hours during the MDMA sessions. DMT, since it winds down within 20 minutes, could make for much more affordable treatments. </p>

<p class="has-text-align-none">Gallimore and Strassman <a href="https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2016.00211/full">have proposed</a> the possibility of extending DMT trips via a steady IV drip, keeping levels of DMT in the body elevated and stable much like we do with anesthesia during surgery. Last year, researchers from Imperial College London kept 11 healthy volunteers in the DMT space for an extended period of 30 minutes, <a href="https://journals.sagepub.com/doi/10.1177/02698811231196877">demonstrating for the first time</a> that “extended DMT,” or DMTx, works and that the length and intensity of DMT therapy sessions could be customized to patient preferences.&nbsp;</p>

<p class="has-text-align-none">“When we speak about precision psychiatry and how to treat individuals according to their specific profiles and needs, a plastic and dynamic psychedelic experience could make things cheaper and more effective,” said Timmermann.</p>

<p class="has-text-align-none">DMT has already shown promising results <a href="https://www.nature.com/articles/s41598-024-53363-y">for depression</a>, and clinical trials are <a href="https://cybin.com/development-pipeline/">underway</a> —&nbsp;and patents <a href="https://www.forbes.com/sites/benjaminadams/2022/08/17/small-pharmas-patented-injectable-dmt-formulation-could-help-battle-depression/?sh=77645ccd641a">being filed</a> —&nbsp;for DMT as an injectable treatment.&nbsp;</p>

<p class="has-text-align-none">Extended DMT would be exciting news on the consciousness science front, too. The longer people can stay in the strange worlds of DMT space, the more access that gives scientists and psychonauts alike to one of the mind’s most fascinating tricks: constructing worlds of experience. And even though these worlds may be so alien that many of us might be tempted to write them off, there’s no explanation for our universe, no matter how sober, that isn’t unfathomably weird, as philosopher Eric Schwitzgebel writes in his book, <a href="https://press.princeton.edu/books/hardcover/9780691215679/the-weirdness-of-the-world?srsltid=AfmBOorISq2hUpj8zTCHSMmWIEAwQReC7pQ41HBk9Ka520s2tfq_EKjl"><em>The Weirdness of the World</em></a>. There’s only “a complex blossoming of bizarre possibilities,” where “something radically contrary to common sense must be true about the fundamental structures of the mind and the world.”</p>

<p class="has-text-align-none">Given how DMT seems to shred just about every bit of common sense, perhaps it’ll help turn up some answers.&nbsp;</p>

<p class="has-text-align-none">Whether that happens may depend on efforts to rein DMT in from the fringes of psychedelia. Given its ubiquity in nature, there’s plenty to go around. And given its presence in our bodies, we all stand to gain from a better understanding of what it’s doing there and why taking more of it leads to what remains perhaps the most bizarre kinds of experiences humans have yet encountered.&nbsp;</p>
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			<entry>
			
			<author>
				<name>Oshan Jarow</name>
			</author>
			
			<title type="html"><![CDATA[Your mind needs chaos]]></title>
			<link rel="alternate" type="text/html" href="https://www.vox.com/the-gray-area/376839/creativity-predictive-processing-chaos-mark-miller" />
			<id>https://www.vox.com/?p=376839</id>
			<updated>2024-10-10T15:58:12-04:00</updated>
			<published>2024-10-12T07:00:00-04:00</published>
			<category scheme="https://www.vox.com" term="Future Perfect" /><category scheme="https://www.vox.com" term="Health" /><category scheme="https://www.vox.com" term="Mental Health" /><category scheme="https://www.vox.com" term="Neuroscience" /><category scheme="https://www.vox.com" term="Podcasts" /><category scheme="https://www.vox.com" term="Science" /><category scheme="https://www.vox.com" term="The Gray Area" />
							<summary type="html"><![CDATA[When you think of what makes us human, would you say it’s our powers of prediction? I probably wouldn’t have, at least not until my conversation with Mark Miller, a philosopher of cognition and research fellow at both the University of Toronto and Monash University in Melbourne. He studies how new ideas about the mind [&#8230;]]]></summary>
			
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<p class="has-text-align-none">When you think of what makes us human, would you say it’s our powers of prediction?</p>

<p class="has-text-align-none">I probably wouldn’t have, at least not until my conversation with Mark Miller, a philosopher of cognition and research fellow at both the University of Toronto and Monash University in Melbourne. He studies how new ideas about the mind can provide insight into human well-being.</p>

<p class="has-text-align-none">Prediction is clearly useful: Being able to anticipate the future helps us strategize in the present.</p>

<p class="has-text-align-none">But too much predictive power is usually the stuff of dystopian sci-fi stories, where being creative and unpredictable are the hallmarks of humanity, while the power of prediction —&nbsp;like the trope of an all-knowing algorithm — is cast as the weapon of technology.&nbsp;</p>

<p class="has-text-align-none">And yet, one of the latest big theories in neuroscience says that humans are fundamentally creatures of prediction, and not only is creativity not at odds with that, but it actually goes hand in hand with improving our predictive power. Life itself, in this view, is one big process of creatively optimizing prediction as a survival strategy in a universe otherwise tending toward chaos.</p>

<p class="has-text-align-none">Miller’s work starts with this big idea known as <a href="https://www.newyorker.com/magazine/2018/04/02/the-mind-expanding-ideas-of-andy-clark">predictive processing</a>, which says that your experience of the world is like a dream — a simulated model constructed by your brain. We’re not observing the world through open windows in our skulls. Rather, in our brain’s pursuit to plan, survive, and achieve our goals, it has learned how to guess what the world is actually like based on incoming sensory data. Those predictions are always uncertain, at least to a degree, which is why the goal of predictive processing is often <a href="https://www.sciencedirect.com/topics/psychology/predictive-processing">described</a> as minimizing that uncertainty.</p>

<p class="has-text-align-none">But an optimal relationship with uncertainty calls for a balance. Through a predictive lens, Miller argues, uncertainty can help us snap out of harmful loops, like depression or addiction. And in general, it turns out that one of the best ways to become healthier, more adaptive creatures is to regularly expose ourselves to different kinds of uncertainty.</p>

<p class="has-text-align-none">Miller’s work goes on to use this idea to explain the value of everything from art and horror movies to meditation and psychedelics. In each case, we’re brought to “the edge of informational chaos,” where our predictive models begin to break down. Surprisingly, he sees creativity and optimizing our predictive powers as complementary forces that help sustain life itself.&nbsp;</p>

<p class="has-text-align-none">So I invited Miller as the next guest for <em>The Gray Area</em>’s series on creativity to discuss the paradox of how we humans survive thanks to prediction but need chaos in order to thrive.</p>

<p class="has-text-align-none">“All of life is this resistance to entropy,” Miller said. “As the universe expands and entropy is inevitable, life is that single force that’s defying that gradient.”&nbsp;</p>

<p class="has-text-align-none"><em>The following excerpt has been edited for length and clarity. Listen to the full </em>Gray Area<em> interview <a href="https://podcasts.apple.com/us/podcast/your-mind-needs-chaos/id1081584611?i=1000672316807">here</a>.</em></p>
<div class="megaphone-fm-embed"><a href="https://megaphone.link/VMP6945048568" target="_blank" rel="noopener noreferrer">View Link</a></div>
<h4 class="wp-block-heading has-text-align-none">Oshan Jarow</h4>

<p class="has-text-align-none">Right now, I&#8217;m looking out my window and I see a particular scene and, naively, it seems to me like the light is coming in from the outside, into my body, reaching my brain, and that&#8217;s what I&#8217;m seeing. What you&#8217;re telling me is actually what I&#8217;m seeing is the model being predicted by my brain. What happens, though, when the light actually does get passed through my body? Am I experiencing that at any point, or when do we switch from experiencing our predictions of the world to raw sensory data?</p>

<h4 class="wp-block-heading has-text-align-none">Mark Miller</h4>

<p class="has-text-align-none">Probably never. That&#8217;s just not what you&#8217;re built to do. And actually you don&#8217;t need access to it. What you need is the driving signal from the world to be making sure that the models that you&#8217;re generating are elegant, sophisticated, and tracking real-world dynamics.</p>

<h4 class="wp-block-heading has-text-align-none">Oshan Jarow</h4>

<p class="has-text-align-none">This does get dizzying the more you think about it. But this is a huge claim: that my experience of the world is not a direct experience of objective reality. It is my brain&#8217;s best guess of the world outside of my skull. How early-stage is predictive processing as a theory?</p>

<h4 class="wp-block-heading has-text-align-none">Mark Miller</h4>

<p class="has-text-align-none">Well, not that early. I don&#8217;t think it&#8217;s irresponsible to say that it&#8217;s the preeminent theory today in all sorts of communities, computational <a href="https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(23)00411-X/abstract">psychiatry</a>, computational psychology, <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/pcn.13138">neuroscience</a>. I mean, if it&#8217;s not the foremost theory, it&#8217;s adjacent. So I guess it&#8217;s a mix. It&#8217;s younger than the other, it is the new kid on the block in a way, but it&#8217;s a very popular new kid and very exciting.&nbsp;</p>

<h4 class="wp-block-heading has-text-align-none">Oshan Jarow</h4>

<p class="has-text-align-none">You wrote a paper about how this predictive framework can explain a lot about what makes us humans happy. So tell me about that. What is the predictive account of happiness?</p>

<h4 class="wp-block-heading has-text-align-none">Mark Miller&nbsp;</h4>

<p class="has-text-align-none">The human system starts predicting for one reason or another that the world is some way. And then the trouble looks like when that prediction becomes strong enough and divergent enough from the way things actually are. So we call it sticky — it has a sticky quality to it.&nbsp;</p>

<p class="has-text-align-none">Just think about depression. You&#8217;ve installed the belief for whatever reason that you just can&#8217;t fit with the world, that either it&#8217;s because you are not good enough or the world isn&#8217;t good enough. But for some reason you can&#8217;t resolve this difference between the way that you want the world to be and the way the world actually is, either because of something on your side or something on the world’s side. One thing that marks depression is that that belief persists even if the conditions were to change. Even if you were to change the situation entirely, there&#8217;s a sticky quality to these pathologies.</p>

<h4 class="wp-block-heading has-text-align-none">Oshan Jarow</h4>

<p class="has-text-align-none">So let me ask you then about swinging back to the positive dimension, happiness in particular. That&#8217;s a picture of depression and psychopathology and mental illness. So what does this predictive framework say about the feeling of happiness itself?</p>

<h4 class="wp-block-heading has-text-align-none">Mark Miller</h4>

<p class="has-text-align-none">Well, I&#8217;m going to say two things. There&#8217;s a difference between momentary subjective happiness and well-being, like having a good life.&nbsp;Just in case anybody doesn&#8217;t know what these are, the momentary subjective being well-being is like hedonic well-being. That&#8217;s just the feeling good stuff.</p>

<h4 class="wp-block-heading has-text-align-none">Oshan Jarow &nbsp;</h4>

<p class="has-text-align-none">Is that like pleasure?</p>

<h4 class="wp-block-heading has-text-align-none">Mark Miller</h4>

<p class="has-text-align-none">Exactly. Overall well-being doesn&#8217;t look like it&#8217;s exactly identical with that because to have a really rich, meaningful, good life may mean you&#8217;re in pain quite a lot. Momentary subjective well-being is a reflection, at least in part, of predicting better than expected. So we have this idea that valence is that good or bad feeling that comes as part of your embodied system telling you how it&#8217;s going. So when you feel good, that&#8217;s your body and nervous system and brain telling you, “I&#8217;ve got it. Whatever&#8217;s happening right now, I&#8217;m on top of it. I&#8217;m predicting it for us. I&#8217;m predicting it well. I&#8217;m managing uncertainty really well.” And when you feel bad, that&#8217;s an indicator: “I don&#8217;t understand something here.”</p>

<h4 class="wp-block-heading has-text-align-none">Oshan Jarow</h4>

<p class="has-text-align-none">How does creativity fit into this story?</p>

<h4 class="wp-block-heading has-text-align-none">Mark Miller&nbsp;</h4>

<p class="has-text-align-none">I think a starting point for thinking about creativity using this model is to start by maybe showing a puzzle. Why would a predictive system that looks like it&#8217;s trying to reduce uncertainty be attracted to situations and indeed make those situations where it&#8217;s bumping into uncertainty? Like why do we build roller coasters? Why do we go to horror movies?&nbsp;</p>

<p class="has-text-align-none">Part of the answer is that too much certainty is a problem for us, especially when that certainty drifts from real-world dynamics. So in order to protect our prediction engine, our brain and nervous system, from getting into what we&#8217;ve called the bad bootstrap, that is from getting very, very certain about something that&#8217;s wrong, it really behooves us to occasionally inject ourselves with enough uncertainty, with enough intellectual humility to be uncertain about your model enough that you can check to see whether or not you&#8217;ve been stuck in one of these bad bootstraps.&nbsp;</p>

<p class="has-text-align-none">If you&#8217;re with me to there, then we have a wonderful first-principles approach to thinking about the benefit of creativity and art, especially provocative art that calls you to rethink who you are. Because as far as we&#8217;ve seen, the research just keeps pointing in this direction, anything that gets you out of your ordinary mode of interacting with the world so that you can check to see how good it is or how poor it is, is gonna be a benefit for us. It&#8217;s gonna protect us from those bad siloed opportunities. I think art does that, right?&nbsp;</p>

<p class="has-text-align-none">You can go somewhere, see something grand, see something beautiful, see something ugly and horrible. If you let yourself be impressed by it, it can be an opportunity for you to be jostled out of your ordinary way of seeing the world, which would let the system check to see whether or not it&#8217;s running optimal models or not.</p>

<h4 class="wp-block-heading has-text-align-none">Oshan Jarow</h4>

<p class="has-text-align-none">So it sounds like you&#8217;re likening creativity to this injection of the right kind of uncertainty into our experience of the world. And in your <a href="https://royalsocietypublishing.org/doi/epdf/10.1098/rstb.2022.0425">paper on horror movies</a>, you used a term that I think captures a lot of this. It&#8217;s a thread that seems to run through everything so far: art, creativity, horror movies, even meditation and psychedelics. You wrote that the brain evolved to seek out the “edge of informational chaos” — a place where our predictive models begin to break down, and in those uncertain zones, we actually have much to learn.</p>

<p class="has-text-align-none">It sounds to me like this edge of chaos actually explains at least one perspective on why art, why creativity, why play, why all these things benefit us. Because that edge is a really healthy place to be. So I wanted to ask you about this framing of the edge of informational chaos and why that&#8217;s a place that our brains would want to go.</p>

<h4 class="wp-block-heading has-text-align-none">Mark Miller&nbsp;</h4>

<p class="has-text-align-none">Where are we gonna learn the most? If you are a learning system, and this is amazing, right from the lab, we see that animals and us, we get rewarded, not only when we get fed and watered and sexed, we get rewarded when we get better information. Isn&#8217;t that amazing to acknowledge?</p>

<p class="has-text-align-none">If you get better information, my system is treating it like I&#8217;ve been fed. That&#8217;s how important good information is for us. And in fact, in lots of situations, it&#8217;s more rewarding for us than the food itself because one bit of food is one thing. Information about how to get food over time, that could be much, much more important. So where do we learn the most?&nbsp;</p>

<p class="has-text-align-none">Well, we don&#8217;t learn where our predictive models are so refined that everything is just being done by rote. And we&#8217;re not learning the most way out in deep volatility, unexpected uncertainty environments. That&#8217;s like where not only do you not know what&#8217;s going on, but you don&#8217;t know how to get to knowing what&#8217;s going on. That&#8217;s why we sometimes have culture shock if we move somewhere else.</p>

<p class="has-text-align-none">So where do we learn the most? We learn at this Goldilocks zone, which is that healthy boundary between order and chaos, right at the edge where our predictive models necessarily break down. And the hope there is that in breaking down, new, better models are possible.</p>

<h4 class="wp-block-heading has-text-align-none">Oshan Jarow</h4>

<p class="has-text-align-none">We&#8217;ve talked about how art and creativity can bring us to that edge of chaos, but you&#8217;ve also said elsewhere that meditation can do a similar kind of thing. Which is confusing at first because meditation looks pretty different from watching a horror movie. In meditation, I&#8217;m sitting there very quietly, in what looks like the opposite of chaos. So how do you understand what meditation is doing in this predictive framework, and how does that relate to creativity and these beneficial kinds of uncertainty?</p>

<h4 class="wp-block-heading has-text-align-none">Mark Miller</h4>

<p class="has-text-align-none">This idea is common now, especially, in the West, that meditation might be more about relaxation, or maybe addressing stress. But that’s not the meat of the program. The center of that program is a deep, profound, and progressive investigation about the nature of who we are and how our own minds work. It’s a deep investigation about the way our emotional system is structured and the nature of our unconscious experience. What are we experiencing? Why are we experiencing it? What does that have to do with the world?</p>

<p class="has-text-align-none">And then we can adjust, progressively and skillfully, the shape of who and what we are so that we fit the world better, so that we are as close as possible to what’s real and true, so that we can be as serviceable as possible.</p>

<p class="has-text-align-none">Ultimately, you can do everything that we’ve been talking about, including all the stuff that psychedelics do for the predictive system, all the stuff that horror and violent video games do, you can do it all contemplatively, in a way that’s better for you.</p>

<h4 class="wp-block-heading has-text-align-none">Oshan Jarow</h4>

<p class="has-text-align-none">So you’re saying that one way to find that thread that puts meditation and horror movies in the same vein of practice is thinking about meditation and psychedelics as injecting uncertainty into our experience of the world. Is that the common currency there?</p>

<h4 class="wp-block-heading has-text-align-none">Mark Miller</h4>

<p class="has-text-align-none">You&#8217;ve got it. Absolutely.</p>

<h4 class="wp-block-heading has-text-align-none">Oshan Jarow</h4>

<p class="has-text-align-none">Let me ask you this. After this whole story we&#8217;ve unpacked, there&#8217;s still a tension that leaves me a little bit uncomfortable. It feels like we&#8217;re saying that creativity is just kind of an input or a means toward juicing the powers of prediction. And part of me pushes against that. It almost feels reductive, right? Is creativity really just this evolutionary strategy that makes us better predictive creatures? Does that make creativity feel less intrinsically valuable?</p>

<p class="has-text-align-none">Because when I think about creativity, at least in part it doesn&#8217;t just feel like a tool for survival that evolution has honed. Sometimes it feels like it’s that which makes life worth living, that it has intrinsic value of its own. Not as a tool for the predictive powers in my brain or the algorithms or whatever. So I&#8217;m curious if you feel this tension at all, and how you think about creativity being framed in the service of prediction.</p>

<h4 class="wp-block-heading has-text-align-none">Mark Miller</h4>

<p class="has-text-align-none">So two things. One, even though we are excited by this new framework, I don&#8217;t think we need to be afraid of it being overly reductionistic. I mean, in a way, it&#8217;s radically reductionistic. We&#8217;re saying that everything that&#8217;s happening in the brain can be written on a T-shirt, basically.&nbsp;</p>

<p class="has-text-align-none">But the way that it actually gets implemented in super complex, beautiful systems like us, it shouldn&#8217;t make us feel like all of the wonderful human endeavors are simply explainable in a sort of overly simplified way. I don&#8217;t have any worry like that. I think if it turned out that life was operating over a simple principle of optimization —&nbsp;that&#8217;s the most beautiful thing I&#8217;ve ever heard, first of all, that all of life is about optimization. All of life is this resistance to entropy. That&#8217;s just what it is to be alive, is just your optimal resistance to entropy. As the universe expands and entropy is inevitable, life is that single force that&#8217;s defying that gradient. That&#8217;s so beautiful.</p>

<p class="has-text-align-none">Two, when it comes to art, I want to even be careful to say that art is only about finding this critical edge. I think that&#8217;s one really interesting way of thinking about it. It&#8217;s one way that we&#8217;ve been thinking about it, if you consider movies and video games as forms of art also.</p>

