14 ms·

Beyond the importance of controlling the placebo effect, I am worried that a lot of the drug-depression research is overlooking an important possibility: that

• photonerd 3y ago
  If qualia are not different that our “neurological machinery” (and all available evidence shows this so far, not least the incoherence of definitions of qualia that try to exclude such) then medicine is already considering such as a major parameter. If they are different (and exist at all) then such needs to be demonstrated before they can be reliably considered. Given even proponents of qualia can’t reliably agree with each on what they even are defined as (other than using vague circular reasoning)… frankly, I’m not holding my breath.
  • lukasb 3y ago
    The way I would rephrase OP is "what is the most useful abstraction for the mechanism of action of these drugs". It might be that limiting yourself to neurological phenomena gives you a much longer, more unwieldy model of what's happening here than an equally predictive model that centers on subjective experience.
    • omginternets 3y ago
      Nit: my feelings are closer to "we are ignoring one of possibly many useful abstractions", but otherwise yes. If I'm being pedantic here, it's that I really don't want to downplay the importance of the pharmacological level of analysis. It's a very useful analysis. It's just not a complete theory of life well-lived.
      • photonerd 3y ago
        We’re not ignoring them. We’re patiently waiting for them to be proven to exist & have a demonstrable mechanism of action. Believe me, I’d be the first to suggest they be considered if we had that. We don’t. It would be great if we did. Until then it’s not medicine, it’s shamanism.
    • photonerd 3y ago
      > limiting yourself to neurological phenomena I’m fine with including other phenomena. As I said in my original comment though: those phenomena need to be demonstrated to exist, first. Until then it’s absolutely unscientific, and medically unsound, to assume they exist & then hope that they magically work. Because that is not science: that’s quackery.
  • omginternets 3y ago
    >If qualia are not different that our “neurological machinery” (and all available evidence shows this so far, not least the incoherence of definitions of qualia that try to exclude such) then medicine is already considering such as a major parameter. No, they are definitely not. I don't see anything in these studies to the effect of "hey, it's the feeling that they feel that's making them better". They're looking for some mysterious mechanism, usually on the cellular or molecular level, whereas "numen" and "transcendence" are not even on the biological level of analysis.
• dv_dt 3y ago
  Another issue is the variability of depression as a diagnosis itself. An admittedly anecdotal set of my encounters with people who take or have taken anti-depressants is most are on changing set of prescriptions because nothing works continuously and a high percentage of them are ones which no anti-depressant drug worked and were fixed by a different diagnoses for something like adhd. How does one evaluate if a new drug works vs depression when there isn’t a consistent diagnosis or presentation of the symptoms.
  • omginternets 3y ago
    Yes, agreed! I think I could even formulate a cogent argument for why the diagnostic variability is itself a result of ignoring qualia, but the last comment has drained me of energy for the day ^^
  • NickM 3y ago
    An admittedly anecdotal set of my encounters with people who take or have taken anti-depressants is most are on changing set of prescriptions because nothing works continuously and a high percentage of them are ones which no anti-depressant drug worked and were fixed by a different diagnoses for something like adhd. An alternative explanation for this is that if you keep giving people different drugs and different diagnoses eventually they will feel better for unrelated reasons and will assume the current diagnosis/drug combo is what “fixed” them.
    • dv_dt 3y ago
      Well except the changing of drugs is usually because they are not feeling better or are feeling worse.
      • NickM 3y ago
        Well sure, but I don't see how that contradicts anything I said.
        • dv_dt 3y ago
• JohnMakin 3y ago
  It can also be harmful. I know someone who went through this treatment, they had an out of body/ego death experience, and were convinced that's what death felt like, and they really liked it. They had a suicide attempt just a few days later. It isn't the type of treatment one tries unless they've exhausted all other options. It's saddening to hear a lot of depression treatments seem largely reliant on placebo effect - for someone with decades of dysthmia, it's really disheartening to hear.
  • teaearlgraycold 3y ago
    That sounds terrible. It really sounds like they were already pretty far gone. I was able to get help with my depression from magic mushrooms, but it was at most a moderate case.
    • xvedejas 3y ago
      I'll just add myself as a case where a mild amount of psychedelic drug use led to a mild amount of depression. Strictly negative for me, even if not profoundly negative. I'm mostly fine now, years later, but I feel possibly permanently slightly worse in mood. I am not now nor have ever been "far gone".
    • bowsamic 3y ago
      LSD was negative for me. It basically made me realise that suicide was an option, and I struggled to stop thinking about it, even now
      • teaearlgraycold 3y ago
        LSD was also bad for me. Just made me feel anxious and self-conscious. Sorry to hear it’s been so difficult for you.
  • omginternets 3y ago
    Sorry, what can be harmful exactly? The experience of drugs? I completely agree. A corollary of my position is that you should be able to fix a fair bit of depression by providing non-pharmacological access to transcendent experience. The drug is then a (very potent and correspondingly sharp) tool among others.
• cooper_ganglia 3y ago
  >I can't really object to rationality on its own, but it may be worth considering non-rational, transcendent experience as a fundamental psychological need. I couldn't agree more, you've made really great points that allowed me to reflect on my own approach to my mental wellbeing. I honestly needed to see this comment right now. Thank you!
  • omginternets 3y ago
    I couldn't be happier! Do me a favor: help me preach the good word that philosophy is an important and practical subject! :) If you want me to really tickle your noodle, consider that a lot of modern-day issues stem from a quest for transcendence in a society that has largely dismantled the institutions capable of delivering it. In particular, I am of the (somewhat provocative) opinion that things like radical Islamic terrorism, fringe climate activism, and the more virulent brands of third-wave feminism are all, at their core, performative quests for such transcendence. But that's all secondary to the fact that I am glad my comment is helpful to you on a personal level :)
    • okwhateverdude 3y ago
      > In particular, I am of the (somewhat provocative) opinion that things like radical Islamic terrorism, fringe climate activism, and the more virulent brands of third-wave feminism are all, at their core, performative quests for such transcendence. Interesting thought. If you have a blog, I'd like to read more.
    • Fluorescence 3y ago
      > at their core, performative quests for such transcendence That sounds like a middlebrow dismissal of what these groups are. I think you can describe them with more tangible psychological/philosophical motivations which I don't find useful to describe as "transcendence" e.g. - belonging : the appeal of the gang, the cult is to find acceptance, your tribe, your family. If life has thrown you to the curb and vulnerable, such organisations will take you in. - guru syndrome : the search for a paternal figure to structure and make sense of the world, to surrender to, to love, to give devotion, to follow, no matter the path - meaning : a thirst, an existential emptiness, a desperation for life to have a purpose, any purpose - rationality : extreme groups are often fighting a real injustice and the tactics often have reasoned philosophical basis - we may not like them, may consider them immoral, but they are often more deeply thoughtful than who they fight - emotion : the injustices are often personally experienced by their adherents, they are angry, they may seek not just redress but revenge, it's a cause which attracts them as a moth to a flame - stimulation : the dreary day to day, the monotony vs. the thrill of action, the fight or in some cases straight-up sociopathic indulgence
• b33j0r 3y ago
  Agree. I have heard stories of people who “had one treatment and never smoked/put their elbows on the dinner table ever again.” My experiences seemed to benefit more from watching David Attenborough and feeling a connection to life. I’d interpret the dad of a family of mountain lions as an analogue of my dad, etc. Seeing events as taking place in a dissociated context. All that introspection is what I found useful about Ketamine. Yeah, sounds silly. But it made me a happier person. To my understanding and experience, these function more to temporarily remove neurological filters than really add much new (same with LSD, etc). Maybe that benefit is “subjective,” but what’s the difference to me, years later?