<p class="has-text-align-none">Another central reason that this kind of system might benefit from artistic expression that we didn&#8217;t cover but that&#8217;s completely relevant for our discussion is that art creates this wonderful opportunity for endless uncertainty and uncertainty management. And not very many things do that.</p>

<p class="has-text-align-none">And as you progressively create dancing, painting, singing, whatever, the enthusiasm of that literally being in the spirit of that creative endeavor, is you managing uncertainty in a new and remarkable way that it&#8217;s never been done before in all of existence through all time. Nobody has ever encountered and resolved that uncertainty in particular. So it should be endlessly rewarding, fascinating.</p>

<p class="has-text-align-none">No wonder we find it so beautiful. It might be by its very nature the purest expression of uncertainty generation and management. That would make it intrinsically valuable for an uncertainty-minimizing system like us.</p>

<p class="has-text-align-none"><em><a href="https://podcasts.apple.com/us/podcast/your-mind-needs-chaos/id1081584611?i=1000672316807">Listen to the rest of the conversation</a> and be sure to follow</em><a href="https://www.vox.com/thegrayarea"> The Gray Area</a><em> on</em><a href="https://podcasts.apple.com/gb/podcast/the-gray-area-with-sean-illing/id1081584611"> <em>Apple Podcasts</em></a><em>,</em><a href="https://open.spotify.com/show/6NOJ6IkTb2GWMj1RpmtnxP"> <em>Spotify</em></a><em>,</em><a href="https://www.pandora.com/podcast/the-gray-area-with-sean-illing/PC:30793"> <em>Pandora</em></a><em>, or wherever you listen to podcasts.</em></p>
						]]>
									</content>
			
					</entry>
			<entry>
			
			<author>
				<name>Oshan Jarow</name>
			</author>
			
			<title type="html"><![CDATA[Nitrous, one of the oldest mind-altering drugs, is back]]></title>
			<link rel="alternate" type="text/html" href="https://www.vox.com/future-perfect/374109/nitrous-oxide-laughing-galaxy-gas-whippets-history" />
			<id>https://www.vox.com/?p=374109</id>
			<updated>2024-10-03T16:52:33-04:00</updated>
			<published>2024-10-03T07:30:00-04:00</published>
			<category scheme="https://www.vox.com" term="Future Perfect" /><category scheme="https://www.vox.com" term="Health" /><category scheme="https://www.vox.com" term="Mental Health" /><category scheme="https://www.vox.com" term="Psychology" /><category scheme="https://www.vox.com" term="The Future of the Mind" />
							<summary type="html"><![CDATA[The sweet, odorless gas technically called nitrous oxide has many names: laughing gas, galaxy gas, hippy crack, whippets, even “the atmosphere of heaven.” Nitrous itself has just as many common uses as it does names. Doctors use it as a mild anesthetic, sending patients off into brief and largely pain-free dissociative euphorias before having a [&#8230;]]]></summary>
			
							<content type="html">
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<figure>

<img alt="An old-fashioned illustration of English tourists dancing after taking laughing gas at a Paris dentist, 1820. " data-caption="English tourists dancing after taking laughing gas at a Paris dentist, 1820." data-portal-copyright="" data-has-syndication-rights="1" src="https://platform.vox.com/wp-content/uploads/sites/2/2024/09/GettyImages-1751846893.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" />
	<figcaption>
	English tourists dancing after taking laughing gas at a Paris dentist, 1820.	</figcaption>
</figure>
<p class="has-text-align-none">The sweet, odorless gas technically called nitrous oxide has many names: laughing gas, galaxy gas, hippy crack, whippets, even “<a href="https://mikejay.net/books/the-atmosphere-of-heaven/">the atmosphere of heaven</a>.”</p>

<p class="has-text-align-none">Nitrous itself has just as many common uses as it does names. Doctors use it as a mild anesthetic, sending patients off into brief and largely pain-free dissociative euphorias before having a tooth pulled or dislocated finger yanked straight. Inhaling nitrous gives a loopy, giddy sort of high that can last up to <a href="https://pubmed.ncbi.nlm.nih.gov/8081181/">five minutes</a>. As a pressurized gas, nitrous also powers <a href="https://www.dawnaerospace.com/latest-news/transitioning-space-propulsion-to-a-nitrous-based-industry-standard">rockets</a>, race cars, and whipped cream dispensers.  </p>

<p class="has-text-align-none">The gas is both legal and widely available. It comes in small pressurized canisters intended for kitchen use; large tanks for heavier applications, like medicine or car engines; or even as the gas that shoots out of whipped cream canisters when there’s no cream left (hence: “whippets”).&nbsp;</p>

<p class="has-text-align-none">Thanks to being both accessible and cheap, nitrous has been used as a recreational drug for decades, from <a href="https://www.youtube.com/watch?v=5bI2fFpz1lE">Grateful Dead</a> concerts in the ’60s to <a href="https://www.latimes.com/archives/la-xpm-1992-03-07-mn-3542-story.html">raves</a> in the ’90s. Lockdowns during the Covid pandemic seem to have set off <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9201030/">a new wave</a> of recreational nitrous use. Today, “People on Nitrous Gas” has its own TikTok <a href="https://www.tiktok.com/discover/people-on-nitrous-gas">discovery tab</a>, with videos racking up millions of views. Celebrities are putting the risks of abuse on display, from <a href="https://www.yahoo.com/entertainment/kanye-west-loses-lawyer-shocking-112257343.html?guccounter=1&amp;guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&amp;guce_referrer_sig=AQAAAEg-ZUh8CHlFfz_YckfzG8OS2nzrn2qK_9bFWwymxF_jU05V5UOcawWGpNziJfFHPbqkRBDV26ukNE9h2xYCdICLCLtuWnKldyYliusXLhO1Zde9IEraNeTcK4Zg99-IlZVKtdVeqMaTFLsytZntSuSGo0LmCSv-6_SuKgwvggA4">Kanye West</a> and <a href="https://www.bet.com/article/y6qcns/sza-shares-concerns-over-nitrous-oxide-galaxy-gas-tik-tok-vertical-celebs">SZA</a>, to <a href="https://www.the-independent.com/arts-entertainment/comedy/features/steve-o-interview-jackass-tour-live-bucket-list-b2367273.html">Steve-O</a> of the stunt show <em>Jackass </em>fame. The <a href="https://www.vulture.com/article/secret-lives-of-mormon-wives-real-housewives-of-salt-lake-city-comparison.html">Mormon mothers</a> and social media influencers of “<a href="https://www.tiktok.com/tag/momtok?lang=en">MomTok</a>,” whose faith <a href="https://www.churchofjesuschrist.org/study/new-era/2007/08/not-even-once?lang=eng">shuns</a> any drug use, recently <a href="https://people.com/secret-lives-of-mormon-wives-laughing-gas-and-botox-derm-answers-our-questions-8711616">said</a> that part of the draw of all the Botox they’ve gotten is getting the nitrous first. “It’s a party,” one said.</p>

<p class="has-text-align-none">Inhaling nitrous is considered relatively safe for people who don’t use it often and don’t take too much. But there are definitely <a href="https://pubmed.ncbi.nlm.nih.gov/26496821/">risks</a>, and more so in recreational contexts. As recreational use rises, particularly <a href="https://files.eric.ed.gov/fulltext/ED611736.pdf">among teenagers</a>, those risks are gaining more attention.&nbsp;</p>

<p class="has-text-align-none">The primary one is vitamin B12 deficiency. Nitrous <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7366039/">inactivates B12</a> in the body, which coupled with long-term use can lead to <a href="https://medicine.yale.edu/news-article/nitrous-oxide-effects-are-reversible-with-early-treatment/#:~:text=When%20recreationally%20inhaled%2C%20nitrous%20oxide,the%20brain%20and%20spinal%20cord.">nerve damage</a> across the brain and <a href="https://casereports.bmj.com/content/16/11/e254727">spine</a>. Without intervention, that can develop into paralysis or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8379581/">brain damage</a>. There’s <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/add.16426">currently</a> no <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/add.16419#:~:text=Unlike%20other%20addictive%20substances%2C%20nitrous,best%20%5B5%2C%206%5D.">consensus</a> as to whether nitrous <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/add.16430">should</a> be labeled an addictive substance. While it doesn’t seem to build the same physical dependency as opioids, it does still carry the risk of habit formation in some cases.</p>

<p class="has-text-align-none">And while nitrous <a href="https://cdn.who.int/media/docs/default-source/46th-ecdd/nitrous-oxide_46th-ecdd_critical-review_public-version.pdf?sfvrsn=f6dcf08d_1">doesn’t have</a> a known fatal dose, deaths from use have been known to <a href="https://pubmed.ncbi.nlm.nih.gov/1506823/">occur</a>, usually from accidents that can happen while high on nitrous or from asphyxiation. Across the UK, where statistics on nitrous are more detailed, there were just 56 deaths <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/deathsrelatedtovolatilesubstancesheliumandnitrogeninenglandandwales/2001to2020registrations">attributed</a> to nitrous between 2001 and 2020, including both recreational and medical settings. (To put that in some perspective, there were nearly <a href="https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/alcoholspecificdeathsintheuk/2021registrations#:~:text=There%20were%209%2C641%20deaths%20related,14.0%20deaths%20per%20100%2C000%20people.">10,000</a> deaths in the UK attributed to alcohol in 2021 alone.)</p>

<p class="has-text-align-none">But while the rise in using recreational nitrous for its brief highs is prompting new concerns, the drug is actually one of the oldest stories in the Western history of mind-altering substance use.&nbsp;</p>

<p class="has-text-align-none">Through the centuries of up-and-down nitrous use across the US and UK, you find a rich, at times hilarious, trail left by this so-called atmosphere of heaven. Theaters across the US in the early 1800s filled with members of the public, watching volunteers inhale nitrous on stage and provide a delirious form of entertainment for the crowds. Traveling caravans brought nitrous shows on the road. Poets celebrated a new form of pleasure, while <a href="https://www.theatlantic.com/magazine/archive/1996/05/the-nitrous-oxide-philosopher/376581/">philosophers tried nitrous</a> in Harvard laboratories, frantically scribbling down rushes of insight.&nbsp;</p>
<img src="https://platform.vox.com/wp-content/uploads/sites/2/2024/09/2_11557a.jpg?quality=90&#038;strip=all&#038;crop=7.8125,0,84.375,100" alt="Wooden engraving of a man prancing around after inhaling nitrous oxide in 1840." title="Wooden engraving of a man prancing around after inhaling nitrous oxide in 1840." data-has-syndication-rights="1" data-caption="An 1840 engraving of a man dancing after inhaling nitrous oxide. | Wellcome Collection" data-portal-copyright="Wellcome Collection" />
<p class="has-text-align-none">The history of nitrous use is a history of shifting cultural attitudes about the mind. More specifically, about the value —&nbsp;or rejection —&nbsp;of chemically altered states of <a href="https://blog.apaonline.org/2024/09/20/are-psychedelic-experiences-intrinsically-valuable/">consciousness</a>. Today, as the gradual <a href="https://www.vox.com/future-perfect/23721486/ketamine-dmt-lsd-psychedelics-magic-mushrooms-legalization-recreation-psilocybin">return of legal access to psychedelics</a> is sparking renewed conversation around the potential benefits, <a href="https://www.vox.com/future-perfect/23954347/psychedelics-bad-trips-ketamine-mdma-psilocybin-lsd-risks">and harms</a>, of mind-altering drugs, seeing the many different iterations of nitrous use across history can help us think more expansively about what, if anything, the strange experiences of nitrous mean and what the future of recreational nitrous might look like.</p>

<h2 class="wp-block-heading has-text-align-none">“A new pleasure for which language has no name”</h2>

<p class="has-text-align-none">In late 18th-century industrial Britain, the air <a href="https://www.tandfonline.com/doi/pdf/10.1080/00022470.1978.10470577#:~:text=Over%20the%20period%201660%2D1800,other%20time%20in%20their%20history.">was foul</a>. Coal smoke and the odor of feces were abundant. Respiratory diseases were rampant, like <a href="https://www.vox.com/future-perfect/24128530/tuberculosis-vaccine-efficacy-solutions-tb-bcg">tuberculosis</a>, which had come to be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5432783/">known</a> as “the robber of youth.”&nbsp;</p>

<p class="has-text-align-none">The deadly air inspired the founding of the Pneumatic Institution in 1799, a medical facility in Bristol intended to study whether gasses could be used as medicines, too. It was there that the first experiments with nitrous began in earnest.</p>

<p class="has-text-align-none">The chemist Joseph Priestley <a href="https://pubmed.ncbi.nlm.nih.gov/30829177/#:~:text=Background%3A%20Joseph%20Priestley%27s%20discovery%20of,N2O)%20was%20recorded%20in%201772.">discovered</a> nitrous oxide in 1772, but dismissed it as toxic. Humphry Davy, a young lab assistant at the Pneumatic Institution, had a hunch that Priestley’s discovery had been confused with a chemically similar but highly irritating compound: nitric oxide.&nbsp;</p>

<p class="has-text-align-none">In April, Davy repeated Priestley’s experiment, and wrote to a friend afterward that he had “made a discovery which proves how necessary it is to repeat experiments,” prefiguring the role of <a href="https://www.vox.com/future-perfect/21504366/science-replication-crisis-peer-review-statistics">replication in science</a> today. Nitrous oxide, when purely synthesized, was perfectly breathable. Davy then set out to breathe as much as he possibly could.</p>

<p class="has-text-align-none">He sealed himself inside a box that was designed to boost the inhalation of gasses. He sat for over an hour while a steady flow of nitrous oxide filled the chamber. When he stepped out, he grabbed a giant silk air-bag full of more nitrous and huffed that too, just for good measure. Then, his mind peeled away from his body, and he “lost touch with all external things,” entering a strange, revelatory world of flashing insights.&nbsp;</p>

<p class="has-text-align-none">That summer, Davy invited dozens of curious writers, physicians, and philosophers to visit the Pneumatic Institute in the late evenings after normal operations had ceased. They all huffed nitrous, experimenting with entirely new regions of the mind.</p>

<p class="has-text-align-none">According to historian Mike Jay, author of <a href="https://yalebooks.yale.edu/book/9780300276091/psychonauts/"><em>Psychonauts: Drugs and the Making of the Modern Mind</em></a>, nitrous gave Western scientists one of the first chemical means of reliably accessing mystical states of consciousness. Against the banality of our ordinary experience, nitrous delivered a shocking contrast, a state of mind full of unfamiliar pleasures that often carried <a href="https://www.vox.com/future-perfect/23972716/psychedelics-meaning-science-psychedelic-mushrooms-ketamine-psilocybin-mysticism">a sense of insight into the nature of the cosmos</a>. The poet Robert Southey, after his first hit of nitrous, <a href="https://publicdomainreview.org/essay/o-excellent-air-bag-humphry-davy-and-nitrous-oxide/">wrote</a> to his brother that “Davy has actually invented a new pleasure for which language has no name.”</p>
<img src="https://platform.vox.com/wp-content/uploads/sites/2/2024/09/Gas-living-room-color-1.jpg?quality=90&#038;strip=all&#038;crop=3.5227272727273,0,92.954545454545,100" alt="A colored etching of poets in a living room, one reclining on a sofa, passing around a balloon of nitrous oxide." title="A colored etching of poets in a living room, one reclining on a sofa, passing around a balloon of nitrous oxide." data-has-syndication-rights="1" data-caption="Colored etching by Robert Seymour of his evening with a group of poets composing verses while on nitrous oxide in 1829. | Wellcome Collection" data-portal-copyright="Wellcome Collection" />
<p class="has-text-align-none">Within a year, however, most who had come to try nitrous lost interest. Its pleasures were new and exciting, but rarely stuck with users once they returned to sobriety after a few minutes. Others who tried the gas just ended up with an upset stomach and the giggles. Davy, who would go on to become president of <a href="https://royalsociety.org/">the Royal Society</a>, stayed with his experiments, eventually producing <a href="https://archive.org/details/researcheschemic00davy/page/n9/mode/2up">a hefty book</a> on the chemistry and philosophy of nitrous.</p>

<p class="has-text-align-none">He predicted that since nitrous temporarily extinguished pain, it could be useful during surgeries. No form of anesthesia existed yet, so surgeries were very painful, and very dangerous. But the idea failed to gain momentum. Instead, nitrous became something else: entertainment.</p>

<h2 class="wp-block-heading has-text-align-none">How nitrous became entertainment, and then medicine</h2>

<p class="has-text-align-none">Though the early enthusiasm for nitrous fizzled, it was easy enough to produce that, as word got out, chemists learned they could make it in their home laboratories. This turned nitrous into something of a <a href="https://www.abc.net.au/news/2019-02-20/laughing-gas-parties-discovery-of-anaesthesia/10811060">party fixture</a>.&nbsp;&nbsp;&nbsp;</p>

<p class="has-text-align-none">“Maybe it will become the custom for us to inhale laughing gas at the end of a dinner party, instead of drinking champagne,” a young German chemist speculated in 1826, after participating in a garden party where guests enjoyed nitrous under the afternoon sun.&nbsp;</p>

<p class="has-text-align-none">Public nitrous shows began <a href="https://books.google.ie/books?id=djPCfSAsHN0C&amp;pg=PA113&amp;lpg=PA113&amp;dq=%22inhaled+the+gas+and+stormed+around+the+lecture+hall%22&amp;source=bl&amp;ots=Ry2S783wwc&amp;sig=ACfU3U1-wSj-2qhXweEMYRPD8hxyuYRpAA&amp;hl=en&amp;sa=X&amp;ved=2ahUKEwiCha-Ln7v-AhXyRkEAHZBCAEUQ6AF6BAgJEAM#v=onepage&amp;q=%22inhaled%20the%20gas%20and%20stormed%20around%20the%20lecture%20hall%22&amp;f=false">taking place</a> as early as an 1814 lecture series in Philadelphia. First, a doctor gave a discourse on the effects of nitrous to the assembled crowd. Then, a series of young men volunteered to inhale balloons of nitrous onstage, putting on a raucous spectacle.</p>

<p class="has-text-align-none">While Davy and his friends had been interested in the mental side of what being on nitrous felt like, these public shows put a spotlight on the uninhibited bodies that the chemical set loose. After inhaling the gas, volunteers would clumsily dance, fight, sing, or even strike up the occasional fencing match. Sometimes, the first row of a theater was <a href="https://www.google.ie/books/edition/The_Wondrous_Story_of_Anesthesia/H--3BAAAQBAJ?hl=en&amp;gbpv=1&amp;dq=horace+wells+knees&amp;pg=PA19&amp;printsec=frontcover">kept empty</a> to protect onlookers from the mayhem.</p>

<p class="has-text-align-none">“On stage, the subjective experience was incidental,” writes Jay. “The moment of return to waking consciousness was not interrogated for mystical revelation, but held up for confused hilarity.”&nbsp;</p>

<p class="has-text-align-none">Soon, nitrous shows were taken on the road, carried by traveling carnivals to new, hooting crowds each night. Volunteers were charged around 25 cents per huff, bringing in good profit for those who’d invested in the necessary gas tanks, tubes, and breathing bags. One traveling nitrous show, put on by Samuel Colt (who would go on to invent the pioneering Colt firearm), dosed roughly 20,000 volunteers from Canada to Maryland.&nbsp;</p>

<p class="has-text-align-none">It was during a show in 1844 that the American dentist Horace Wells <a href="https://www.google.ie/books/edition/The_Wondrous_Story_of_Anesthesia/H--3BAAAQBAJ?hl=en&amp;gbpv=1&amp;dq=horace+wells+knees&amp;pg=PA19&amp;printsec=frontcover">witnessed</a> a teenager on nitrous slam into a wooden bench. The boy, Wells noticed, felt no pain, which led him to wonder whether he could give the gas to clients to numb the pain of having a tooth pulled.</p>