  • omginternets 3y ago
    >Yeah, sounds silly. It only sounds silly to our modern sensibilities, which I am increasingly considering regressive on the specific question of "what is a life well-lived". To a pre-modern society that considers e.g. dreams to be vehicles of important meaning, religiousity to be a good thing in measure, idle time to be a gift and introspection to be one of the major points of existence, it doesn't sound silly at all. It sounds wise. I'm a scientist by training and an engineer by trade, but as an empiricist, I am forced to admit that my life has gotten better by making room for the irrational, superstitious, obliquely-associative, self-contradictory omginternets to exist. Make of that what you will ;)
  • pard68 3y ago
    That's not silly at all. Like the other guy who posted, connecting back to "life" is pretty important. My family committed to this at a very extreme level in 2020 and we fulfilled it in April 2021. Our lives have been changed for the better in so many ways!
    • whoisburbansky 3y ago
      Wait are y'all the folks who moved together cross-country so you could be neighbors with your siblings?
      • 3y ago
• Waterluvian 3y ago
  A very fascinating thought to consider. Though I struggle not to be equally suspect than this is also just hopeful thinking.
  • omginternets 3y ago
    >Though I struggle not to be equally suspect than this is also just hopeful thinking. I think we all do. Certainly, I struggle with that as well. I think this is an inherent property of undecidable questions (contrary to most well-formed scientific theories, which are valuable precisely because they can distinguish themselves from hopeful thinking). Here's something to consider: some kind of hopeful thinking may be a fundamental psychological need. When I saw the title of this HN post, I had thought that perhaps this was the question that ketamine researchers were considering, but alas not.
    • Waterluvian 3y ago
      Now that is an idea that resonates with me. It feels like a slightly abstract application of “it’s the journey not the destination.”
      • omginternets 3y ago
        Something to throw into Google Translate, since we're talking about things that IMO are better described with poetry than analysis :) >Tout le monde veut être libre >Personne veut être seul >Pas d'ordre à donner ou à recevoir >Personne à faire rêver ou à décevoir >Ne rien n'attendre des autres, pas d'espoir...
• cpncrunch 3y ago
  Your comment seems to ignore the main point of the article: that the placebo group did actually have life-changing resolution of their depression symptoms.
  • omginternets 3y ago
    I'm not sure I see a contradiction. This is compatible with the established idea that you can have transcendent insight without drugs, and with the equally-established idea of suggestion as one of the principal mechanisms behind placebo effects. A cohort was put in a situation that facilitated reflection upon life in a closed setting; that's exactly what I'm suggesting is helpful. See also: "you're not anxious; you're distracted."
    • ctb9 3y ago
      Agreed, if anything this placebo finding supports your idea that the experience mediates the improvement more than the chemical itself. I once attended a talk by a neuroscientist at UCSF, Adam Gazzaley, that really helped me see what the future of medicine could look like if we appreciated the power of experience, and more importantly if we could measure and then alter said experience in a realtime closed-loop system. My takeaway was that one day we might think of blasting our synapses with SSRIs or Adderall similarly to civil war era surgeons...the bone saw does prevent gangrene, but in a such an inefficient way.
• acchow 3y ago
  Much of the benefit of psychedelics is the introspection, which you can do sober as well (although the depth of the reflection is magnified and qualitatively different while tripping). This is confirmed by the linked study (which shows that placebo-ketamine is also very effective).
  • alisson_dover 3y ago
    Many psychedelic-era personas expressed this sentiment as well: you don't need psychedelic drugs to reach that state, you could also spend 10 years practicing meditation daily. This view ignores the major application of these substances. Ketamine-induced self-therapy is accessible instantly and acts as a major reset. When you are experiencing long-term depression and/or anxiety, the advice to "just meditate" or do deep introspection is wildly counter-productive. Depressive state is very frequently accompanied by an unhealthy focus on the internal voice and on over-analyzing own life/motivations/purpose/etc. Having an "introspection session" in this state is a borderline dangerous advice.
    • omginternets 3y ago
      I just want to endorse this comment. Psychadelic drugs have a miraculous property: they elicit transcendent states reliably. Eat the mushroom and you will experience it. There are corresponding risks to this, of course, but that's the flip side of their utility as a (sharp) tool.
      • justatdotin 3y ago
        these tools allow exploration of not just introspection but also states that otherwise belong safely behind a closed door. Yes I might actually enjoy having countless shards of the universe's ideas slicing through my ego for a few hours at night over the weekend; no I never want that to experience that during a workday.
        • Muromec 3y ago
          Working is overrated and may be part of the problem of having depression in the first place. Maybe we are solving the wrong problem after all. Depression is a signal, it’s evolution whispering that life sucks in some major way. Throwing SSRI at problem silences this voice. But maybe it does and psychodelics fix that, instead of suppressing alerts indefinitely.
• tonnydourado 3y ago
  > that the thing about ketamine/psilocybin/etc that is helping with depression is not some latent property of the molecule, but rather the actual transcendent experience I thought the same thing when reading the article, but then I started to wonder how the fuck would you double blind that?
  • omginternets 3y ago
    Well, you wouldn't. It's largely a metaphysical stance rather than a scientific one[0], which I suspect is precisely why modern medicine is struggling to engage with it. [0] Mostly. Part of it falls under Dennett's notion of an intentional stance, but that requires us to take self-report seriously, and so precludes a number of experimental designs.
  • contrarian1234 3y ago
    give patients a strong sedative (or after a period of sleep deprivation) and administer the drug while they're asleep?
  • astrange 3y ago
    Could give them a psychoactive that's not reputed to help with depression. As long as they don't know what a trip looks like they won't know you gave them DMT when they're talking to the machine elves.
  • travisjungroth 3y ago
    You don’t. It’s fundamentally incompatible. But that’s fine. People are able to acquire knowledge in ways besides randomized, controlled, double-blind trials. Nearly all knowledge is acquired in some other way. I say this as someone who writes A/B testing software for a living.
• earljwagner 3y ago
  Tom Wolfe, in "Sorry, But Your Soul Just Died", Forbes Magazine, 1996 http://www.psy.vanderbilt.edu/courses/psy115w/Fall02/TomWolfe-SorryButYourSoul.htm http://www.psy.vanderbilt.edu/courses/psy115w/Fall02/TomWolf... Which brings us to the second most famous statement in all of modern philosophy: Nietzsche's "God is dead." The year was 1882. (The book was Die Frohliche Wissenschaft [ The Gay Science ].) Nietzsche said this was not a declaration of atheism, although he was in fact an atheist, but simply the news of an event. He called the death of God a "tremendous event," the greatest event of modern history. The news was that educated people no longer believed in God, as a result of the rise of rationalism and scientific thought, including Darwinism, over the preceding 250 years. But before you atheists run up your flags of triumph, he said, think of the implications. "The story I have to tell," wrote Nietzsche, "is the history of the next two centuries." He predicted (in Ecce Homo ) that the twentieth century would be a century of "wars such as have never happened on earth," wars catastrophic beyond all imagining. And why? Because human beings would no longer have a god to turn to, to absolve them of their guilt; but they would still be racked by guilt, since guilt is an impulse instilled in children when they are very young, before the age of reason. As a result, people would loathe not only one another but themselves. The blind and reassuring faith they formerly poured into their belief in God, said Nietzsche, they would now pour into a belief in barbaric nationalistic brotherhoods: "If the doctrines...of the lack of any cardinal distinction between man and animal, doctrines I consider true but deadly"--he says in an allusion to Darwinism in Untimely Meditations --"are hurled into the people for another generation...then nobody should be surprised when...brotherhoods with the aim of the robbery and exploitation of the non-brothers...will appear in the arena of the future... Nietzsche said that mankind would limp on through the twentieth century "on the mere pittance" of the old decaying God-based moral codes. But then, in the twenty-first, would come a period more dreadful than the great wars, a time of "the total eclipse of all values" (in The Will to Power ). This would also be a frantic period of "revaluation," in which people would try to find new systems of values to replace the osteoporotic skeletons of the old. But you will fail, he warned, because you cannot believe in moral codes without simultaneously believing in a god who points at you with his fearsome forefinger and says "Thou shalt" or "Thou shalt not."