<p class="has-text-align-none">Wells first tried on himself, inhaling nitrous and having another dentist pull his own wisdom tooth. It was a great success: Wells felt no pain, and proclaimed “a new era in tooth pulling.” He successfully performed the procedure on a few of his patients, before convincing a surgeon at the prestigious Massachusetts General Hospital to let Wells administer the gas during an operation, doubling as <a href="https://www.google.ie/books/edition/Blessed_Days_of_Anaesthesia/9gYTDAAAQBAJ?hl=en&amp;gbpv=1&amp;dq=horace+wells+%22denounced+as+an+imposition%22&amp;pg=PA21&amp;printsec=frontcover">a demonstration</a> for a strictly medical audience.</p>

<p class="has-text-align-none">It didn’t go well. Nervous in front of a scrupulous crowd, Wells pulled away the nitrous balloon a little <a href="https://www.google.ie/books/edition/Blessed_Days_of_Anaesthesia/9gYTDAAAQBAJ?hl=en&amp;gbpv=1&amp;dq=horace+wells+%22denounced+as+an+imposition%22&amp;pg=PA21&amp;printsec=frontcover">too quickly</a>. During the operation, the patient appeared to groan in pain (though it was later deemed an involuntary and unconscious response). Onlookers nevertheless booed Wells out of the theater, and the embarrassment pushed him into a depression that culminated in suicide.</p>

<p class="has-text-align-none">But the demonstration inspired Wells’s former partner to try a similar procedure, only with a different substance: a solvent called <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4920664/">ether</a>.&nbsp;</p>

<p class="has-text-align-none">After a few successful experiments using ether as an anesthetic, another demonstration was arranged in the same theater where Wells’s had failed. This time, ether was successfully administered as a pain-vanquishing anesthetic, prompting one of the most significant medical breakthroughs of the century, as well as a revisitation of Wells’s work with nitrous.</p>

<p class="has-text-align-none">The hospital theater was renamed “<a href="https://www.massgeneral.org/museum/exhibits/ether-dome">The Ether Dome</a>,” while anesthetic use of both ether and nitrous began to spread across the country.</p>

<h2 class="wp-block-heading has-text-align-none">The next 150 years of nitrous</h2>

<p class="has-text-align-none">The rise of anesthetics like nitrous in medicine was accompanied by a decline in their use&nbsp;as recreational drugs.&nbsp;</p>

<p class="has-text-align-none">Physicians began to think of nitrous-induced revelations as gibberish, closer to delirium than real insight. Too much interest in their short-lived pleasures, doctors <a href="https://www.academia.edu/2221699/Anesthetics_and_the_Chemical_Sublime">began to write</a>, could pose a public health risk.</p>

<p class="has-text-align-none">Recreational anesthetics like nitrous would “delight the animal sensations, while they destroy the moral sentiments; they introduce their victims to a fool’s paradise; they mock them with joys which end in sorrows.” Jay describes the mid-1800s arc of nitrous as a “shift away from subjectivity,” prefiguring the same trajectory across a variety of disciplines, <a href="https://journals.sagepub.com/doi/abs/10.1177/0952695119874009">including psychology</a>.</p>

<p class="has-text-align-none">Through the middle of the 19th century, nitrous settled into dentistry while falling out of philosophy, with at least one major exception that ultimately proved the rule: the eccentric American philosopher Benjamin Blood.&nbsp;</p>

<p class="has-text-align-none">In 1860, during what he expected to be a very normal visit to the dentist, he awoke from a routine dose of nitrous with the vague sense that he’d glimpsed the essence of all philosophy, the “secret or problem of the world,” as <a href="https://ia801307.us.archive.org/18/items/cu31924029019003/cu31924029019003.pdf">he later wrote</a>.&nbsp;</p>

<p class="has-text-align-none">Blood asked dentists and doctors why their gas had given him a spiritual epiphany. He <a href="https://ia801307.us.archive.org/18/items/cu31924029019003/cu31924029019003.pdf">learned</a> two things. First, that “nearly every hospital and dentist office has its reminiscences of patients who, after a brief anesthesia, uttered confused fragments of some inarticulate import which always had to do with the mystery of life.” Across the country, patients returning from anesthesia had been asking their doctors something to the effect of, “What does it all mean, or amount to?”&nbsp;</p>

<p class="has-text-align-none">Second, the doctors and the dentists couldn’t care less. Blood received smiles and shrugs, but no explanations. So he spent 14 years reviving the tradition of nitrous self-experimentation, eventually publishing <a href="https://archive.org/details/anstheticrevela00bloogoog/page/n9/mode/2up">a pamphlet</a>: <em>The Anaesthetic Revelation and the Gist of Philosophy.</em></p>

<p class="has-text-align-none">It didn’t get particularly famous, but it did catch the attention of Harvard philosopher William James. Inspired by Blood’s curious writings, James followed Humphry Davy’s old protocol, heating a beaker of ammonium nitrate in the Harvard chemistry laboratory, capturing the escaping gas, and inhaling deeply with pen and paper in hand. His subsequent <a href="https://www.cs.cmu.edu/~ehn/release/nitrous.html">experience</a> of “intense metaphysical illumination” informed the rest of his life’s work, where he would go on to become <a href="https://link.springer.com/referenceworkentry/10.1007/978-0-387-79061-9_1552#:~:text=William%20James%20is%20known%20as,and%20studied%20the%20human%20mind.">known</a>, today, as the father of American psychology.&nbsp;</p>

<p class="has-text-align-none">Meanwhile, innovations in the delivery mechanisms for laughing gas were starting to ramp up its use in dentistry. George Poe, cousin of the poet Edgar Allen Poe, figured out how to <a href="https://www.theguardian.com/society/article/2024/jul/04/revolution-in-the-air-how-laughing-gas-changed-the-world">manufacture nitrous</a> in liquid form. This allowed for packaging and distributing it in easy-to-use canisters. By 1883, he was supplying <a href="https://www.npr.org/2007/01/13/6830090/dr-poe-and-his-curious-breathing-machine">5,000 dentists</a> with canned nitrous oxide across the country.&nbsp;&nbsp;&nbsp;</p>

<p class="has-text-align-none">Once nitrous came in a convenient package, people began finding all sorts of new uses for it. In 1914, American rocketeer Robert Goddard filed <a href="https://patents.google.com/patent/US1103503">a patent</a> suggesting it could work as a rocket propellant, where it’s <a href="https://www.dawnaerospace.com/latest-news/prevalence-of-nitrous-based-in-space-propellants">still used</a> today.&nbsp;</p>
<img src="https://platform.vox.com/wp-content/uploads/sites/2/2024/09/GettyImages-583937001.jpg?quality=90&#038;strip=all&#038;crop=0,7.7547404711741,100,84.490519057652" alt="Clubgoers at Studio 54 in New York enjoy a tank of nitrous oxide on the dance floor in 1977." title="Clubgoers at Studio 54 in New York enjoy a tank of nitrous oxide on the dance floor in 1977." data-has-syndication-rights="1" data-caption="Clubgoers at Studio 54 in New York enjoy a tank of nitrous oxide on the dance floor in 1977. | Allan Tannenbaum/Getty Images" data-portal-copyright="Allan Tannenbaum/Getty Images" />
<p class="has-text-align-none">But the innovation that brought nitrous back into style as a contemporary recreational drug was a little more mundane: whipped cream canisters. It turned out that dispensing cream out of a nitrous gas cylinder delivers the perfectly fluffy whipped cream we can so easily buy in grocery stores today.</p>

<p class="has-text-align-none">These whipped cream canisters are also where the name “whippets” comes from, and how we’ve landed in the awkward situation of <a href="https://files.eric.ed.gov/fulltext/ED611736.pdf">rising nitrous use</a> among teenagers.</p>

<h2 class="wp-block-heading has-text-align-none">Nitrous, today and tomorrow</h2>

<p class="has-text-align-none">In the neighboring arena of psychedelic drugs, many advocates are <a href="https://www.vox.com/future-perfect/360200/how-to-buy-psychedelics-lsd-shrooms-stores">pushing for wider accessibility</a> to these mind-altering substances. With nitrous, that accessibility is already here, and now, attracting strong criticism.</p>

<p class="has-text-align-none">The UK recently reinstated <a href="https://www.bbc.com/news/health-67346032">a shade of prohibition</a>, making possession of nitrous oxide for “unlawful use” illegal. You can still use it to dispense whipped cream and other culinary delights, but if you’re just interested in a giggly high, or even seeing whether it might reveal, as Blood thought, the world’s philosophical secret, that’s unlawful. But prohibition inevitably pushes drug use underground, where it’s guaranteed to be riskier and less well-informed than legal, regulated, and educated use.</p>

<p class="has-text-align-none">And with a substance like nitrous that has relatively few risks <a href="https://www.euda.europa.eu/spotlights/spotlight-recreational-use-nitrous-oxide-laughing-gas_en">when used responsibly and occasionally</a>, there’s an opportunity to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9517250/">work on promoting</a> more responsible <a href="https://www.them.us/story/everything-you-need-to-know-about-whippets-and-how-to-stay-safe">forms of use</a> through public education (such as awareness that the gas impairs the body’s ability to take in oxygen, so doing whippets in a tight, closed space is probably not as safe as in a backyard).&nbsp;</p>

<p class="has-text-align-none">Since nitrous-related substance abuse is such a small problem relative to opioids and alcohol, it hasn’t received all that much study. The past few years of data, however, have prompted <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/add.16380">a new conversation</a> around whether nitrous <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/add.16430">should be</a> considered addictive. It <a href="https://gladstonesclinic.com/blog/addiction-news/hippy-crack-nitrous-oxide-addiction/">doesn’t</a> seem to form a physical dependence, like opioids, and has no physical symptoms of withdrawal. But it does seem capable of forming a more psychological form of dependence (dissociative pleasure basically on tap does obviously pose some habit-forming risk), prompting <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/add.16426">concerns</a> around how exactly to label it.</p>

<p class="has-text-align-none">Either way, ensuring support and harm reduction is available to those who need it may prove to be a challenge. But if we can’t figure out how to handle recreational use with nitrous, it’s difficult to imagine how we’d do it in a world where LSD and psilocybin mushrooms <a href="https://www.vox.com/future-perfect/360200/how-to-buy-psychedelics-lsd-shrooms-stores">become widely available</a>, too.&nbsp;</p>
<img src="https://platform.vox.com/wp-content/uploads/sites/2/2024/09/GettyImages-1276667241.jpg?quality=90&#038;strip=all&#038;crop=0,0.014810426540279,100,99.970379146919" alt="Discarded canisters of nitrous oxide on a road." title="Discarded canisters of nitrous oxide on a road." data-has-syndication-rights="1" data-caption="Discarded canisters of nitrous oxide. | Adam Webb/Getty Images" data-portal-copyright="Adam Webb/Getty Images" />
<p class="has-text-align-none">More broadly, though, set against the long history of different approaches and interpretations of nitrous, our current situation isn’t all that new. Today’s social media spectacles of nitrous use are just digitized versions of the same nitrous shows from the 1800s. Back then, some people <a href="https://books.google.ie/books?id=djPCfSAsHN0C&amp;pg=PA113&amp;lpg=PA113&amp;dq=%22inhaled+the+gas+and+stormed+around+the+lecture+hall%22&amp;source=bl&amp;ots=Ry2S783wwc&amp;sig=ACfU3U1-wSj-2qhXweEMYRPD8hxyuYRpAA&amp;hl=en&amp;sa=X&amp;ved=2ahUKEwiCha-Ln7v-AhXyRkEAHZBCAEUQ6AF6BAgJEAM#v=onepage&amp;q=%22inhaled%20the%20gas%20and%20stormed%20around%20the%20lecture%20hall%22&amp;f=false">believed</a> that wild behaviors while on nitrous revealed “the volatility of the democratic masses.” What might it say about our own cultural moment that recreational nitrous use is returning as a sort of performative delirium?&nbsp;</p>

<p class="has-text-align-none">As far as the philosophy of nitrous goes, I imagine curious experimenters today are working with different substances, like <a href="https://newrepublic.com/article/169525/psychonauts-training-psychedelics-dmt-extended-state">extended DMT</a>. Maybe someone like Benjamin Blood will come along and make the case that we still have much to learn from nitrous. Maybe dentists will begin to read up on metaphysics and begin engaging with their woozy patients rather than dismissing their experiences.&nbsp;</p>

<p class="has-text-align-none">Or, maybe nothing much will happen with nitrous. The social media hype will die down as <a href="https://www.technologyreview.com/2023/02/15/1067904/ai-automation-drug-development/">new drugs</a> take its place, and it will sink back into relative obscurity, propelling rockets and numbing minor surgeries, inspiring the occasional dorm-room conversation about God and the nature of pleasure. At the very least, as its long history shows, nitrous will always remain capable of giving us a great story.</p>
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				<name>Oshan Jarow</name>
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			<title type="html"><![CDATA[How zapping the brain can supercharge meditation]]></title>
			<link rel="alternate" type="text/html" href="https://www.vox.com/future-perfect/375119/meditation-benefits-science-mindfulness-brain-stimulation" />
			<id>https://www.vox.com/?p=375119</id>
			<updated>2024-10-01T17:14:52-04:00</updated>
			<published>2024-10-02T08:30:00-04:00</published>
			<category scheme="https://www.vox.com" term="Emerging Tech" /><category scheme="https://www.vox.com" term="Future Perfect" /><category scheme="https://www.vox.com" term="Health" /><category scheme="https://www.vox.com" term="Innovation" /><category scheme="https://www.vox.com" term="Psychology" /><category scheme="https://www.vox.com" term="Technology" /><category scheme="https://www.vox.com" term="The Future of the Mind" />
							<summary type="html"><![CDATA[Life is not just a deluge of bad news. Every day, all sorts of wonderful things are happening. People fall in love. New vaccines are getting closer to saving the roughly 500,000 children who die from malaria each year. And for those of us interested in the science of meditation, which promises a deeper understanding [&#8230;]]]></summary>
			
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<p class="has-text-align-none">Life is not just a deluge of bad news. Every day, all sorts of <a href="https://www.vox.com/future-perfect/2023/12/28/24003198/10-good-things-that-happened-in-2023">wonderful things are happening</a>. People fall in love. <a href="https://www.vox.com/future-perfect/22307700/malaria-rna-vaccines-covid-19">New vaccines</a> are getting closer to saving the roughly <a href="https://ourworldindata.org/malaria-introduction#:~:text=Only%20a%20small%20fraction%20of,children%20on%20any%20average%20day.">500,000 children</a> who die from malaria each year. And for those of us interested in the science of meditation, which promises a deeper understanding of human psychology and the upper bounds of subjective well-being, the field is entering an incredibly exciting new era.</p>

<p class="has-text-align-none">Research from the early 1990s helped establish the therapeutic potential of mindfulness, while more recent years have seen the investigation of the actual mechanisms that connect meditation to various health benefits. Now, as <a href="https://www.vox.com/future-perfect/23836358/meditation-mindfulness-enlightenment-science-contemplative-buddhism-spirituality">I’ve previously written</a>, meditation science is going even further, exploring much larger questions that can go well beyond the simple promises of mindfulness-based stress relief.&nbsp;</p>

<p class="has-text-align-none">According to neuroscientist <a href="https://mbb.harvard.edu/people/matthew-sacchet">Matthew Sacchet</a> — who runs a bridge project between Harvard Medical School and Massachusetts General Hospital called the <a href="https://meditation.mgh.harvard.edu/">Meditation Research Program</a>&nbsp;— today’s new wave of research is characterized by probing the mechanisms that underlie <a href="https://www.scientificamerican.com/article/advanced-meditation-alters-consciousness-and-our-basic-sense-of-self/">advanced meditation</a>.&nbsp;</p>

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<h2 class="wp-block-heading">This story was first featured in the&nbsp;<a href="https://www.vox.com/pages/future-perfect-newsletter-signup">Future Perfect newsletter</a>.</h2>



<p class="has-text-align-none">Sign up&nbsp;<a href="https://www.vox.com/pages/future-perfect-newsletter-signup">here</a>&nbsp;to explore the big, complicated problems the world faces and the most efficient ways to solve them. Sent twice a week.</p>
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<p class="has-text-align-none">This includes a variety of techniques that don’t so much relax the mind as <a href="https://onlinelibrary.wiley.com/doi/10.1002/wps.21214">transform it</a>. Advanced practices lead to “states and stages of meditation that unfold with time and mastery,” but can uncover insights that are relevant for consciousness in general, Sacchet told me.&nbsp;</p>

<p class="has-text-align-none">And this isn’t just for Buddhist monks. In addition to shedding light on one of humanity’s most stubbornly puzzling mysteries, deeper insights into the workings of consciousness could help us think more expansively about mental health, and how to cultivate it.</p>

<p class="has-text-align-none">The expanding field is leading cognitive scientists to study a dizzying array of strangely powerful meditative states, from absorptions into rapturous beams of pleasure <a href="https://www.vox.com/future-perfect/354069/what-if-you-could-have-a-panic-attack-but-for-joy">like the jhānas</a> to temporarily switching consciousness off through a self-induced kind of drug-free general anesthesia known as “<a href="https://link.springer.com/article/10.1007/s10548-024-01052-4">cessation</a>.”&nbsp;</p>

<p class="has-text-align-none">But the field still suffers from heavy reliance on data that shows a wealth of correlations, while falling short of demonstrating real causation. Neuroimaging studies that use tools like EEG and fMRI scan a meditator’s brain at a single point in time and give us associations between meditation and the brain’s structure or function.&nbsp;&nbsp;</p>

<p class="has-text-align-none">So far, though, they can’t actually tell us what meditation really does to the brain, or the changes it causes. Maybe people who are drawn to meditation are predisposed to certain patterns of brain activity, and our heap of correlations tells us more about those willing to meditate than anything actually caused by meditation.</p>

<p class="has-text-align-none">Sacchet explained that the neuroscience of meditation has been almost entirely informed by studies that are stuck on the correlation question. That’s why he’s so excited about a new strategy: the possibility of combining meditation research with non-invasive brain stimulation, or “neuromodulation” techniques, which use electrical currents and magnetic fields to fiddle with brain activity in ways that can help isolate the changes that meditation actually causes.</p>

<p class="has-text-align-none">In late August, Sacchet <a href="https://www.sciencedirect.com/science/article/pii/S0149763424003312#:~:text=The%20inclusion%20of%20neuromodulation%20might,changes%20linked%20to%20the%20intervention.">co-authored a review</a> that looked across all the recent research combining neuromodulation with meditation, trying to organize the field and get a sense of where things stand. It’s still early days, but initial signs are promising, and next steps are emerging.&nbsp;</p>

<h2 class="wp-block-heading">The science of electrically zapping and magnetically pulsing meditating brains</h2>

<p class="has-text-align-none">In the land of non-invasive brain stimulation, there are two giants: <a href="https://www.mcleanhospital.org/video/what-transcranial-magnetic-stimulation-tms-and-how-does-it-work">transcranial magnetic stimulation</a> (TMS), and <a href="https://www.med.upenn.edu/brainstimcenter/transcranial-electric-stimulation-tes.html#:~:text=Transcranial%20electric%20stimulation%20(TES)%20is,limited%20to%20tDCS%20and%20tACS.">transcranial electrical stimulation</a> (tES).&nbsp;</p>

<p class="has-text-align-none">During TMS, a power source pulses electrical currents through loops of copper wire, creating a magnetic field along the coil.&nbsp;</p>

<p class="has-text-align-none">Hold the coil right above someone’s head, and the field passes through the scalp like a ghost phasing through a wall. The process either increases or decreases targeted brain activity depending on where you’re aiming the coil, how frequently electrical pulses are being delivered, and the field’s intensity. TMS has been in use for years in the treatment of psychiatric disorders like severe depression.</p>

<p class="has-text-align-none">Meanwhile, tES is a family of techniques that alter brain activity by sending weak electrical currents through electrodes placed on the scalp.</p>