  • deleted 3y ago
    [deleted]
• nullindividual 3y ago
  I find this... frustrating to read, at the least. This post assumes that all depression is a _lack_ of something external to the body. Or that depression is simply a chemical imbalance. It takes no accounting of physical deficiencies that can _never_ be cured and require a lifetime of maintenance, of which Ketamine can be (literally) lifesaving. The post is irresponsible. No one should be thinking that some sort of "transcendence" will solve their issue, or that is what their problem is. Always discuss treatment with a psychiatrist.
  • format997 3y ago
    I mean, I guess it depends on what the truth is. Clearly the two of you have very different perspectives on what the underlying cause of depression or mental illness is. If your view is incorrect, it could also be equally irresponsible, could it not?
  • Spivak 3y ago
    I feel like depression as a term is overloaded because it's a description of a symptom rather than a particular cause. If you're depressed because you have a chemical imbalance then you're a great candidate for SSRIs and the like. Serotonin? In this economy? If you're depressed because your life is miserable in some fashion then there's a lot of potential options but this sounds like what you're talking about with K as one treatment. If you're depressed, you don't respond to SSRIs and "my life is good, why am I still like this?" describes you I think the parent is saying that transcendence is potentially one treatment for this.
    • nullindividual 3y ago
      Depression comes in many forms, you're correct, including depression due to physical deformities in the brain. This would fall under the last category where some forms of depression can be made worse by SSRIs and SNRIs, though those classes of drugs are most commonly ineffective for any patient.
  • omginternets 3y ago
    Nothing I wrote is in opposition with psychiatric treatment.
• Aurornis 3y ago
  > I am worried that a lot of the drug-depression research is overlooking an important possibility: that the thing about ketamine/psilocybin/etc that is helping with depression is not some latent property of the molecule, but rather the actual transcendent experience of the trip. Ketamine dosed at levels used in a lot of the original depression studies won’t result in anything resembling a “trip”. Many of the more responsible clinics will carefully administer IV ketamine infusions over 40 minute (IIRC) spans at levels that only result in a little dizziness. The association between ketamine depression therapy and “tripping” is a more recent development, pushed partially by clinics and influencers seizing on the trend in the most dramatic way possible. Some of the clinics will now dose people with excessively high doses with the goal of inducing trips and overt experiences, even though this isn’t supported by the literature. I’m actually growing concerned that the pop-culture obsession with tripping and the over zealousness of ketamine providers is going to result in regulatory crackdown on the whole process. A few months ago I was discussing the topic with a psychiatrist friend. She had tried prescribing ketamine for several patients, optimistically. However, a number of them complained that it wasn’t enough because they weren’t having full on hallucinations like they had read about online or in books. Several of them also started trying to demand higher and very early refills, despite her explaining up front that she was only willing to follow the dosing protocols used in studies.
  • raydiatian 3y ago
    > at levels that only result in a little dizziness. Anecdotal first hand account, I would have to completely disagree with you. I tried intravenous ketamine therapy about a year ago. I’m plenty experienced with psychoactives, having experienced several at varying doses, so I knew what I was in for. My IVKT experience was a full on trip, definitely not just passive dizziness.
    • astrange 3y ago
      Is it possible that being an experienced tripper (psychonaut?) sensitizes you to new psychoactives?
      • 3y ago
• KptMarchewa 3y ago
  I am a materialist. I agree delusions are powerful mechanism against depression, but most of them, like religion, have awful side effects.
  • HKH2 3y ago
    Materialism has plenty of awful side effects like hubris, nihilism, and anti-natalism.
    • mistermann 3y ago
      ...perceptions of omniscience.
  • omginternets 3y ago
    The words you're saying aren't materialist so much as they are logical positivist. As it turns out, there are things that are both true but not provable (be it empirically or analytically).
    • KptMarchewa 3y ago
      Prove it.
      • omginternets 3y ago
        Spoken like a positivist. Here you go: https://plato.stanford.edu/entries/goedel-incompleteness/ https://plato.stanford.edu/entries/goedel-incompleteness/
• agumonkey 3y ago
  So you think the effects lie at the conceptual/existential plane of our brains rather than the neurobiological one?
  • vlunkr 3y ago
    Why not either? Or both?
  • omginternets 3y ago
    I don't think there's a neat distinction separating the two. Or, I could have just as well answered "both, but medicine is ignoring one".
    • agumonkey 3y ago
      Oh to me there's an easy one: - conceptual layer failure => asylum - neurobio layer failure => life support
      • omginternets 3y ago
        The people running the asylum reject that distinction, as do the people running the hospitals.
        • agumonkey 3y ago
          care to educate me further ?
• brotchie 3y ago
  Simple size of 1, but you're correct in how a heroic dose psilocybin trip completely cured my existential depression, to the extent I can't even relate to the struggles of my past self. It certainly FELT to be a property of the transcendent experience and not a biological side effect of the substance. Being blasted out into the infinite space of all possible chaotic realities but being able to successfully "crawl back" to THIS reality as an oasis / point of stability was a life changing experience. Although it was what you'd otherwise describe as a "bad trip", it flipped a switch in my brain from "existence is pointless" to "existence is a miracle." Haven't felt existential dread since.
  • RHSman2 3y ago
    If you’d had a crazy life experience that took you to the edge without said product, let’s say a full on mountaineering epic that bought close to the edge, would that remain in your consciousness and alter your being? Perhaps but data would suggest not or it has limited efficacy. There is something within these molecules that combine experiences and some change to alter awareness. And you don’t need to mountaineer
    • dr_dshiv 3y ago
      So the life changing nature of a cancer diagnosis relies on the “molecules” — or else it isn’t effective? I don’t understand.
    • lewispollard 3y ago
      I'm somewhat experienced in mountaineering and have done several dangerous trips that have been incredible and memorable experiences. I would say, firstly, yes they have had a positive impact on my mental health, I have less fear, and the memory of those expeditions make me happy. But, as someone who tripped a lot in their 20s, I would say that trip experiences are just an entirely different "level" of experience to conventional experiences. There's something inherently transcendent in the way psychedelics alter your perception and inner world that you can't experience by mountaineering or extreme sports or what have you. You could argue that it's down to the chemistry, which would be partially true, but I don't think it's entirely mechanical, it's the quality of the experience that's different. I have never been pulled into inner space to meet fantastic beings of light who told me everything was going to be fine during a scrambling experience, nor have I dissolved my experience like a mist into complete, transcendent emptiness and calm at the peak of a mountain. Mostly, I've just been cold, hungry and tired up there :)
• oldman_peter 3y ago
  > Fixing depression is not like fixing a car. it's like fixing the way you drive your car
• caturopath 3y ago
  > Importantly, this tracks with what we know about the protective effects of things like religiosity against depression I always took the mechanism to be community, that sort of thing. I guess if you're right we'd expect Pentacostals to be protected more than Lutherans, etc.? Do we have any idea what data is out there that might be able to disentangle this sort of question?
  • omginternets 3y ago
    I'm not sure I'd agree, at least not directly. Community is transcendence of self, and both Pentacostals and Lutherans concern themselves with questions of divine order. I'm not sure I see a significant difference between the two (for our purposes, at least).
• growingkittens 3y ago
  Do studies commonly take into account a history of trauma? In my experience with medical professionals, trauma is barely considered or outright ignored. Screening processes, when used, are ...generic. I notice that many transformational psychedelics stories involve some form of previous traumatic experience.
• j45 3y ago
  Relative to this article Perhaps being able to keep a perspective on hope and of hope for long enough is part of the shift, assisted by ingestion or not. Placebo as science is learning is relative. The body does literally change based on thought. A recent Huberman podcast literally stated the brain itself is a pharmacy and creates certain substances as triggered. Not implying it’s the same for everyone, but interesting nonetheless. If ketamine/shrooms push and hold a different perspective for long enough that it is difficult to unsee, unfeel or unexperience, that’s kind of interesting for sure .
• TotalCrackpot 3y ago
  Maybe you don't really have to "fix" depression, I am very nihilistic and I do just fine - I don't kill myself because I don't give a fuck enough to do that. Looks easy to me. We are just on a flying stone in the cosmos, we shouldn't really except anything out of this.