<p class="has-text-align-none">There’s a lot of research on neuromodulation techniques in general, with TMS dating back to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4815479/#:~:text=The%20current%20use%20of%20electromagnetic,the%20human%20brain%20in%201985.">1985</a>, and tES <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7058222/">before</a> that. There’s less that looks directly at their combination with meditation. And there’s even fewer studies that focus only on healthy participants, which was an inclusion criteria for Sacchet’s review.</p>

<p class="has-text-align-none">That’s worth dwelling on for a second. Much of the existing research on both meditation and neuromodulation positions them as potential treatments for recognized illnesses, like depression. But a deeper understanding of how advanced meditation and neuromodulation affect well-being could have implications for everyone, not just people currently categorized as mentally ill.&nbsp;</p>

<p class="has-text-align-none">Overall, only six studies met all the criteria for inclusion in Sacchet’s review. Across them, neuromodulation was generally found to enhance outcomes when compared with control groups. Combining tES and mindfulness meditation, for example, <a href="https://linkinghub.elsevier.com/retrieve/pii/S2405844017325677">improved working memory</a>.&nbsp;</p>

<p class="has-text-align-none">In <a href="https://www.nature.com/articles/s41598-021-02177-3">another study</a>, a single round of tES paired with mindfully walking on a treadmill temporarily reduced anxiety. Another <a href="https://www.sciencedirect.com/science/article/pii/S1697260022000515?via%3Dihub">TMS study of 32 participants</a> found that engaging in “self-compassion” practices&nbsp;while receiving TMS pulses to the <a href="https://www.sciencedirect.com/topics/psychology/dorsolateral-prefrontal-cortex">dorsolateral prefrontal cortex</a> increased self-compassion compared to controls doing the practice without TMS.</p>

<p class="has-text-align-none">Obviously, six studies don’t make a field. But the early experiments are proving a positive safety profile, and more general insights and hypotheses are beginning to emerge.</p>

<p class="has-text-align-none">Why is it that pulsing magnetic fields or zapping particular brain networks seems to amplify meditation’s effects? One idea offered in the review is the <a href="https://www.sciencedirect.com/science/article/abs/pii/S0149763409000591?via%3Dihub">neural efficiency hypothesis</a>. If two brains both solve the same puzzle, but one shows less activity in the process, that brain could be considered more efficient, solving the same task with less energy expended. And more efficiency could support higher intelligence. </p>

<p class="has-text-align-none">In the case of brain stimulation plus meditation, it’s like running a marathon while benefiting from a tailwind. Being pushed along in the direction you’re already heading can help you progress faster while expending less energy.&nbsp;</p>

<h2 class="wp-block-heading">The next generation of modulated meditation research</h2>

<p class="has-text-align-none">Both fields —&nbsp;neuromodulation and meditation science —&nbsp;are still growing rapidly. As each develops new insights, they can inform new ways of more effectively combining the fields.</p>

<p class="has-text-align-none">For example, <a href="https://www.pnas.org/doi/full/10.1073/pnas.1112029108">a</a> <a href="https://link.springer.com/article/10.3758/s13415-015-0358-3">growing</a> <a href="https://www.nature.com/articles/s41598-018-28274-4">heap</a> of studies is establishing that a collection of brain regions known as the default-mode network (DMN) is critical to meditative experiences (<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10032309/">psychedelic ones, too</a>). The DMN is associated with self-referential thinking —&nbsp;autobiographical memories, <a href="https://www.cell.com/trends/cognitive-sciences/abstract/S1364-6613(16)30075-4?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1364661316300754%3Fshowall%3Dtrue">mind wandering</a>, or daydreaming about yourself. Given all the <a href="https://tricycle.org/magazine/anatta-buddhism/">Buddhist talk</a> of the self as some sort of illusion, you might not be surprised to learn that meditation is often linked to a <a href="https://www.sciencedirect.com/science/article/pii/S0149763424003312#:~:text=The%20inclusion%20of%20neuromodulation%20might,changes%20linked%20to%20the%20intervention.">reduction</a> of activity in parts of the DMN. The mind becomes less self-centric.</p>

<p class="has-text-align-none">But neuromodulation research has yet to really take up the study of what happens when you use external means to help along the quieting of the DMN during meditation, creating a very conspicuous next step for the field.</p>

<p class="has-text-align-none">That research is already underway. Meditation teacher Shinzen Young and neuroscientist Jay Sanguinetti work together at the University of Arizona’s <a href="https://consciousness.arizona.edu/sema-lab">Sonication Enhanced Mindful Awareness (SEMA) lab</a>. Not only are they <a href="https://www.youtube.com/watch?v=spukj-4sYS0">cooking up studies</a> there that target the DMN of meditators, they’re also working on a new generation of neuromodulation technology —&nbsp;transcranial focused ultrasound, or tFUS.</p>

<p class="has-text-align-none">Instead of magnetic fields or electrical currents, tFUS uses very high-frequency sound waves, which offer a roughly tenfold increase over TMS and tES in their precision for targeting specific areas in the brain. In <a href="https://www.frontiersin.org/journals/human-neuroscience/articles/10.3389/fnhum.2024.1392199/full">a pilot study published earlier this year</a>, a group of researchers including Sanguinetti and Young showed they could successfully reduce activity in the DMN by shooting tFUS at one of its major hubs, the posterior cingulate cortex. Though participants weren’t meditating during the process, they did report increases in mindfulness and modest reductions in their sense of self. </p>

<p class="has-text-align-none">Now, they’re <a href="https://crowdfund.arizona.edu/project/42862?_gl=1*1b0438y*_gcl_au*MTU4NTYzMTkzNi4xNzIzNDIyNDMw*_ga*MTUyNzQ2MDM5OS4xNzIzNDIyNDMw*_ga_7PV3540XS3*MTcyNzczNTA1NS44LjEuMTcyNzczNTQzNS4wLjAuMzUwOTY2NTQ5">crowdfunding</a> for what would be the first experiment to combine tFUS with a meditation retreat.</p>

<p class="has-text-align-none">If ultrasound continues on its present trajectory, it’s going to make a really exciting addition to the neuromodulation arsenal. In addition to using these techniques to amplify meditation’s effects, neuroscientists will benefit from a greater ability to carry out what are known as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4528817/#:~:text=Perturbation%20is%20a%20key%20part,best%20understood%20in%20the%20brain.">perturbational</a> procedures. That means basically being able to safely, non-invasively turn activity in specific parts of the brain up and down, just to see what happens. </p>

<p class="has-text-align-none">To date, neuroimaging studies have helped build correlations between meditation practices and changes to the brain’s structure and function. More targeted neuromodulation studies, however, will help to actually decipher causality.</p>

<p class="has-text-align-none">“This field has a lot of promise,” said Sacchet, but there’s “a lot of work to be done to do it right.”</p>
						]]>
									</content>
			
					</entry>
			<entry>
			
			<author>
				<name>Oshan Jarow</name>
			</author>
			
			<title type="html"><![CDATA[Do the benefits of the expanded child tax credit actually fade with time?]]></title>
			<link rel="alternate" type="text/html" href="https://www.vox.com/future-perfect/371858/child-tax-credit-poverty-economics-future-benefits" />
			<id>https://www.vox.com/?p=371858</id>
			<updated>2024-09-16T10:13:35-04:00</updated>
			<published>2024-09-17T08:00:00-04:00</published>
			<category scheme="https://www.vox.com" term="Economy" /><category scheme="https://www.vox.com" term="Future Perfect" /><category scheme="https://www.vox.com" term="Money" /><category scheme="https://www.vox.com" term="Policy" /><category scheme="https://www.vox.com" term="Poverty" />
							<summary type="html"><![CDATA[In 2021, the US cut child poverty by as much as 40 percent using one of the most effective anti-poverty tools the country had ever devised: the expanded child tax credit (CTC). By sending unconditional monthly checks of up to $300 per child to the nation’s poorest families —&#160;including those with little to no income [&#8230;]]]></summary>
			
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<figure>

<img alt="A group of people stand outside a red brick building with green roofs and white stone trim, holding black-and-white signs in two rows that read “Make the child tax credit permanent.”" data-caption="New Hampshire parents and other child tax credit supporters gather toand demand the credit be made permanent on September 14, 2021, in Manchester, New Hampshire. | Scott Eisen/Getty Images for ParentsTogether" data-portal-copyright="Scott Eisen/Getty Images for ParentsTogether" data-has-syndication-rights="1" src="https://platform.vox.com/wp-content/uploads/sites/2/2024/09/gettyimages-1235261204.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" />
	<figcaption>
	New Hampshire parents and other child tax credit supporters gather toand demand the credit be made permanent on September 14, 2021, in Manchester, New Hampshire. | Scott Eisen/Getty Images for ParentsTogether	</figcaption>
</figure>
<p class="has-text-align-none">In 2021, the US cut child poverty by as much as <a href="https://www.cbpp.org/research/federal-tax/recovery-package-should-permanently-include-families-with-low-incomes-in-full">40</a> percent using one of the <a href="https://www.vox.com/future-perfect/2023/9/21/23882353/child-poverty-expanded-child-tax-credit-census-welfare-inflation-economy-data">most effective</a> anti-poverty tools the country had ever devised: the expanded child tax credit (CTC).</p>

<p class="has-text-align-none">By sending unconditional monthly checks of up to $300 per child to the nation’s poorest families —&nbsp;including those with little to no income who had <a href="https://www.vox.com/future-perfect/23965898/child-poverty-expanded-child-tax-credit-economy-welfare-phase-ins">typically been excluded</a> from such programs — the “child allowance” <a href="https://www.census.gov/content/dam/Census/library/working-papers/2022/demo/sehsd-wp2022-24.pdf">lifted 2.1 million</a> children out of poverty who would’ve otherwise been left behind.<br><br>Arguments against such programs that give unconditional cash usually assert that it’ll drive low-income people to quit their jobs, ultimately harming the economy. But research found <a href="https://www.nber.org/papers/w29823">little to no drop</a> in employment rates as a result of the expanded CTC. Yet despite a <a href="https://static1.squarespace.com/static/5ecd75a3c406d1318b20454d/t/6148f183c62fb147d0d25138/1632170373799/Economist+CTC+Letter+9-14-21+430pm.pdf">flurry of support</a> from prominent economists and <a href="https://www.filesforprogress.org/memos/MEMO-FCF-CTC.pdf">recipients</a> alike, politicians failed to reach an agreement to make the temporary expansion permanent, and <a href="https://www.vox.com/future-perfect/2022/4/18/23026908/child-tax-credit-joe-manchin-policy-feedback-partisan">Congress let it expire</a> at the end of 2021.</p>

<p class="has-text-align-none">Some concerns that sank the program’s political chances, like Sen. Joe Manchin’s <a href="https://abcnews.go.com/Politics/sen-joe-manchin-suggests-child-tax-credit-payments/story?id=81865740">worry</a> that recipients will spend the cash on drugs, don’t hold up to the <a href="https://documents1.worldbank.org/curated/en/617631468001808739/pdf/WPS6886.pdf">abundant</a> <a href="https://www.cbpp.org/blog/9-in-10-families-with-low-incomes-are-using-child-tax-credits-to-pay-for-necessities-education#:~:text=Poverty%20and%20Inequality-,9%20in%2010%20Families%20With%20Low%20Incomes%20Are%20Using%20Child,to%20Pay%20for%20Necessities%2C%20Education&amp;text=Some%2091%20percent%20of%20families,%2C%20and%20utilities%20%E2%80%94%20or%20education.">evidence</a>. But there are still some economists who remain skeptical, unmoved by the steady stream of positive research on short-term programs —&nbsp;which they <a href="https://www.nytimes.com/2022/12/20/opinion/child-tax-credit-basic-income.html">concede</a> looks very good. Their concern, however, is with the distant future.</p>

<p class="has-text-align-none">“My main problem with a permanent CTC,” said University of Chicago economist <a href="https://harris.uchicago.edu/directory/bruce-d-meyer">Bruce Meyer</a> via email, “is that it would reverse the work-based welfare reforms of the ’90s that dramatically increased employment and were associated with a decline in the share of kids growing up in single-parent families.”</p>

<p class="has-text-align-none">The thinking goes like this: As parents receive strings-free cash, many of their incomes will indeed be pushed above the poverty line. At first. But some will also choose to work less, others will divorce more, and fraying the twin threads of marriage and work in low-income communities will ultimately harm children’s prospects for upward mobility. The initial anti-poverty benefits would, generations down the line, be swallowed up by <a href="https://www.aei.org/op-eds/unintended-consequences-democrats-child-tax-credit-will-cost-jobs/">unintended consequences</a>.&nbsp;</p>

<p class="has-text-align-none">By concentrating their concerns on the far future, they render much of the <a href="https://guaranteedincome.us/">growing base</a> of short-term <a href="https://www.nber.org/papers/w24337">research</a> moot, especially in terms of convincing holdout politicians, like Manchin, whose <a href="https://www.axios.com/2021/10/17/scoop-manchins-red-lines">insistence</a> on adding work requirements to any expanded CTC is what killed the child allowance.</p>

<p class="has-text-align-none">Enter a <a href="https://www.nber.org/papers/w32870">new working paper</a> from <a href="https://economics.barnard.edu/profiles/elizabeth-ananat">Elizabeth Ananat</a> and <a href="https://cprc.columbia.edu/directory/irwin-garfinkel">Irwin Garfinkel</a>, two economists at Columbia University. Expanding on work they first <a href="https://www.cambridge.org/core/journals/journal-of-benefit-cost-analysis/article/benefits-and-costs-of-a-child-allowance/665380DF301F990D8FDB06A7BB3D5BD9">published in 2022</a>, their research surveys long-run cash and quasi-cash transfer programs (like food stamps) in the US in an effort to predict the overall effects of a child allowance over the very long run. Instead of the grim and jobless future forecast by expanded CTC critics, they find that a future shaped by a permanent child allowance is well worth the investment.</p>

<p class="has-text-align-none">Ananat and Garfinkel found that the total long-run benefits to society of making a child allowance permanent outweigh the costs by nearly 10 to 1. While the paper may not sway skeptical economists, the dramatic returns could still help build political momentum to pass the policy. And it at least shows that researchers are now taking the long-run concerns raised by critics seriously.</p>

<h2 class="wp-block-heading has-text-align-none"><strong>What a return on investment of 10 to 1 for an expanded CTC actually means</strong></h2>

<p class="has-text-align-none">Ananat and Garfinkel’s original cost-benefit calculations did not make for light reading. Although the paper was well-received by her colleagues, the problem, Ananat said, is that no one else read it.&nbsp;</p>

<p class="has-text-align-none">So they <a href="https://www.povertycenter.columbia.edu/publication/2024/updating-benefit-cost-child-allowance-model">built a homepage</a> for their research on Columbia University’s Center on Poverty and Social Policy’s website, and as new relevant studies on the subject come out, they’ve been updating their findings. This most recent 2024 working paper reports on the updated results of their earlier work, while trying to offer a more widely accessible version of their research.</p>

<p class="has-text-align-none">Their promise of a 10 to 1 return is, frankly, massive. For every $100 or so billion the child allowance would cost the government each year, society would reap additional long-term benefits of about $929 billion. Those dollars represent benefits like improved child and parent health and longevity, higher future earnings for children, and reduced crime and health care costs. There would be an effect from the small dip in employment that their calculations predict, and a resulting decrease in tax revenue — but it would amount to just $2.4 billion. That’s a drop in a bucket overflowing with almost a trillion dollars in benefits.</p>

<p class="has-text-align-none">But the nuances of such long-term returns can be difficult to convey. “A little bit shows up in the first few years in the form of reduced [child abuse and neglect], reduced hospitalizations, and those sorts of things,” said Ananat. “But most of it doesn’t show up until the kids grow up. So that requires a very patient type of investor.”</p>

<p class="has-text-align-none">Imagine Vice President <a href="https://www.vox.com/politics/367990/kamala-harris-policy-positions-issues-guide">Kamala Harris</a> wins the presidential election in November, and immediately upon taking office implements a child allowance (as her recently unveiled economic agenda <a href="https://taxfoundation.org/research/all/federal/kamala-harris-tax-plan-2024/">intends</a>). That would cost roughly $97 billion for 2025 alone. But at the end of the year, if you tallied up all the benefits, you wouldn’t see that $929 billion that Ananat and Garfinkel calculated anywhere. It could be decades before the full value of that nearly one trillion is actually realized.&nbsp;</p>

<div class="wp-block-vox-media-highlight vox-media-highlight">
<h2 class="wp-block-heading">What is refundability?</h2>



<p class="has-text-align-none">Usually, a tax credit gives Americans a break by lowering the amount of taxes they owe. But that means someone who doesn’t owe any taxes —&nbsp;like someone who is unemployed and has no taxable income — won’t benefit from the credit. Currently, the child tax credit (CTC) excludes about <a href="https://www.cbpp.org/research/federal-tax/year-end-tax-policy-priority-expand-the-child-tax-credit-for-the-19-million">19 million</a> children from the lowest-income families, because they don’t earn enough to qualify for the full benefit.</p>



<p class="has-text-align-none">The American Rescue Plan made the CTC “fully refundable” through the end of 2021, which meant that even parents with no income, so who owe no taxes, still received the full value of the benefit. In <a href="https://www.vox.com/2016/5/23/11440638/child-benefit-child-allowance">other</a> rich countries that style child benefits this way, they’re known as “<a href="https://tcf.org/content/commentary/investing-in-our-kids-using-one-simple-tool-cash/">child allowances</a>.”&nbsp;</p>
</div>

<p class="has-text-align-none">Notably, though, it’s not a one-time deal. According to Ananat and Garfinkel, every year that the child allowance is in place will reap <em>another</em> $929 billion in long-term benefits. So if you take the Tax Foundation’s <a href="https://taxfoundation.org/blog/expanded-child-tax-credit-permanent/">estimate</a> that Harris’s child allowance would cost $1.6 trillion over 10 years, Ananat and Garfinkel’s work suggests over that same time period, it would accrue something like $9.3 trillion in long-term benefits.&nbsp;</p>

<p class="has-text-align-none">“The CTC is worth so much money in the future, that even though some of it only happens 50 years from now, it’s still worth $10 for every dollar you spend today,” said Ananat.</p>

<p class="has-text-align-none">The child allowance is fully refundable, meaning the full value goes to the poorest families, without a work requirement. (The current CTC is only partially refundable, which means that parents must first earn income before qualifying for the benefit.) But Ananat and Garfinkel also crunched a second set of cost-benefit calculations on a partially refundable CTC, matching recent CTC <a href="https://www.cbsnews.com/news/child-tax-credit-senate-vote/">compromises</a> that boost the payment amount while keeping a work requirement of some sort.&nbsp;</p>

<p class="has-text-align-none">They find that doing so would reduce the annual cost to $31 billion, while also reducing the total annual social benefit to $131 billion. That means that adding work requirements shrinks the program from a nearly 10 to 1 return on investment, to just over a 4 to 1 return. And those benefits would exclude children who are in the deepest poverty — the very ones who need such help the most.</p>

<p class="has-text-align-none">Now, converting a variety of outcomes into dollar valuations, and assigning benefits that will come in the future a value for the present, is tricky business. These estimates should be held lightly. But if they’re even in the right ballpark, then every year we don’t implement a child allowance is an absolutely massive missed opportunity. We’d experience as much as a <a href="https://www.cbpp.org/research/federal-tax/recovery-package-should-permanently-include-families-with-low-incomes-in-full">40 percent</a> drop in child poverty immediately, and begin layering on trillions of dollars in long-run benefits.</p>

<h2 class="wp-block-heading has-text-align-none"><strong>Critics and the econometric alternatives</strong></h2>

<p class="has-text-align-none">There are basically two ways to try and predict the effects of a child allowance in the deep future. Either way, you’re dealing with serious ambiguity.</p>

<p class="has-text-align-none">Like Ananat and Garfinkel, you can scour the existing evidence from similar long-run programs that have raised family incomes in the US, tabulate a comprehensive list of all their documented benefits and costs, calculate a per-$1,000 effect size for each cost and benefit, and then apply those values to a hypothetical child allowance.</p>