• louison11 3y ago
  For sure. In indigenous circles, the perception is often that science’s approach to psychedelics is quite ill-fitted because it seeks to separate the molecules from the non-physical essence of the medicines. What is called “set and setting” in the secular world, is called “sorcery” or “ceremony” for them. They understand the many transcendental layers opened by this medicine in a profound, intimate manner, and many of these traditions have developed, refined and passed down over generations intricate spiritual sciences meant to work with these unseen forces with the most grace possible. So, naturally when westerns come and want to isolate compounds and get rid of the ceremonial background because it’s “unscientific”, the only possible reaction is to put one’s hand in the face and think “here we go again, THIS too will be colonized.” This world has far many more dimensions than what modern science is able to address. And many of these plants/compounds open access to these dimensions. It’s really important I think that we have the humility to learn from the people who have worked with these medicines for a very long time. Context: I have apprenticed and studied very closely under various traditional lineages for the past few years.
  • e9 3y ago
    Where can we find more information or learn from you?
    • louison11 3y ago
      I feel flattered, thank you. I’m not sure what specific type of information you wish to learn. Most of what I have learned is passed down in person through the ceremonies. Usually people find these things when they are ready for them. It presents itself when the social circle becomes aligned. For me, the entrance was by getting closer to holistic circles (meditation, sound healing…) in the SF Bay Area. There are also more commercial offerings that can be found on platform like retreat.guru - but I’d always exercise more caution when working with people who advertise themselves. Always look for sincerity. Otherwise, I write about the relationship between technology and spirituality here: https://louison.substack.com/ https://louison.substack.com/ You may also get more information about traditional indigenous ceremonies/sorcery reading Carlos Castaneda, Ruiz or looking for other books in that category.
• xwowsersx 3y ago
  Excellent point and very well stated.
• colordrops 3y ago
  > In other words, the trip is the point, not the mechanistic neuro-tinkering Are you claiming that there is a soul? Becauae many posit that the brain and thus our experiences are made of matter and energy and as mechanistic as anything else.
  • LoganDark 3y ago
    Many people have the experience of what could be called a soul, even if what they are experiencing is not some hidden spiritual plane of the universe. Perhaps "soul" could be better defined as something inherent to one's experience, rather than some outside entity that grants life to a vessel.
  • omginternets 3y ago
    I believe I addressed the question of materialism vs dualism in my original comment?
    • colordrops 3y ago
      Did you edit the comment? I don't recall seeing the footnote before. In any case it was a rhetorical question to understand your reasoning, as I personally don't take a stance on whether a soul exists or not.
      • omginternets 3y ago
        I did a few days ago, yes. But yeah, fair point!
• Natsu 3y ago
  > but rather the actual transcendent experience of the trip I've seen the results ketamine can give first hand, and the dangers of it, but I'm more convinced it may just be getting proper sleep given the connection between sleep apnea and depression. I would bet that if they engineer a version that does not cause psychosis it will work just as well for the population it does work on. And we should not be quick to dismiss psychosis, it's a major risk factor for violence, something I have also seen first hand.
  • omginternets 3y ago
    To your point, I think that what you describe is also a common cause for depression. As Freud said (paraphrasing): most of my patient's aren't mentally ill, they just haven't learned how to live well. There is much to be said for the idea that psychological needs are (mostly) physiological needs like sleep, food, water and exercise. If we extend that to include social needs like love, security, a healthy sex life, stimulating conversation and adventure, we start to approach a notion of transcendence.
    • Natsu 3y ago
      In our case, I think sleep apnea is a cause. Tripping was never really happening and relief brought on by ketamine was never more than temporary. But it is true that ketamine can cure depression, at least for a time. It's effectiveness is not something you merely guess at like most meds, if it's working, it seems to simply get rid of the depression outright. So... definite potential and definite danger, though I think the trips are likely harmful, rather than being the benefit of it.