<p class="has-text-align-none">To do that, they looked at past long-run programs like pension <a href="https://socialwelfare.library.vcu.edu/programs/mothers-aid/">programs</a> for mothers from before the New Deal, the 1960s rollout of <a href="https://www.usda.gov/media/blog/2014/10/15/commemorating-history-snap-looking-back-food-stamp-act-1964#:~:text=On%20August%2031%2C%201964%2C%20President,struggling%20to%20make%20ends%20meet.">food stamps</a>, a series of US guaranteed income <a href="https://widerquist.com/basic-income-guarantee-experiments-1970s-quick-summary-results/">experiments</a> through the ’70s, and <a href="https://www.vox.com/future-perfect/2019/10/3/20895338/earned-income-tax-credit-2019-henrik-kleven">expansions</a> in the 1990s to the earned income tax credit.</p>

<p class="has-text-align-none">Notably, none of these programs are actually a CTC. And although each policy was chosen because it does a similar thing — effectively raises a family’s income — each took place in a different social and economic context than whatever the 2030s and beyond will look like.&nbsp;</p>

<p class="has-text-align-none">The other way to try and predict hypothetical economic futures is to use the economist’s version of a magic eight ball: <a href="https://www.econlib.org/library/Enc/ForecastingandEconometricModels.html">the econometric model</a>. These are mathematically constructed versions of reality, where fuzzy human behaviors have been translated into precise probabilities and equations. In these computational worlds, you can plug in a variable of interest, like a child allowance, and statistically churn out a prediction of its impact.</p>

<p class="has-text-align-none">Then, economists scrutinize the assumptions of the model, and debate how much insight those results can offer about the actual meatspace world that we all live in.&nbsp;</p>

<p class="has-text-align-none">That’s how Bruce Meyer, <a href="https://www.aei.org/profile/kevin-corinth/">Kevin Corinth</a> from the American Enterprise Institute (AEI), and their colleagues <a href="https://www.nber.org/papers/w29366">predicted</a> that replacing the old CTC, which incentivized work, with the expanded CTC that provides low-income families the benefit no matter whether they’re already working or not, would ultimately “<a href="https://www.washingtonpost.com/opinions/2021/10/14/press-pause-rush-extend-child-tax-credit/">do more harm than good</a>.” Specifically, that it would drive 1.5 million working parents to quit their jobs altogether, and cap the anti-poverty impact at 22 percent, rather than the 40 or so percent seen during the temporary expansion.</p>

<p class="has-text-align-none">Those numbers all hinge, however, on <a href="https://jainfamilyinstitute.org/the-expanded-child-tax-credit-and-parental-employment-tenuous-evidence-points-to-work-disincentives/">controversial</a> assumptions <a href="https://cpb-us-w2.wpmucdn.com/voices.uchicago.edu/dist/a/3122/files/2021/10/Note-on-Participation-Elasticities_10_21_2021.pdf">coded</a> into the model about how likely people — low-income single mothers in particular —&nbsp;are to stop working if they get an extra few hundred bucks per month from the CTC. Other models using different assumptions find much lower reductions in work, including Corinth’s own colleagues from the AEI, who <a href="https://grantseiter.com/CTC-Labor-Response/intro.html">predicted</a> the effect on employment would be only a fifth as strong, with 296,000 parents quitting their jobs rather than 1.5 million.&nbsp;</p>

<p class="has-text-align-none">In each case, these models are reflections of their coded-in assumptions. Like extrapolating from other policies in different historical eras, “Taking a given change in the [child] tax credit’s incentive to work and plugging in a labor supply elasticity is a fraught enterprise,” Jain Family Institute research associate <a href="https://jainfamilyinstitute.org/our-team/jack-landry/">Jack Landry</a> told me last year.&nbsp;</p>

<p class="has-text-align-none">When I asked Meyer about the Ananat and Garfinkel study, he dismissed it as “very selective” in its literature review. And <a href="https://www.aei.org/profile/scott-winship/">Scott Winship</a>, who directs the Center on Opportunity and Social Mobility at the AEI, said via email that “you’re more likely to find that a policy is worthwhile if you simply assume the largest potential costs don’t exist (in this case, worsened child outcomes in the long run from reduced parental work and increased single parenthood). That’s what they do.”</p>

<p class="has-text-align-none">There is, of course, no perfect way to predict the future. Otherwise I’d have cashed out of the stock market with millions by now. But that’s where critics of a permanently expanded, fully refundable child tax credit are now situating their case. Advocates can either follow them into the future, arguing that long-run benefits will outweigh long-run costs. Or, they could instead focus on building the political momentum necessary to pass a policy that will always have its detractors, while unambiguously helping millions of kids in the present.</p>

<h2 class="wp-block-heading has-text-align-none"><strong>Will a child allowance in the US ever exist anywhere other than the future?</strong></h2>

<p class="has-text-align-none">Vice President Kamala Harris has already <a href="https://taxfoundation.org/blog/harris-child-tax-credit-economic-agenda/">announced</a> that bringing back the expanded CTC is part of her planned presidential economic agenda.&nbsp;</p>

<p class="has-text-align-none">Ananat emphasized that “this isn’t a politically motivated” study, but<strong> </strong>that even if her research won’t convert skeptical economists, it can still be helpful to those working on political organizing. She said,“People can see this and feel inspired, like, ‘Oh, 10 to 1, that’s worth making more phone calls for.’”</p>

<p class="has-text-align-none">I’m not optimistic that economists will ever strike a unanimous agreement about the future of an expanded CTC (though it’s worth emphasizing that to the degree consensus does exist, it certainly <a href="https://static1.squarespace.com/static/5ecd75a3c406d1318b20454d/t/6148f183c62fb147d0d25138/1632170373799/Economist+CTC+Letter+9-14-21+430pm.pdf">is in support)</a>. Even if they did, how much stock should we really place in specific predictions that span decades? The world is <a href="https://www.google.com/books/edition/The_Uncontrollability_of_the_World/_5EBEAAAQBAJ?hl=en">unpredictable</a>, and seemingly more so every year.&nbsp;</p>

<p class="has-text-align-none">The decision to implement a child allowance will always have to be made under some degree of uncertainty. Trying to predict the impact of a child allowance decades into the future is always going to be a balancing act of ambiguity and speculation. Peering into the <a href="https://www.nber.org/papers/w29366">economic models</a> that raise concerns about how desirable a future shaped by a child allowance really is, you find a <a href="https://jainfamilyinstitute.org/the-expanded-child-tax-credit-and-parental-employment-tenuous-evidence-points-to-work-disincentives/">latticework of tenuous assumptions</a>. Similarly, critics say that when you look under the hood of the 10-to-1 return on investment claim, you find a selective literature review.</p>

<p class="has-text-align-none">But the flood of research on the temporary expansion washed away most uncertainty about the short term. Canada’s had a child allowance for years, and it <a href="https://www.niskanencenter.org/bad-arguments-child-allowance/">doesn’t look</a> to be hastening a grim and jobless future. A guaranteed huge drop in child poverty in the short term, plus the potential accrual of trillions of dollars in additional benefits, sounds like a worthwhile bet to me. And even if slouching employment among recipients did start to cause concern in a decade or two, and researchers came to suspect the child allowance was to blame, the wonderfully certain thing about public policy is that it can always be changed.&nbsp;&nbsp;</p>
						]]>
									</content>
			
					</entry>
			<entry>
			
			<author>
				<name>Oshan Jarow</name>
			</author>
			
			<title type="html"><![CDATA[Psychedelics and therapy might come apart]]></title>
			<link rel="alternate" type="text/html" href="https://www.vox.com/future-perfect/370242/psychedelics-and-therapy-might-come-apart" />
			<id>https://www.vox.com/370242/psychedelics-and-therapy-might-come-apart</id>
			<updated>2024-10-16T18:04:18-04:00</updated>
			<published>2024-09-05T11:59:21-04:00</published>
			<category scheme="https://www.vox.com" term="The Highlight" />
							<summary type="html"><![CDATA[For 38 years, the Multidisciplinary Association for Psychedelic Studies, or MAPS, has been working toward undoing the prohibition of psychedelic drugs. Their strategy: gain FDA approval for MDMA, the club drug turned novel PTSD treatment. But a few weeks ago, the FDA rejected the MDMA therapy proposed by Lykos Therapeutics, the for-profit outgrowth of MAPS. [&#8230;]]]></summary>
			
							<content type="html">
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<figure>

<img alt="Against a yellow and teal swirled background, a hand holds a large white pill." data-caption="" data-portal-copyright="Paige Vickers/Vox; Getty Images" data-has-syndication-rights="1" src="https://platform.vox.com/wp-content/uploads/sites/2/2024/10/MDMA_Fix_a0f29e.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" />
	<figcaption>
		</figcaption>
</figure>
<p class="has-text-align-none">For 38 years, the Multidisciplinary Association for Psychedelic Studies, or MAPS, has been working toward undoing the prohibition of psychedelic drugs. Their strategy: gain FDA approval for MDMA, the club drug turned novel <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10660711/">PTSD treatment</a>. But a few weeks ago, <a href="https://www.vox.com/future-perfect/365820/mdma-therapy-lykos-therapeutics-maps-psychedelics-ecstasy">the FDA rejected the MDMA therapy proposed by Lykos Therapeutics</a>, the for-profit outgrowth of MAPS.</p>

<p class="has-text-align-none">I’ve <a href="https://www.vox.com/future-perfect/365820/mdma-therapy-lykos-therapeutics-maps-psychedelics-ecstasy">previously reported</a> how choosing the drug, MDMA, and the condition, PTSD, were political choices. In 2022, <a href="https://theintercept.com/2022/07/26/mdma-psilocybin-fda-ptsd/">a letter</a> from the US Health and Human Services Department’s assistant secretary for mental health and substance use signaled that even the Biden administration expected MDMA therapy to pass. </p>

<p class="has-text-align-none">But echoing <a href="https://www.vox.com/future-perfect/353752/mdma-fda-approval-hearing-lykos-blinding-misconduct-allegations">concerns</a> around how well the Lykos data actually demonstrated safety and efficacy prior to the August vote, the FDA asked the company for another Phase 3 clinical trial, which would take millions of dollars more and several years, at least. Shortly after, Lykos <a href="https://www.reuters.com/business/healthcare-pharmaceuticals/lykos-cuts-workforce-by-75-2024-08-15/#:~:text=Aug%2015%20(Reuters)%20%2D%20Lykos,its%20MDMA%2Dbased%20PTSD%20treatment.">cut</a> 75 percent of its staff; the founder of MAPS, Rick Doblin, resigned from the Lykos board; and the journal <em>Psychopharmacology </em><a href="https://www.statnews.com/2024/08/11/mdma-ptsd-lykos-maps-retractions/">retracted</a> three papers that had been part of the evidence base for MDMA therapy. </p>

<p class="has-text-align-none">The hope for Lykos’s treatment was to launch a new era of medicine for the <a href="https://jamanetwork.com/journals/jama/fullarticle/2808951#:~:text=Psychedelic%20Therapy%E2%80%94A%20New%20Paradigm%20of%20Care%20for%20Mental%20Health,-Rachel%20Yehuda%2C%20PhD&amp;text=An%20increasing%20number%20of,%2C%20eating%20disorders%2C%20and%20addictions.">mind</a> and <a href="https://www.vox.com/future-perfect/2024/5/15/24156372/psychedelics-chronic-pain-cluster-headache-medicine-lsd-psilocybin">body</a>. (Maybe even one that assumes less of a distinction between the two). Instead, proponents for the mainstreaming of psychedelics are now wondering whether the path forward includes therapy at all.</p>

<h2 class="wp-block-heading has-text-align-none">Will the psychedelic therapy bundle unravel?</h2>

<p class="has-text-align-none">It’s worth acknowledging the simplest answer as to why things went sideways. The most obvious explanation is still probably one of the most relevant: The data just <a href="https://www.biopharmadive.com/news/lykos-fda-advisory-committee-mdma-adcomm-ptsd/717646/">wasn’t</a> compelling enough to satisfy the FDA.</p>

<p class="has-text-align-none">The safety database assembled by Lykos included data from 476 participants, which the FDA said was <a href="https://www.fda.gov/media/178984/download">too small</a> to make confident assessments on some of the potential risks, like heart complications from elevated blood pressure and heart rate. Other data was left uncollected, like positive reactions to MDMA that help regulators gauge abuse potential. </p>

<p class="has-text-align-none">And there was the specter of functional unblinding: when participants can pretty accurately guess whether or not they’ve been given a psychedelic, placebo controls are less effective in reducing biased results. That cast doubt on how much of the improvements — roughly 70 percent of participants with PTSD across the two Phase 3 clinical trials showed enough healing to no longer meet the criteria for having the condition — were actually attributable to the drug versus people’s expectations of healing, or disappointment at receiving a placebo.</p>

<p class="has-text-align-none">But the drug is only half of the equation. The other component is psychotherapy, which received <a href="https://link.springer.com/article/10.1007/s00213-024-06620-x#auth-Joshua_D_-Woolley-Aff3-Aff4">surprisingly little attention</a>, let alone clinical trials to determine the safety and efficacy of the actual therapy protocol.</p>

<p class="has-text-align-none">That’s especially strange since <a href="https://maps.org/mdma/mdma-resources/treatment-manual-mdma-assisted-psychotherapy-for-ptsd/">the therapy protocol</a> MAPS used across all of its clinical trials is unusual, particularly from a regulatory perspective. One of its core ideas, the mechanism of healing, is encouraging “the participant to trust their inner healing intelligence,” or a person’s “innate capacity to heal the wounds of trauma.” It also mentions that “the participant may have transpersonal experiences that might transcend conventional Western concepts of consciousness.” This is all language I would absolutely love to be a fly on the wall as the FDA discusses. </p>

<p class="has-text-align-none">Some critics <a href="https://www.regulations.gov/comment/FDA-2024-N-1938-0043">worried</a> that the unusual protocol, with its allowance of certain forms of physical contact between therapist and patient (like holding a participant&#8217;s hand, or “focused body work” where therapists give patients resistance to push against), can actually incentivize boundary violations. </p>

<p class="has-text-align-none">But in all likelihood, the FDA probably didn’t discuss inner healing or the Western concepts of consciousness, because it doesn’t <a href="https://aeon.co/essays/psychotherapy-is-meant-to-help-but-what-about-when-it-harms">regulate therapy</a>. That left the agency in a difficult spot, having to consider approving a treatment where a very consequential half — in terms of both safety and efficacy — was beyond its control.</p>

<p class="has-text-align-none">Given the decades of preparation, certainty of intense scrutiny, and intention to break away from the psychedelic stereotype of hippies and love-is-all-you-need, it’s interesting that MAPS still built its therapy protocol around something as far-out, at least relative to mainstream psychology, as an inner-healing intelligence. </p>

<p class="has-text-align-none">I asked MAPS about this. Director of communications Betty Aldworth responded that “the only thing about the MDMA-assisted therapy protocol that is alien to mainstream psychiatry is the eight-hour session.” She pointed to the rise of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4707273/">integrative therapy techniques</a> — a category defined by flexibility and tuning techniques to meet a patient’s particular needs in which they see their own treatment protocol — which has been gaining wider acceptance since the 1990s. </p>

<p class="has-text-align-none">Still, I find it hard to imagine that if MAPS had chosen to integrate MDMA with a mode of therapy grounded in more evidence and mainstream familiarity, like <a href="https://www.newyorker.com/culture/annals-of-inquiry/can-cognitive-behavioral-therapy-change-our-minds">cognitive behavioral therapy</a> (CBT), it would have faced less turbulence. </p>

<p class="has-text-align-none">That being said, I’m not sure that MDMA plus CBT would make for better patient outcomes than a protocol more specifically tuned to the nuances of working with a substance like MDMA. CBT was not designed for psychedelic drugs. It wields the powers of rational reflection to try and reprogram unhelpful or harmful patterns of thought. Given the <a href="https://www.vox.com/future-perfect/23972716/psychedelics-meaning-science-psychedelic-mushrooms-ketamine-psilocybin-mysticism">strange power</a> of psychedelics, designing a therapy protocol that works with that power, rather than ignores it, does make sense.</p>

<p class="has-text-align-none">But doing so might have also harmed their chances at FDA approval.&nbsp;</p>

<h2 class="wp-block-heading has-text-align-none">Does evangelism undermine scientific integrity?</h2>

<p class="has-text-align-none">Questions around therapy aside, both MAPS and Lykos <a href="https://www.statnews.com/2024/08/17/mdma-psychedelics-rick-doblin-lykos-exit/">faced another issue</a>: the ethics of having passionate advocates leading psychedelic research.&nbsp;</p>

<p class="has-text-align-none">In a <a href="https://www.regulations.gov/comment/FDA-2024-N-1938-0038">letter</a> submitted to the FDA shortly before the June 6 advisory committee meeting, a participant from MAPS’s first Phase 3 <a href="https://www.nature.com/articles/s41591-021-01336-3">trial</a> recalls her therapist telling her she was “helping make history,” that she was “part of a movement,” and reminding her that her actions during and after the trial “could jeopardize legalization.” <strong> </strong></p>

<p class="has-text-align-none">This kind of pressure should never be placed on patients, much less when <a href="https://www.jneurosci.org/content/39/2/307">suggestibility-enhancing</a> drugs are involved, and even less when you’re trying to convince the world that psychedelic science is legitimate and trustworthy.&nbsp;</p>

<p class="has-text-align-none">Through the past year, allegations that a culture of “<a href="https://www.nytimes.com/2024/03/21/health/psychedelics-roland-griffiths-johns-hopkins.html">psychedelic evangelism</a>” is undermining the integrity of psychedelic science have been <a href="https://www.nytimes.com/2024/08/23/opinion/psychedelics-mdma-mental-health.html">mounting</a>.</p>

<p class="has-text-align-none">Aldworth, the MAPS director of communications, couldn’t speak to the specific incident, but said that such external pressure to “perform well” can interfere with a person’s treatment and cause intense suffering. She added that the trial therapists were explicitly trained not to “bring the psychedelic hype into the sessions,” and noted that Lykos used independent adherence raters to observe recordings of randomly selected sessions to ensure therapists were following protocol. </p>

<p class="has-text-align-none">The incident wasn’t exactly isolated. Former MAPS staffers have spoken out about “a culture that brushed ethical issues under the rug,” as Anna Silman of Business Insider <a href="https://www.businessinsider.com/mdma-therapy-maps-lykos-rick-doblin-fda-legalization-trials-2024-5">recently reported</a>. </p>

<p class="has-text-align-none">I don’t think it’s necessarily a problem to be funding science, even managing clinical trials, about something you believe in. But it does raise the risk of bias, and demands an even higher commitment to strategies for mitigating those risks.</p>

<p class="has-text-align-none">Rather than zooming in on what MAPS or Lykos can do differently to guard against bias, the best thing that can happen for the quality of psychedelic science is to expand and diversify the field. The more points of view, types of organizations, research questions, and sources of funding, the more psychedelic science can insulate itself from the blind spots or biases of any one in particular.</p>

<h2 class="wp-block-heading has-text-align-none">What’s next for psychedelic therapy?</h2>

<p class="has-text-align-none">So should emerging psychedelic companies bend their treatment protocols toward what has the best chance of passing the system as it is? Or, should they commit to optimizing for patient outcomes, which even former director of the National Institute of Mental Health Thomas Insel <a href="https://www.statnews.com/2024/07/25/fda-mdma-ptsd-ruling-shows-need-for-psychotherapy-drug-combined-approval/">writes</a> means emphasizing therapy, while making the overall treatment “ill-suited for FDA review”? </p>

<p class="has-text-align-none">Some psychedelic therapies, like the biotech company Compass Pathways’s psilocybin <a href="https://compasspathways.com/our-work/comp360-psilocybin-treatment-in-trd/">treatment for depression</a>, already use a scaled-back form of therapy, which they call “psychological support.” </p>

<p class="has-text-align-none">That’s at least in part due to the differences between MDMA and psilocybin. On the former, you generally still have your wits about you — so a talk therapy session is a perfectly viable thing to do. Your usual sense of self is largely still there, just with an infusion of more neurotransmitters like serotonin and oxytocin. Or, from the first-person perspective: <a href="https://www.bloomsbury.com/us/i-feel-love-9781635579581/">love</a>. On psilocybin, carrying on a conversation with a therapist could be a bit more of a challenge, and even <a href="https://pubs.acs.org/doi/10.1021/acschemneuro.3c00289#:~:text=Recent%20findings%20have%20shown%20that,outcomes%2C%20such%20as%20personality%20changes.">undermine the potency</a> of the experience.&nbsp;</p>

<p class="has-text-align-none">But, crucially, the FDA’s decision doesn’t change much for the other, ongoing realms of the psychedelic revival. State legalizations, religious exemptions, and academic research can all carry on largely unaffected. There already exists an immense base of historical and anthropological evidence for their efficacy in other domains, like spiritual and religious practices. (FDA approval of Lykos’s treatment wouldn’t have automatically guaranteed rescheduling or legalization of all MDMA, anyway.)&nbsp;</p>

<p class="has-text-align-none">Whatever happens with questions around the unbundling of psychedelics and therapy, reporting on this saga over the past few months has left me with a sense that there’s a larger unbundling in order: that of <a href="https://www.vox.com/future-perfect/365820/mdma-therapy-lykos-therapeutics-maps-psychedelics-ecstasy">psychedelic medicine from the psychedelic revival at large</a>. The two are, frankly, different ball games. The quicker we can untangle them, and avoid conflating one with the other, the better for both. &nbsp;</p>
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									</content>
			
					</entry>
			<entry>
			
			<author>
				<name>Oshan Jarow</name>
			</author>
			
			<title type="html"><![CDATA[What do you do if The Really Big One strikes on your vacation?]]></title>
			<link rel="alternate" type="text/html" href="https://www.vox.com/climate/368920/what-to-do-natural-disaster-vacation-travel-earthquake-wildfire-hurricane-flooding" />
			<id>https://www.vox.com/?p=368920</id>
			<updated>2024-08-26T18:55:17-04:00</updated>
			<published>2024-08-28T08:00:00-04:00</published>
			<category scheme="https://www.vox.com" term="Climate" /><category scheme="https://www.vox.com" term="Even Better" /><category scheme="https://www.vox.com" term="Life" /><category scheme="https://www.vox.com" term="Natural Disasters" /><category scheme="https://www.vox.com" term="Travel" />
							<summary type="html"><![CDATA[Earlier this year, projections from UN Tourism put international travel on track to recover to pre-pandemic levels — putting a swell of tourism on a collision course with the increasing danger of climate disasters, from wildfires ripping through Greece to megaquake warnings in southern Japan. While peak tourism season is mostly behind us, off-season travel [&#8230;]]]></summary>
			
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<figure>

<img alt="A person walks past an area of a damaged building, which is cordoned off with construction equipment nearby, in Hualien, Taiwan. " data-caption="The aftermath of an earthquake on April 4, 2024, in Hualien, Taiwan. A 7.5 magnitude earthquake hit eastern Taiwan, triggering a tsunami warning for coastlines in Taiwan, the Philippines and Japan. | Annabelle Chih/Getty Images" data-portal-copyright="Annabelle Chih/Getty Images" data-has-syndication-rights="1" src="https://platform.vox.com/wp-content/uploads/sites/2/2024/08/gettyimages-2136599218.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" />
	<figcaption>
	The aftermath of an earthquake on April 4, 2024, in Hualien, Taiwan. A 7.5 magnitude earthquake hit eastern Taiwan, triggering a tsunami warning for coastlines in Taiwan, the Philippines and Japan. | Annabelle Chih/Getty Images	</figcaption>
</figure>
<p class="has-text-align-none">Earlier this year, <a href="https://www.unwto.org/news/international-tourism-to-reach-pre-pandemic-levels-in-2024">projections from UN Tourism</a> put international travel on track to recover to pre-pandemic levels — putting a swell of tourism on a collision course with the increasing danger of climate disasters, from wildfires <a href="https://www.cnn.com/2024/08/16/climate/greece-wildfires-athens-photos-climate-intl/index.html">ripping through Greece</a> to <a href="https://www.technologyreview.com/2024/08/15/1096682/what-japans-megaquake-warning-really-tells-us/">megaquake warnings</a> in southern Japan. While peak tourism season is mostly behind us, off-season travel is <a href="https://www.cnn.com/travel/the-end-of-off-season-travel-cmb/index.html">swelling</a>, which may or may not be evidence of a backlash against the “<a href="https://www.vox.com/the-highlight/358195/the-case-against-summer">summer industrial complex</a>.” Volatility is in the air, as well as, apparently, the ground, seas, and forests. Plus, some extreme weather patterns, like the <a href="https://www.noaa.gov/news-release/noaa-predicts-above-normal-2024-atlantic-hurricane-season">Atlantic hurricane season</a>, are just kicking off.</p>

<p class="has-text-align-none">And 2024 isn’t an anomaly (at least, in terms of climate patterns). Last winter, a 7.8 earthquake in Turkey and Syria leveled over 6,000 buildings and <a href="https://www.vox.com/world/2023/2/7/23589541/turkey-earthquake-syria-death-toll-news-updates">killed thousands</a>. In the spring, a half-year’s worth of rain in Italy’s Emilia Romagna region led to floods, canceled a Formula One Grand Prix, and <a href="https://climate-adapt.eea.europa.eu/en/metadata/case-studies/mental-health-support-for-people-affected-by-floods-in-emilia-romagna#:~:text=In%20May%202023%2C%20six%20months,Romagna%20report%2C%20CEMS%20bulletin%20n.">killed 17 people</a>. In the final dregs of summer, devastating <a href="https://www.nytimes.com/2023/09/01/us/hawaii-tourists-economy.html">wildfires</a> closed the beaches of Hawaii and displaced thousands of locals in Maui.&nbsp;</p>

<p class="has-text-align-none">And then there’s all that lies in wait, like the “<a href="https://www.newyorker.com/magazine/2015/07/20/the-really-big-one?_sp=ff8ebf55-e7a9-4a86-9986-a24f05fbccfa.1723657514668">Really Big One</a>,” a projected earthquake reaching up to a 9.2 on the Richter scale and subsequent 700-mile seismic wave that will, on some unknown day, devastate North America’s West Coast. Or that Nankai Trough Megaquake that southern Japan braced for earlier this month, now <a href="https://www3.nhk.or.jp/nhkworld/en/news/backstories/3509/">projected</a> to kill 230,000 people whenever it strikes.&nbsp;&nbsp;</p>

<p class="has-text-align-none">Now look, the odds that you’re vacationing in a spot where an anticipated natural disaster finally happens are very low. But as the climate of the planet changes, disaster patterns are shifting and are occurring in <a href="https://www.ipcc.ch/report/ar6/wg1/downloads/faqs/IPCC_AR6_WGI_FAQ_Chapter_11.pdf">unprecedented locations</a>. Even traveling to places that have been <a href="https://www.vox.com/climate/2023/7/13/23792409/floods-vermont-new-york-natural-disaster-insurance-global-climate-risk-change">historically mellow,</a> at least in terms of climate, still doesn’t guarantee a smooth ride. Tornado Alley — the oval-shaped epicenter of tornado formations in the US stretching from northeastern Texas to western Missouri —&nbsp;is <a href="https://www.scientificamerican.com/article/watch-out-tornado-alley-is-migrating-eastward/">traveling eastward</a>, spreading concentrated storms to new places. And hail, I kid you not, is <a href="https://www.nature.com/articles/s41612-024-00728-9#:~:text=Near-surface%20hailstones%20%3C4%20cm,are%20expected%20across%20the%20U.S.">getting bigger</a>.&nbsp;</p>

<p class="has-text-align-none">And if your travels aren’t thwarted by a long-awaited supervolcanic eruption, even a modest thunderstorm, particularly in drought-stricken areas where the soil can’t absorb new moisture, can still cause flash flooding by your hotel and throw a wrench in your plans. (Moab, Utah, home of a popular hiking spot called the Morning Glory Arch, <a href="https://x.com/Rainmaker1973/status/1806289416475841017">saw extraordinary flooding</a> earlier this year during peak season.)&nbsp;&nbsp;</p>

<p class="has-text-align-none">That said, this doesn’t all mean that disasters themselves are on the rise. Despite very <a href="https://openknowledge.fao.org/server/api/core/bitstreams/7c48cdf4-6153-41df-b3ed-4db1d09a1b0f/content">high-profile</a> organizations <a href="https://unfccc.int/news/climate-change-leads-to-more-extreme-weather-but-early-warnings-save-lives">repeating</a> the claim that the rate of natural disasters has <a href="https://gadebate.un.org/en/72/secretary-general-united-nations">quadrupled</a> —&nbsp;or more —&nbsp;in the last 50 years, the nonprofit Our World in Data finds that <a href="https://ourworldindata.org/disaster-database-limitations#:~:text=UN%20Framework%20Convention%20on%20Climate,weather%2C%20and%20improved%20reporting.%E2%80%9D">it’s actually unclear</a> whether that’s just a byproduct of better technology enabling more reporting of disasters, or reflects a real increase in catastrophes. In fact, disaster deaths per capita have actually been on <a href="https://ourworldindata.org/grapher/decadal-average-death-rates-from-natural-disasters">a steep decline</a> in recent decades, thanks to improved infrastructure, early warning systems, and more adeptly coordinated responses.&nbsp;&nbsp;</p>
<img src="https://platform.vox.com/wp-content/uploads/sites/2/2024/08/gettyimages-2165981652.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" alt="Two men in helmets and jackets haul a long hose toward a forest fire burning twice as tall as they are, through dry grass and scrub." title="Two men in helmets and jackets haul a long hose toward a forest fire burning twice as tall as they are, through dry grass and scrub." data-has-syndication-rights="1" data-caption="Volunteers extinguish a forest fire in Ano Patima in the northern Athens region of Greece, on August 12, 2024. | Socrates Baltagiannis/picture alliance via Getty Images" data-portal-copyright="Socrates Baltagiannis/picture alliance via Getty Images" />
<p class="has-text-align-none">But regardless of the overall rate or deadliness of natural disasters, climate change is pushing those that do occur to their <a href="https://www.vox.com/22616968/ipcc-climate-change-report-attribution-extreme-weather-heat-fire">extremes</a>. A warmer climate is an <a href="https://news.stanford.edu/stories/2021/12/warming-makes-weather-less-predictable">increasingly unpredictable</a> one, and the planet is on a 14-month <a href="https://www.noaa.gov/news/earth-just-had-its-warmest-july-on-record#:~:text=The%20average%20July%20global%20surface,high%20temperatures%20for%20the%20planet.">streak</a> of setting record-high temperatures. More disruptive heat waves, wildfires, flooding, droughts, tropical cyclones (the world is just now moving into the upswing of the Atlantic hurricane season, which is projected to be one of <a href="https://www.noaa.gov/news-release/highly-active-hurricane-season-likely-to-continue-in-atlantic">the most intense</a> on record), and landslides are all in the forecast.&nbsp;</p>

<p class="has-text-align-none">“We’ve seen with climate change that severe weather threats, including extreme heat, are happening outside of the time of year and places that people typically associate with these extreme weather events,” said <a href="https://wmo.int/profile/jonathan-porter">Jon Porter</a>, weather forecasting company AccuWeather’s chief meteorologist. “Do not be lulled into any false sense of security.”</p>

<p class="has-text-align-none">So unless you have an in at a <a href="https://www.vox.com/future-perfect/24139145/fallout-amazon-prime-video-game-nuclear-war-existential-risk">billionaire’s bunker</a> to shield you from unexpected climate surprises along your journey, here’s how to be a bit more prepared for travel and learn to navigate a more unpredictable, disaster-prone world.&nbsp;</p>

<h2 class="wp-block-heading has-text-align-none">Before you travel, consider planning for chaos</h2>

<p class="has-text-align-none">I’ve been fortunate to do a fair bit of travel in my lifetime, and whether going to Southeast Asia or Latin America, my natural disaster preparation has generally held steady: pay it no mind, travel anyway, and leave my fate up to the gods.</p>

<p class="has-text-align-none">But, like many others, I’m starting to lose faith in that strategy. So I went looking to see how more prudent travelers might handle things. I expected to find a bunch of totally reasonable steps that I nevertheless couldn’t actually imagine myself doing. I’m stubborn, after all. But it turns out, there’s a number of pretty simple things a traveler can do to help lower the odds of getting caught unprepared during a disaster. I’m learning that the beginning of wisdom, at least when it comes to travel, might be something like downloading the Federal Emergency Management Agency’s (FEMA) <a href="https://www.ready.gov/fema-app">app</a>.&nbsp;</p>

<p class="has-text-align-none">Just like getting some Duolingo in to polish your Spanish before heading to Spain, you might browse some basic <a href="https://community.fema.gov/ProtectiveActions/s/article/Hurricane">hurricane protective strategies</a> before heading to Puerto Rico. Or peruse this <a href="https://www.ready.gov/earthquakes#:~:text=Prepare%20Before%20an%20Earthquake&amp;text=Make%20an%20Emergency%20Plan%3A%20Create,fire%20extinguisher%20and%20a%20whistle.">earthquake preparedness guide</a> before going anywhere near the Pacific Northwest. FEMA’s app bills itself as “your personalized disaster resource,” which rings pretty dystopian. But easy access to FEMA’s disaster resources —&nbsp;from real-time emergency alerts to help finding nearby shelter during a rushed evacuation —&nbsp;can help prevent a bad situation from getting worse. Although it’s a US agency, FEMA has resources for global travel, too.</p>

<p class="has-text-align-none">When planning a trip, you could pop open the <a href="https://gdacs.org/">Global Disaster Alert and Coordination System</a>, a joint project between the United Nations (UN) and European Commission that shows real-time global disaster alerts from the past four days on a handy map. In addition to not literally traveling into an active disaster, knowing the seasons and usual suspects of your destination can help you decide which among the FEMA app’s preparation guides you might skim beforehand.</p>

<p class="has-text-align-none">Once you know where you want to go, you could even enroll in the <a href="https://step.state.gov/">State Department’s Smart Traveler Enrollment Program</a>, a free service that registers your trip with the nearest US embassy to your destination. They’ll keep you updated with safety alerts in your destination country, and help the US embassy contact you if a natural disaster strikes while you’re there.</p>

<div class="wp-block-vox-media-highlight vox-media-highlight">
<h2 class="wp-block-heading">Skipping a flight to reduce emissions</h2>



<p class="has-text-align-none">Although today, aviation makes up only <a href="https://ourworldindata.org/global-aviation-emissions#:~:text=Aviation%20accounts%20for%202.5%25%20of,to%20global%20warming%20to%20date.&amp;text=Flying%20is%20one%20of%20the,of%20the%20world%27s%20carbon%20emissions.">2.5 percent</a> of the world’s carbon emissions, that number is on a sharp upward trajectory that’s already quadrupled since the 1960s. That makes ditching big flights an extremely <a href="https://www.thetimes.com/article/92eb96e2-5dda-4d32-9533-56a763a1fab1">carbon-friendly</a> decision. For now, anyway. <a href="https://www.vox.com/2020/2/27/20994118/carbon-offset-climate-change-net-zero-neutral-emissions">Carbon offsets</a> can hasten global decarbonization, even if they <a href="https://www.vox.com/23817575/carbon-offsets-credits-financialization-ecologi-solutions-scam">don’t actually offset</a> your flight’s emissions. And in the hopefully not-too-distant future, <a href="https://www.nature.com/articles/s41893-022-01046-9">net-zero aviation</a> could become feasible.</p>
</div>

<p class="has-text-align-none">The usuals of travel obviously still apply, like sending your itinerary to family or close friends, or making copies of important documents like your passport. But as extreme weather spreads to places that aren’t accustomed to it (like Vermont, which just experienced a magnitude of <a href="https://www.cnn.com/2024/07/30/weather/vermont-flooding-rain-climate/index.html">destructive rainfall</a> that is expected only once in every 1,000 years), some unusual steps might also be helpful. For example, you might look for social media accounts of local organizations that <a href="https://preparecenter.org/topic/social-media-disasters/">provide emergency alerts,</a> so that you aren’t reliant on official communication channels that may not be prepared to get information out fast. Or, if you really want to hedge your bets, you can travel with a satellite phone so that you don’t lose the ability to communicate even if the area you’re in does.</p>

<p class="has-text-align-none">In addition, FEMA <a href="https://www.fema.gov/blog/travel-preparedness-3-tips-safe-adventure">recommends</a> adding an emergency kit to your packing list, with things like nonperishable food, first aid kits, flashlights, power banks for your phones, and flares. <a href="http://ready.gov">Ready.gov</a>, a public service campaign that helps Americans prepare for and respond to disasters, also has a sample <a href="https://www.ready.gov/plan-form">family emergency communication plan</a> you can have everyone in your party fill out before traveling. That way, if you do get separated or cut off from communication, everyone has contact numbers, emergency meeting places, and medical information on hand.</p>

<p class="has-text-align-none">But there’s a limit to the kinds of things you can really plan ahead for. The varieties of disaster may never cease to surprise us, like Boston’s <a href="https://www.boston.gov/news/100-years-ago-today-molasses-crashes-through-bostons-north-end">Great Molasses Flood</a> of 1919.</p>

<h2 class="wp-block-heading has-text-align-none">If you happen to be a tourist during a disaster</h2>

<p class="has-text-align-none">All right, so what if<em> </em>you actually are hanging out on Vancouver Island when the Really Big One does rumble and splash across the Pacific Northwest? What if you were traveling through the state of Rio Grande do Sul in southern Brazil when flooding killed <a href="https://www.cbsnews.com/news/brazil-floods-death-toll-missing-persons-rio-grande-do-sul/">over 100 people</a> in May, forced 160,000 more from their homes, and effectively <a href="https://www.pbs.org/newshour/world/extreme-weather-wreaks-havoc-around-the-world">shut down</a> a city of 4 million people?&nbsp;&nbsp;</p>

<p class="has-text-align-none">Some <a href="https://www.nationalgeographic.com/travel/article/what-to-do-if-youre-caught-in-a-disaster-while-travelling#:~:text=Basic%20things%20to%20remember%20include,and%20neck%20with%20your%20arms.">rules of thumb</a>: If you aren’t literally caught in the middle of what’s going on, try to assess the situation before springing into action. If you’re staying with a hotel, they’re usually in touch with local authorities, and are a good source of information. “It’s important to listen to local and state officials,” said <a href="https://www.fema.gov/profile/jaclyn-rothenberg">Jaclyn Rothenberg</a>, FEMA public affairs director. “Carefully monitor local radio, television, social media, and other local sources for updates.”</p>

<p class="has-text-align-none">The US Bureau of Consular Affairs website <a href="https://travel.state.gov/content/travel/en/international-travel/emergencies/what-state-dept-can-cant-do-crisis.html">advises</a>, shockingly, that “the best time to leave a country is before a crisis.” In this specific scenario, that’s hard to know. The US government’s main commitment is to keep citizens informed of both safety developments and travel options —&nbsp;only in limited circumstances will they actually help evacuate citizens. Specifically, if there are no commercial transport options, and consular officers are nearby, and conditions permit, then the government may help identify and/or arrange transport.&nbsp;</p>

<p class="has-text-align-none">But keep in mind that if you do wind up in a US government-assisted evacuation, it won’t foot the bill. If you don’t have money on hand, you’ll have to sign a form promising the government you’ll pay it back before getting on the transport. Just imagine; there could be a tsunami rushing around your dwindling plot of high land while you’re stuck in a line to get on the escape bus as each American fills out the IOU paperwork. I doubt —&nbsp;I hope — that’s not how it plays out in practice. But when you’re dealing with bureaucracies, you never know. Also, pets are not allowed on the transport (but service animals are).</p>

<p class="has-text-align-none">Let’s say things happened too fast, and you’re still on the ground when disaster sets in. If you’re facing flooding or a tsunami, seek out high ground. If it’s an earthquake, get away from buildings, the collapse of which <a href="https://www.vox.com/2015/4/27/8501281/earthquake-risk">kills far more people</a> than the actual quake itself. During wildfires or volcanic eruptions, make plans to evacuate, and cover your mouth and nose if the air is already thick with ash (N95 masks certified by the National Institute for Occupational Safety and Health <a href="https://ww2.arb.ca.gov/smokereadyca#:~:text=People%20who%20must%20be%20outdoors,NIOSH%2Dcertified%20N95%20respirator%20mask.">are best</a>, and make a good addition to your travel packing list).</p>

<p class="has-text-align-none">Travel insurance can add another layer of protection — though it can nudge up the overall cost of your trip. Policies usually <a href="https://disb.dc.gov/page/taking-trip-information-about-travel-insurance-you-should-know-you-hit-road#:~:text=Cost%20of%20travel%20insurance%3A%20Travel,%24500%20depending%20on%20the%20coverage.">cost</a> between 4 and 10 percent of your trip’s price, but they often have an <a href="https://www.allianztravelinsurance.com/get-help.htm">emergency assistance number</a> you can call. They can help refer you to local medical providers, make emergency travel arrangements, or even get you emergency cash to get out. If you go this route, take care to check whether disaster-related expenses are included in your policy.&nbsp;&nbsp;</p>

<p class="has-text-align-none">If phone lines are down and communication is cut off once you’ve found immediate safety, one of the most common recommendations across government agencies is to take to social media. Post that you’re all right, saving your family the trouble of waiting on the State Department’s hotline to make sure you’re okay.&nbsp;</p>

<h2 class="wp-block-heading has-text-align-none">The economics, and ethics, of disaster travel</h2>

<p class="has-text-align-none">So, you made it home. But let’s say the first-hand brush with disaster, and seeing the havoc it can wreak, particularly on less developed areas with fewer resources which will <a href="https://www.weforum.org/agenda/2023/01/climate-crisis-poor-davos2023/">disproportionately shoulder the brunt</a> of climate change’s extreme weather upticks, left you unsettled. What can you do to help?</p>

<p class="has-text-align-none">At an institutional level, economic development can help make communities more resilient in the face of disaster. A powerful way to soften the impact of an extremifying climate is, for example, <a href="https://www.unisdr.org/files/8545_povertyreduction1.pdf">to reduce poverty</a>.</p>

<p class="has-text-align-none">The UN’s 2019 <a href="https://hdr.undp.org/system/files/documents/hdr2019.pdf">Human Development Report</a> looked at this relationship more broadly, using their Human Development Index (HDI) that measures a combination of health, education, and standard of living. They found that from 1980 to 2017, natural disasters led to a 0.5 percent annual drop in the HDI of developed countries, but a larger 1.2 percent drop for countries with fewer resources.</p>

<p class="has-text-align-none">The world has excelled in many <a href="https://ourworldindata.org/much-better-awful-can-be-better">measures of development and progress</a> through recent centuries (while <a href="https://royalsociety.org/news-resources/projects/biodiversity/human-impact-on-biodiversity/#:~:text=The%20main%20direct%20cause%20of,timber%20which%20drives%20around%2020%25.">others are backsliding</a>). But zooming into more recent times, progress on things like the UN’s Sustainable Development Goals that would raise HDI —&nbsp;like ending global poverty, or abolishing hunger and improving nutrition worldwide — is <a href="https://www.vox.com/future-perfect/2023/9/22/23884636/united-nations-sustainable-development-goals-extreme-poverty-hunger-climate-change-ukraine">slowing to a crawl</a>.</p>

<p class="has-text-align-none">But neither you nor I can end global poverty or cut emissions worldwide on our own (though individual choices <a href="https://www.vox.com/culture/368201/volunteer-charity-donations-systemic-change-activism-nonprofits-loneliness-philanthropy">can still influence</a> structural problems). One strategy is to consider how visitor presence and tourism dollars will interact with the local economy, and either align with the local community’s well-being, or not.&nbsp;</p>

<p class="has-text-align-none">For example, during the Maui wildfires last year, local officials <a href="https://www.theguardian.com/us-news/2023/aug/14/hawaii-fires-maui-requests-tourists-stay-away">all but begged</a> tourists to stay away. Part of the problem was the sheer absurdity of tourists snorkeling in the same waters that crews were still searching to find missing residents who’d jumped in to avoid the flames. Tourists were sucking away resources that residents of the Lahaina area badly needed.</p>

<p class="has-text-align-none">But tourism makes up roughly <a href="https://www.mauicounty.gov/DocumentCenter/View/102556/010_06_County-Profile">40 percent</a> of Maui’s economy. So a month after the fire, losing about <a href="https://www.hawaii.edu/news/2023/09/22/wildfires-maui-economy/#:~:text=Maui%20lost%20more%20than%20%2413,the%20weeks%20following%20the%20fire.">$13 million per day</a> in visitor spending relative to normal, residents, government officials, and business owners began <a href="https://www.vox.com/2023/10/6/23898399/maui-reopening-wildfires-hawaii-tourism-displaced-residents">asking tourists to come back</a>, at least to the parts of Maui that weren’t most affected by the fires. Still, <a href="https://www.euronews.com/travel/2022/05/03/hawaiian-overtourism-residents-beg-tourists-to-stop-visiting-amid-post-pandemic-boom">overtourism</a> is a major issue across Hawaii at large. Even when there’s no disaster fallout demanding extra resources, many locals and government officials alike have been trying to <a href="https://pacificties.org/tourism-in-hawaii-needs-to-change/#:~:text=Bisch%20cites%20several%20negative%20effects,%2C%20as%20Bisch%20says%2C%20%E2%80%9C%E2%80%A6">slow the tide</a> of tourists, whose hordes have clogged infrastructure, deprived residents of resources as they’re diverted to high-demand areas, threatened endangered species, and trampled sacred land.&nbsp;</p>

<p class="has-text-align-none">Sometimes, though, locals are more unified in their embrace of tourism, even in the immediate wake of a disaster. When a 6.8-magnitude earthquake hit rural parts of Marrakesh, Morocco, in September 2023, thousands <a href="https://www.reuters.com/world/africa/morocco-earthquake-death-toll-passes-2800-survivors-camp-outdoors-2023-09-11/">died</a>, villages were devastated, roads were closed, and locals <a href="https://www.nytimes.com/2023/09/12/travel/tourism-morocco-maui.html#:~:text=With%20the%20high%20tourism%20season,in%20funds%20for%20relief%20efforts.">continued</a> to <a href="https://www.euronews.com/travel/2023/11/17/solidarity-warms-the-heart-tourism-has-helped-morocco-recover-from-its-deadly-earthquake">welcome</a> the flow of tourism that, ultimately, helped fund relief efforts.&nbsp;</p>

<p class="has-text-align-none">There’s no blanket recommendation here —&nbsp;different areas have different situations. Government officials and business owners might even send mixed messages on whether your presence would be welcomed. Cultivating a habit of trying to understand at least a little about the state of the local communities on our travel lists can help align trips with the well-being of more vulnerable places.&nbsp;</p>

<p class="has-text-align-none">Even as tourism rates trend toward a full rebound, the world is warmer and less predictable. “Extreme and severe weather events in the United States and around the world are becoming more frequent, having a greater impact, and affecting places where people may not be as prepared to handle them,” AccuWeather chief meteorologist Jon Porter said.</p>

<p class="has-text-align-none">Uncertainty is becoming the kind of travel companion you just can’t get rid of. Globally, we’re already on a path toward making natural disasters <a href="https://ourworldindata.org/natural-disasters#:~:text=Disasters%20%E2%80%93%20from%20earthquakes%20and%20storms,over%20the%20last%20few%20decades.">less and less deadly</a>. We’ll need to keep up that momentum, while maybe even doing the unthinkable: changing our own personal travel habits, at least a little bit.  </p>
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			<entry>
			
			<author>
				<name>Oshan Jarow</name>
			</author>
			
			<title type="html"><![CDATA[MDMA therapy didn’t get FDA approval. Now what?]]></title>
			<link rel="alternate" type="text/html" href="https://www.vox.com/future-perfect/365820/mdma-therapy-lykos-therapeutics-maps-psychedelics-ecstasy" />
			<id>https://www.vox.com/?p=365820</id>
			<updated>2024-08-20T11:20:36-04:00</updated>
			<published>2024-08-13T11:36:00-04:00</published>
			<category scheme="https://www.vox.com" term="Criminal Justice" /><category scheme="https://www.vox.com" term="Future Perfect" /><category scheme="https://www.vox.com" term="Health" /><category scheme="https://www.vox.com" term="Mental Health" /><category scheme="https://www.vox.com" term="Policy" /><category scheme="https://www.vox.com" term="Psychology" /><category scheme="https://www.vox.com" term="The Future of the Mind" /><category scheme="https://www.vox.com" term="War on Drugs" />
							<summary type="html"><![CDATA[The FDA has decided not to approve MDMA therapy for the treatment of post-traumatic stress disorder, dealing an unexpected blow to the growing movement to raise psychedelics from the underground as a new, strangely powerful type of medicine.&#160; Psychoactive drugs like psilocybin, LSD, and MDMA have been illegal for decades. But academic research looking into [&#8230;]]]></summary>
			
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<img alt="" data-caption="" data-portal-copyright="" data-has-syndication-rights="1" src="https://platform.vox.com/wp-content/uploads/sites/2/2024/08/MDMA_option01_No.jpg?quality=90&#038;strip=all&#038;crop=0,0,100,100" />
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<p class="has-text-align-none">The FDA has decided <a href="https://news.lykospbc.com/2024-08-09-Lykos-Therapeutics-Announces-Complete-Response-Letter-for-Midomafetamine-Capsules-for-PTSD">not to approve</a> MDMA therapy for the treatment of post-traumatic stress disorder, dealing an unexpected blow to <a href="https://www.vox.com/future-perfect/23721486/ketamine-dmt-lsd-psychedelics-magic-mushrooms-legalization-recreation-psilocybin">the growing movement</a> to raise psychedelics from the underground as a new, <a href="https://www.vox.com/future-perfect/23972716/psychedelics-meaning-science-psychedelic-mushrooms-ketamine-psilocybin-mysticism">strangely powerful</a> type of medicine.&nbsp;</p>

<p class="has-text-align-none">Psychoactive drugs like psilocybin, LSD, and MDMA have been illegal for decades. But academic research looking into how they could be used across various fields, from neuroscience to medicine, <a href="https://www.tandfonline.com/doi/abs/10.1080/02791072.1991.10472572">resumed</a> in the 1990s, slowly building momentum toward <a href="https://www.vox.com/future-perfect/360200/how-to-buy-psychedelics-lsd-shrooms-stores">expanding access</a> outside of tightly regulated research organizations. One of the most promising directions has been developing psychedelics as medical treatments for a broad range of hard-to-treat but widespread conditions, from <a href="https://www.vox.com/future-perfect/2020/10/9/21506664/psychedelics-mental-health-depression-ptsd-psilocybin-mdma">depression</a> and anxiety to <a href="https://www.vox.com/future-perfect/2024/5/15/24156372/psychedelics-chronic-pain-cluster-headache-medicine-lsd-psilocybin">chronic pain</a>.&nbsp;</p>

<div class="wp-block-vox-media-highlight vox-media-highlight">
<h2 class="wp-block-heading">What went wrong?</h2>



<p class="has-text-align-none">Listen to Vox’s Haleema Shah chronicle the past, present, and future of MDMA in <a href="https://www.vox.com/today-explained-podcast/363903/mdma-medicine-ptsd-fda">this three-part audio series</a>.</p>



<blockquote class="tiktok-embed" cite="https://www.tiktok.com/@vox/video/7400858118915165470" data-video-id="7400858118915165470"> <section> <a target="_blank" title="@vox" href="https://www.tiktok.com/@vox?refer=embed" rel="noopener">@vox</a> MDMA is on the brink of becoming medicine in the US. Listen to &#034;Today, Explained&#034; for more. <a title="psychotherapy" target="_blank" href="https://www.tiktok.com/tag/psychotherapy?refer=embed" rel="noopener">#psychotherapy</a> <a title="therapy" target="_blank" href="https://www.tiktok.com/tag/therapy?refer=embed" rel="noopener">#therapy</a> <a title="ptsdawareness" target="_blank" href="https://www.tiktok.com/tag/ptsdawareness?refer=embed" rel="noopener">#ptsdawareness</a> <a title="ptsd" target="_blank" href="https://www.tiktok.com/tag/ptsd?refer=embed" rel="noopener">#ptsd</a> <a target="_blank" title="♬ original sound  - Vox" href="https://www.tiktok.com/music/original-sound-Vox-7400861422772603679?refer=embed" rel="noopener">♬ original sound  &#8211; Vox</a> </section> </blockquote> 
</div>

<p class="has-text-align-none">That momentum — which has grown <a href="https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2795948">rapidly</a> in recent years —&nbsp;<a href="https://theintercept.com/2022/07/26/mdma-psilocybin-fda-ptsd/">was widely expected</a> to culminate in the FDA’s approval of MDMA therapy this summer, which would have allowed health care professionals to prescribe supervised MDMA therapy sessions to people with PTSD. Until things went sideways.</p>

<p class="has-text-align-none">Instead, the FDA declined to approve the new treatment submitted by <a href="https://lykospbc.com/about-us/mental-health-trailblazers/">Lykos Therapeutics</a>, an organization that develops innovations to “transform mental healthcare,” according to a <a href="https://news.lykospbc.com/2024-08-09-Lykos-Therapeutics-Announces-Complete-Response-Letter-for-Midomafetamine-Capsules-for-PTSD">statement published by Lykos</a>. </p>

<p class="has-text-align-none">The FDA is requesting Lykos conduct an additional Phase 3 study, as the agency couldn’t approve the treatment “based on data submitted to date.” In addition, piling on the drama, the day after the FDA’s decision, the journal <em>Psychopharmacology</em> <a href="https://www.statnews.com/2024/08/11/mdma-ptsd-lykos-maps-retractions/">retracted</a> three studies on MDMA therapy that had been organized by Lykos. The retraction letter cites ethical misconduct at a research site that was <a href="https://maps.org/2019/05/24/statement-public-announcement-of-ethical-violation-by-former-maps-sponsored-investigators/">reported</a> to the FDA and in a public statement in 2019, but not to the journal in particular.   </p>

<p class="has-text-align-none">The decision will have far-reaching ripple effects. Some psychedelic advocates will have to put celebrations they’ve been planning for decades on pause; others will rejoice at dodging the bullet of Lykos’s spiritually inflected <a href="https://www.vox.com/future-perfect/355687/fda-mdma-therapy-maps-lykos-cult">therapy protocol</a> being the one that breaks the dam of psychedelic treatment. The millions of Americans suffering from PTSD will have to wait for a reformulated attempt at MDMA therapy to pass. And the broader momentum of the psychedelic revival will continue teetering on the edge of mainstream acceptance.</p>

<p class="has-text-align-none">Overall, though, the decision amounts to more of a delay than a death blow to psychedelic therapy.&nbsp;</p>

<h2 class="wp-block-heading has-text-align-none">The last-minute drama that derailed Lykos’s MDMA therapy, briefly explained</h2>

<p class="has-text-align-none">Lykos Therapeutics <a href="https://news.lykospbc.com/2024-02-09-Lykos-Therapeutics-Announces-FDA-Acceptance-and-Priority-Review-of-New-Drug-Application-for-MDMA-Assisted-Therapy-for-PTSD">received</a> priority review from the FDA back in February, which <a href="https://www.fda.gov/patients/fast-track-breakthrough-therapy-accelerated-approval-priority-review/priority-review">fast-tracked</a> the potential treatment for a decision within six months. Even the Biden administration was <a href="https://theintercept.com/2022/07/26/mdma-psilocybin-fda-ptsd/">anticipating</a> its approval. If accepted, Lykos’s application would have likely only gained approval for their <a href="https://pubs.acs.org/doi/10.1021/acsomega.1c05520?ref=pdf">proprietary formulation</a> of MDMA, not the illicit form of the drug that’s currently considered a <a href="https://www.dea.gov/drug-information/drug-scheduling#:~:text=Schedule%20I%20drugs%2C%20substances%2C%20or,)%2C%20methaqualone%2C%20and%20peyote.">Schedule I substance</a>. That means Lykos’s version of MDMA could have been used in prescribed treatment environments, but general MDMA, or “ecstasy,” would remain illegal outside of medical environments.</p>

<p class="has-text-align-none">Still, even approval of a pharmaceutical product including MDMA would solidify the idea that MDMA — a drug that carries <a href="https://newyorklegaldefense.com/practice-areas/new-york-drug-crime-lawyers/ecstasy-charges/#:~:text=An%20arrest%20for%20possession%20of,offender%20could%20face%209%20years.">federal penalties</a> of up to three years in jail and a $5,000 fine — can be a real medicine, challenging its designation as having “no currently accepted medical use” by the Drug Enforcement Administration. So FDA approval wouldn’t spell the end of the psychedelic prohibition that began in 1970, but it would provide ammunition for broader efforts to reschedule psychedelics and expand access.&nbsp;</p>

<p class="has-text-align-none">But the optimism around approval began to sour in late March, when the Institute for Clinical and Economic Review (ICER), a nonprofit that evaluates evidence for health care interventions, published a <a href="https://icer.org/news-insights/press-releases/icer-releases-draft-evidence-report-on-treatment-for-post-traumatic-stress-disorder/">report</a> that called Lykos’s clinical trial design into question. They also shared concerns about unreported adverse events and <a href="https://www.statnews.com/2024/07/19/mdma-for-ptsd-fda-concerned-lykos-clinical-trial-misconduct-claims/">ethical misconduct</a> by therapists during treatment sessions.&nbsp;</p>

<p class="has-text-align-none">Those concerns reached a crescendo during <a href="https://www.vox.com/future-perfect/353752/mdma-fda-approval-hearing-lykos-blinding-misconduct-allegations">an FDA advisory committee meeting</a> on June 4, where a panel of independent experts convened to review Lykos’s evidence and advise the FDA on its ultimate decision. During the nine-hour meeting, panelists expressed significant misgivings about the clinical trial designs, focusing on how difficult it is to <a href="https://www.theatlantic.com/health/archive/2024/06/psychedelics-mdma-ptsd-fda-placebo/678588/">establish placebo controls</a> in psychedelic studies. By “blinding” people as to whether they received the active drug or an inactive placebo, they help prevent people’s expectations from biasing their response to treatment, isolating the effects of the drug. But&nbsp;people tend to know whether or not they’ve taken MDMA or magic mushrooms pretty quickly.&nbsp;</p>

<p class="has-text-align-none">Concerns around failed placebo controls, or “functional unblinding,” <a href="https://www.theatlantic.com/health/archive/2024/06/psychedelics-mdma-ptsd-fda-placebo/678588/">are not unique</a> to psychedelic science. But the advisory committee felt these issues cast significant doubt across the positive findings. Beyond the concerns with study design, three members of <a href="https://www.psymposia.com/">Psymposia</a>, a non-profit research and media organization that focuses on psychedelic science and harm reduction, went so far as to <a href="https://www.vox.com/future-perfect/355687/fda-mdma-therapy-maps-lykos-cult">accuse Lykos of being a “therapy cult”</a> bent on furthering mystical and utopian goals. Ultimately, the advisory committee voted almost unanimously that there was insufficient evidence to support the treatment, and that the benefits do not outweigh the risks.</p>

<p class="has-text-align-none">Despite the criticisms, experts <a href="https://themicrodose.substack.com/p/the-psychedelics-world-reacts-to">across the psychedelics world</a> felt that the functional unblinding issues that concerned the advisory committee had already been discussed in detail by the FDA and Lykos when they <a href="https://news.lykospbc.com/2024-06-13-Lykos-Therapeutics-Statement-on-FDA-Advisory-Committee-Meeting">collaborated</a> on the Phase 3 trial design back in 2017. That included the FDA <a href="https://maps.org/news/media/press-release-fda-grants-breakthrough-therapy-designation-for-mdma-assisted-psychotherapy-for-ptsd-agrees-on-special-protocol-assessment-for-phase-3-trials/">signing off</a> on the methodology to handle placebo controls. The FDA typically follows advisory committee recommendations, but hopes remained that this time would be different.</p>

<p class="has-text-align-none">It was not.</p>

<h2 class="wp-block-heading has-text-align-none">How to (almost) turn MDMA into a legal therapy</h2>

<p class="has-text-align-none">Classical psychedelics like psilocybin and LSD were made illegal by the <a href="https://www.dea.gov/drug-information/csa">Controlled Substances Act</a> (CSA) in 1970. MDMA was <a href="https://www.nytimes.com/1985/06/01/us/us-will-ban-ecstasy-a-hallucinogenic-drug.html">added to the list</a> in 1985, shortly after it began <a href="https://www.theatlantic.com/health/archive/2013/09/electronic-dance-music-s-love-affair-with-ecstasy-a-history/279815/">spreading</a> across the electronic dance music scene. Drug Enforcement Administration (DEA) officials <a href="https://www.nytimes.com/1985/06/01/us/us-will-ban-ecstasy-a-hallucinogenic-drug.html">felt</a> that MDMA abuse had become a nationwide problem.&nbsp;&nbsp;&nbsp;&nbsp;</p>

<p class="has-text-align-none">Banning MDMA triggered Rick Doblin, a 32-year-old doing informal psychedelics research, to found <a href="https://maps.org/">MAPS</a> in 1986, the Multidisciplinary Association for Psychedelic Studies. He figured that even though it could take decades, the surest way to undo psychedelic prohibition was through FDA approval.</p>

<p class="has-text-align-none">MAPS began as a non-profit, but <a href="https://maps.org/news/bulletin/a-wholly-public-benefit-model/">launched</a> a separate for-profit arm in 2014, called the MAPS public benefit corporation. The corporation was dedicated to winning FDA approval for MDMA, and eventually, bringing it to market. In early 2024, the MAPS public benefit corporation <a href="https://psychedelicalpha.com/wp-content/uploads/2024/01/amy-emerson-ceo-letter.pdf">rebranded itself</a> as Lykos Therapeutics, largely because it was pretty awkward to have the original non-profit that still does drug decriminalization advocacy work share a name with a highly regulated for-profit pharmaceutical company focused only on medical treatments.&nbsp;</p>

<p class="has-text-align-none">Two major aspects of Lykos’s submitted treatment plan —&nbsp;using MDMA rather than other psychedelics, and focusing on PTSD rather than other conditions —&nbsp;were calculated decisions.&nbsp;</p>

<div class="wp-block-vox-media-highlight vox-media-highlight">
<h2 class="wp-block-heading">Read more about the mystery of psychedelics</h2>



<ul class="wp-block-list">
<li><a href="https://www.vox.com/future-perfect/355687/fda-mdma-therapy-maps-lykos-cult" data-type="link" data-id="https://www.vox.com/future-perfect/355687/fda-mdma-therapy-maps-lykos-cult">The biggest unknown in psychedelic therapy is not the psychedelics</a><br></li>



<li><a href="https://www.vox.com/future-perfect/23972716/psychedelics-meaning-science-psychedelic-mushrooms-ketamine-psilocybin-mysticism" data-type="link" data-id="https://www.vox.com/future-perfect/23972716/psychedelics-meaning-science-psychedelic-mushrooms-ketamine-psilocybin-mysticism">Why psychedelics produce some of the most meaningful experiences in people’s lives</a><br></li>



<li><a href="https://www.vox.com/future-perfect/2024/5/15/24156372/psychedelics-chronic-pain-cluster-headache-medicine-lsd-psilocybin">Psychedelics could treat some of the worst chronic pain in the world</a></li>
</ul>



<p class="has-text-align-none"><strong>Have questions, comments, or ideas? </strong>Email me: oshan.jarow@voxmedia.com. </p>
</div>

<p class="has-text-align-none">Today, PTSD affects about <a href="https://www.ptsd.va.gov/understand/common/common_adults.asp#:~:text=About%205%20out%20of%20every,some%20point%20in%20their%20life.">13 million</a> Americans, or 5 percent of the US population. It’s been <a href="https://psychiatryonline.org/doi/10.1176/appi.ajp.2017.17080955#:~:text=Pharmacotherapy%20for%20PTSD&amp;text=As%20a%20result%20of%20the,PTSD%20(51%2C%2052).">25 years</a> since the last FDA-approved treatments for the disorder: the antidepressants sertraline and paroxetine. But only about 60 percent of patients <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278188/">respond to treatment</a> at all, and just 20 to 30 percent shake the disorder altogether. The current <a href="https://www.ptsd.va.gov/professional/treat/txessentials/overview_therapy.asp">gold-standard treatment</a> is trauma-focused psychotherapy, where dropout rates <a href="https://pubmed.ncbi.nlm.nih.gov/32284816/">are high</a>, and many patients still retain their symptoms <a href="https://jamanetwork.com/journals/jama/article-abstract/2422548">after treatment</a>. Veteran organizations like the Department of Veterans Affairs have been <a href="https://theintercept.com/2024/05/20/va-veterans-mdma-ptsd/">looking to MDMA therapy</a> to help treat PTSD and stem the growing <a href="https://www.militarytimes.com/veterans/2022/09/17/veterans-suicide-rate-may-be-double-federal-estimates-study-suggests/">suicide crisis</a> among veterans, creating an opportunity for politicians across the aisle to <a href="https://theintercept.com/2022/07/14/ptsd-psychedelic-therapy-research-congress/">work together</a> toward approval.&nbsp;&nbsp;&nbsp;&nbsp;</p>

<p class="has-text-align-none">“We had to choose which psychedelic and which patient population would be most likely to be successful from a political perspective,” Doblin <a href="https://www.bostonmagazine.com/health/2019/09/10/rick-doblin/">told Boston Magazine</a> in 2019. “We don’t really do science; we do political science.”</p>

<p class="has-text-align-none">While MDMA does pose some physiological risks that classical psychedelics don’t, like <a href="https://www.healthline.com/health/substance-use/mdma-effects-on-heart">raising</a> heart rates and blood pressure, the actual subjective experience of being on MDMA is generally euphoric. MDMA helps release a slew of neurotransmitters, like serotonin (<a href="https://my.clevelandclinic.org/health/articles/22572-serotonin">dubbed</a> the “feel-good hormone”) and oxytocin (“<a href="https://www.health.harvard.edu/mind-and-mood/oxytocin-the-love-hormone">the love hormone</a>”). The rush of positive feelings has always made MDMA a popular club drug. But paired with psychotherapy, MDMA can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7046795/">boost tolerance</a> to traumatic memories by dialing down the mind’s tendency to avoid them, opening a window to <a href="https://www.sciencedirect.com/science/article/pii/S0278584617308655">reconsolidate memories</a> that hold fear.&nbsp;</p>

<p class="has-text-align-none">Meanwhile, tripping on the “classical psychedelics” — psilocybin, LSD, DMT, or mescaline — runs a much wider spectrum of possible experiences. Varieties of euphoria are <a href="https://www.sciencedirect.com/science/article/abs/pii/S2451902224000843">still common</a>. But slipping into a <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0293349">long</a> and <a href="https://bulletin.hds.harvard.edu/a-theological-reckoning-with-bad-trips/">hellish nightmare</a>, like an existential thorn in your grip on the world that never dislodges, can happen too, even if only in rare cases. <a href="https://www.vox.com/future-perfect/23954347/psychedelics-bad-trips-ketamine-mdma-psilocybin-lsd-risks">Bad trips</a> are comparatively less of a concern with MDMA, and therefore can pose less of a public health risk.</p>

<p class="has-text-align-none">By itself, MDMA does not, however, guarantee a good time. Since it can kick up painful memories we normally avoid, MDMA is not immune to bad trips. That’s why Lykos insists on pairing MDMA with therapists who can help support people through difficult experiences, especially in vulnerable populations suffering from depression or PTSD.</p>

<p class="has-text-align-none">Having attending therapists is definitely a good harm-reduction strategy. But they can’t fully eliminate the risks, either. At least one participant in MAPS’s studies reported an increase in suicidal ideation after their treatment sessions, and <a href="https://www.statnews.com/2024/05/24/mdma-treatment-ptsd-fda-asked-to-probe-adverse-events/">some controversy has erupted</a> around why that didn’t show up in the published results. And since MDMA can make people <a href="https://www.jneurosci.org/content/39/2/307">more suggestible</a>, the safety and efficacy of the actual therapy protocols are <a href="https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2802941">just as important</a> as the drug itself.</p>

<p class="has-text-align-none">But as the former director of the National Institute of Mental Health, Thomas Insel, <a href="https://www.statnews.com/2024/07/25/fda-mdma-ptsd-ruling-shows-need-for-psychotherapy-drug-combined-approval/">recently wrote</a>, “the U.S. regulatory system is not optimized for mental health care,” precisely because we lack a federal agency charged with reviewing the safety and efficacy of psychological interventions, like MDMA’s companion therapy. So MAPS developed <a href="https://maps.org/mdma/mdma-resources/treatment-manual-mdma-assisted-psychotherapy-for-ptsd/">its own therapy protocol</a>, and held it constant throughout its trials to try and isolate the drug effects, which are technically the only part of this treatment the FDA actually regulates.</p>

<p class="has-text-align-none">MAPS ran two Phase 3 clinical trials, each turning up pretty positive results. The <a href="https://www.nature.com/articles/s41591-021-01336-3">first trial</a>, published in 2021, found that MDMA therapy successfully treated 67 percent of participants, reducing their symptoms to the point where they no longer met the criteria for PTSD. In the placebo group, that number was 32 percent. The <a href="https://www.nature.com/articles/s41591-023-02565-4">second trial</a>, published in 2023, found similar results: 71 percent from the treatment group no longer met PTSD criteria, compared to 48 percent from the placebo group. (Note, however, that even though people likely knew when they were in the placebo group, which just received drug-free psychotherapy, they hit impressive <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0062599">treatment rates</a>.)</p>

<p class="has-text-align-none">While the FDA declined to approve Lykos’s new drug application today, organizations developing similar treatments are <a href="https://psychedelicalpha.com/data/psychedelic-drug-development-tracker">close behind.</a> And even among those who’ve advised against approving MDMA therapy, there’s <a href="https://www.vox.com/future-perfect/353752/mdma-fda-approval-hearing-lykos-blinding-misconduct-allegations">a sentiment</a> that it should <em>eventually</em> get approved. Just not yet, and not like this.</p>

<p class="has-text-align-none">“I don’t think we’re quite there yet,” said Kim Witczak, a consumer representative who voted against MDMA therapy during the advisory committee meeting. In an <a href="https://www.bbc.com/future/article/20240620-fda-advisors-voted-against-mdma-therapy-researchers-are-still-fighting-for-it">email</a> to the BBC, she added: “The time to be cautious is now, not afterwards.”</p>

<h2 class="wp-block-heading has-text-align-none">What happens next</h2>

<p class="has-text-align-none">In a <a href="https://news.lykospbc.com/2024-08-09-Lykos-Therapeutics-Announces-Complete-Response-Letter-for-Midomafetamine-Capsules-for-PTSD">press release</a> Friday, Lykos announced receipt of a complete response letter (CRL) from the FDA, which includes details as to why the agency declined to approve the treatment. The letter isn’t available to the public, but Lykos states that the letter echoes many of the same concerns that were raised in the June 4 advisory meeting, and requests an additional Phase 3 clinical trial to study safety and efficacy. Lykos will request a meeting to ask the agency to reconsider, but if they don’t, another trial “would take several years,” the company writes.</p>

<p class="has-text-align-none">“The FDA request for another study is deeply disappointing, not just for all those who dedicated their lives to this pioneering effort, but principally for the millions of Americans with PTSD, along with their loved ones, who have not seen any new treatment options in over two decades,” said Amy Emerson, CEO of Lykos. “While conducting another Phase 3 study would take several years, we still maintain that many of the requests that had been previously discussed with the FDA and raised at the Advisory Committee meeting can be addressed with existing data, post-approval requirements or through reference to the scientific literature.”</p>

<p class="has-text-align-none">But then, the next day, the journal <em>Psychopharmacology</em> <a href="https://link.springer.com/article/10.1007/s00213-024-06665-y">retracted</a> three studies on MDMA therapy funded by MAPS and organized by Lykos, citing protocol violations and unethical conduct during Phase 2 trials at a particular study site in Canada. A number of authors on the papers were affiliated with either MAPS or Lykos.</p>

<p class="has-text-align-none">At the “MP4” study site in Vancouver, a therapist treating participants on MDMA during the trial <a href="https://qz.com/1809184/psychedelic-therapy-has-a-sexual-abuse-problem-3">entered into a sexual relationship</a> with a participant after the dosing sessions had ended, but while still providing treatment. The participant later <a href="https://www.statnews.com/2024/08/11/mdma-ptsd-lykos-maps-retractions/">sued the unlicensed therapist</a> for alleged sexual assault in civil court (the case was later <a href="https://cms.qz.com/wp-content/uploads/2020/02/23-court-dismissed.pdf?_gl=1*1dceqsv*_ga*MTg0ODAyMjY2NS4xNzIzNDk3MzY2*_ga_V4QNJTT5L0*MTcyMzU1ODA5Mi4yLjEuMTcyMzU1OTQxOS42MC4wLjA.">dismissed</a>). Shortly after the allegations went <a href="https://maps.org/2019/05/24/statement-public-announcement-of-ethical-violation-by-former-maps-sponsored-investigators/">public</a>, MAPS <a href="https://maps.org/2019/05/24/statement-public-announcement-of-ethical-violation-by-former-maps-sponsored-investigators/">submitted reports</a> about the incident to the FDA, cut ties with the therapist, and incorporated a new code of ethics that explicitly forbids sexual contact between patients and therapists in their training program.<strong> </strong></p>

<p class="has-text-align-none">The retractions don’t affect the Phase 3 trial results that Lykos’s submission to the FDA rested on. But they do contribute to rising skepticism around the strength of MAPS’s data and conduct. While MAPS reported the incident to the FDA in 2019, they didn’t report directly to <em>Psychopharmacology</em> that data gathered from the site of the incident was included in their papers. Some authors disagree with the retraction and feel a correction that gave updated results without including data from that particular site would have been appropriate. </p>

<p class="has-text-align-none">Overall, while no new details about the incident that went public in 2019 have come to light, the timing of the retraction does add to a growing cloud of concerns around whether the internal <a href="https://www.businessinsider.com/mdma-therapy-maps-lykos-rick-doblin-fda-legalization-trials-2024-5">culture of evangelism</a> at MAPS creates tension with high standards of scientific integrity.</p>

<p class="has-text-align-none">Whatever happens next with Lykos,<strong> </strong>other companies are moving toward their own new drug applications. One of the <a href="https://psychedelicalpha.com/news/late-stage-psychedelic-trials-a-brief-review-of-the-two-most-mature-psychedelic-drug-development-programs">most likely</a> next applicants, the biotech company Compass Pathways, is pairing psilocybin with “psychological support,” which looks like a more hands-off version of Lykos’s approach to therapy. Meanwhile, states can continue passing <a href="https://www.vox.com/future-perfect/360200/how-to-buy-psychedelics-lsd-shrooms-stores">a variety of legislations</a>, from decriminalization to legalizing supervised <a href="https://www.nytimes.com/2023/01/03/health/psychedelic-drugs-mushrooms-oregon.html">adult use models</a>, like Oregon’s approach.&nbsp;&nbsp;&nbsp;</p>

<p class="has-text-align-none">Alongside state legislation, psychedelic research in academia will continue its expansion from medical applications, <a href="https://www.vox.com/future-perfect/23972716/psychedelics-meaning-science-psychedelic-mushrooms-ketamine-psilocybin-mysticism">consciousness science</a>, all the way out to <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2023.1082933/full">humanities scholars</a>. Religious groups can continue seeking legal exemptions for their use of <a href="https://www.nytimes.com/2024/05/12/us/psychedelic-drugs-church-religion.html">psychedelics as sacraments</a>. And the psychedelic underground will continue providing access (for both better and worse) to those who manage to find it.</p>

<p class="has-text-align-none">The decision will likely put a dent in the valuation of some psychedelic start-ups, and bring on a wave of skeptical press. But Lykos’s failure may actually increase the odds that subsequent psychedelic treatments pass the FDA approval process. Applicants now know where the FDA is going to focus, and how to strengthen their applications in response.</p>

<p class="has-text-align-none">Both <a href="https://clinicaltrials.gov/study/NCT05624268">Compass Pathways</a> and the nonprofit <a href="https://clinicaltrials.gov/study/NCT06308653?term=NCT06308653&amp;ra=">Usona Institute</a> have Phase 3 clinical trials — the last step before putting together a new drug application for FDA consideration&nbsp;— underway for psilocybin as a treatment for depression. And a <a href="https://psychedelicalpha.com/data/psychedelic-drug-development-tracker">very long list</a> of organizations have Phase 2 trials ongoing for psychedelics ranging from LSD to 5-MeO-DMT (<a href="https://www.nytimes.com/2022/03/20/us/toad-venom-psychedelic.html">found</a> in the poisonous secretions of a Sonoran Desert toad). More are on the horizon.</p>

<p class="has-text-align-none">So the prospects for psychedelic therapy remain good, if a little frazzled. But at the same time, FDA approval of a pharmaceutical product that can exclusively be used in medical settings will not put an end to the psychedelic prohibition. At least, not in the way that many advocates have been hoping for decades.</p>

<iframe frameborder="0" height="200" src="https://playlist.megaphone.fm/?e=VMP9852302001" width="100%"></iframe>

<p class="has-text-align-none">When Doblin founded MAPS in 1986, Lykos’s ancestor, the idea wasn’t just to eventually produce a new type of prescribable therapy. As journalist Anna Silman recently <a href="https://www.businessinsider.com/mdma-therapy-maps-lykos-rick-doblin-fda-legalization-trials-2024-5">reported</a>, Doblin envisioned MAPS as a Trojan horse to rekindle the psychedelic renaissance that <a href="https://www.independent.co.uk/independentpremium/long-reads/optimism-hippies-sixties-history-hollywood-zen-a9156511.html">crashed and burned</a> in the 1960s by routing it through the FDA. Once approved as a medicine, psychedelics could rise from the underground into mainstream acceptance, opening the door for expanded access outside of a doctor’s office.&nbsp;</p>

<p class="has-text-align-none">But some critics have long <a href="https://www.vox.com/future-perfect/23721486/ketamine-dmt-lsd-psychedelics-magic-mushrooms-legalization-recreation-psilocybin">been wary of medicalization</a> as the best path toward an equitable psychedelic revival that ever escapes the medical ambit to make the most of their diverse potentials. Psychedelics —&nbsp;used responsibly — can contribute to our perennial <a href="https://www.vox.com/future-perfect/23972716/psychedelics-meaning-science-psychedelic-mushrooms-ketamine-psilocybin-mysticism">search for meaning</a>, scientific <a href="https://centerforminds.org/">innovation</a>, and even <a href="https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2023.1082933/full">expanding</a> our cultural imagination. But those aspects will be undermined if psychedelics get stuck as medicines, and medicines alone.</p>

<p class="has-text-align-none">For a true psychedelic renaissance to kick in, they need to be removed from Schedule I of the Controlled Substances Act. FDA approval is one strategy that could support that process, while treating people in significant need along the way. We’ll see if the next application gets enough escape velocity to not only clear FDA approval, but the medical establishment altogether.</p>

<p class="has-text-align-none"><em><strong>Update, August 13, 11:36 am:</strong> This story has been updated multiple times, most recently to include details of </em>Psychopharmacology<em>’s retraction of three MAPS-funded papers. </em></p>
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