• raducu 3y ago
  >. Beyond the importance of controlling the placebo effect, I am worried that a lot of the drug-depression research is overlooking an important possibility: that the thing about ketamine/psilocybin/etc that is helping with depression is not some latent property of the molecule, but rather the actual transcendent experience of the trip. In other words, the trip is the point, not the mechanistic neuro-tinkering. I remember the first time I ever tried a benzodiazepine. I then realized I am anxious most times, that that default state is not ""normal" and that you can actually change it. And for brief periods of times I was able to re-create the effects of it at will. Also just having a xanax pill in my wallet cured my panic attacks. My hypothesis is that even "temporary" positive psychological experiences can have profound effects on the brain, show it there is a better state and in certain conditions the brain will figure a path. I don't know when I learnt to move my ears, twist my tongue sideways or when I self learnt "voluntary tubal opening", but without going into mumbo-jumbo, I think there's a lot more we can control about our brains and bodies than we think.
• scotty79 3y ago
  > but rather the actual transcendent experience of the trip As a materialist I think it's absurd. But I think that trip is sure sign that the substance actually does something to neurons. And in case of some substances like drugs if you reduce dosage or adjust protocol so that trip doesn't happen means that you also got rid of any significant effect it might have on the brain. In my opinion saying that experience of the trip healed me is a bit like saying that my experiencing of reduced immobility of walking in a cast made by bones fuse together and heal, mind is so powerful.
  • omginternets 3y ago
    >And in case of some substances like drugs if you reduce dosage or adjust protocol so that trip doesn't happen means that you also got rid of any significant effect it might have on the brain. We agree. My point is that the evidence seems to be going in the direction of: 1. removing transcendence removes part of the benefit; and, 2. to complicate matters, many protocols fail to properly control for transcendent experience because a lot of control groups are placed in a quiet room, free of distraction, and invited to ponder life. We're both materialists. Mine is a materialist position.
    • scotty79 3y ago
      > We're both materialists. Mine is a materialist position. I'm not quite sure about you because you are using words like transcendence. ;-) In my view the deep experience of the trip, what you call transcendence, is just another hallucination, just hallucination of meaning and understanding instead of simple images, sounds or sensations.
      • omginternets 3y ago
        Transcendence is a qualia of experience; it says nothing about whether an immaterial substance is required to experience it.
  • anon84873628 3y ago
    Yeah. Seems likely that the subjective experience of the trip is simply what you feel when firing/rewiring the networks that cause the healing. There's no incompatibly between "it's the experience" and "it's the neurology" because they are one in the same. But there are a lot of different ways to do the healing (e.g. consistent meditation as others mentioned) which will of course be coupled to different feelings/experiences. The "large psychedelic dose" method is just one end of the "works fast + feels strongly" spectrum. Of course as the science/technology develops we will find other points on the spectrum that balance the properties differently -- maybe even through placebo effect alone as suggested here.
• AlecSchueler 3y ago
  I think you could be right but I wouldn't worry about scientists trying to remove the trip aspect, as doing so in a clinical setting would be a good way to prove/disprove your hypothesis.
• spacecadet 3y ago
  Predicted? I doubt anything has changed since his time.
• varispeed 3y ago
  > In other words, the trip is the point, not the mechanistic neuro-tinkering It's bizarre that people would think any different of it? It's like therapy on steroids. It's an equivalent of scientist saying that eating an invoice for therapy doesn't get you "cured". Doh?
• deleted 3y ago
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• Errancer 3y ago
  I generally agree with you, but I would like to comment on the expression you used: "As a scientist, I can't really object to rationality on its own, but it may be worth considering non-rational, transcendent experience as a fundamental psychological need.". I think you would agree that if evaluations such as life-meaningfulness are secondary-properties or qualia like you said then arranging it as a debate between rationality vs irrationality is out of the picture. It is customary to consider various forms of mysticisms as opposed to rationality but it doesn't have to be the case as long as we properly define what is entailed by such experience. I suppose that the reason people might object to such idea is that they are implicitly committed to a form of positivism and they sense that if people can experience evaluations then the fact/value distinction is undermined. Therefore I think that while it is understandable what you mean when you use the term "rationality" as equated with positivism it would be good for the long term debate to separate those two, since I take it that people like us would like to have it both: science and a form of atheistic mysticism [0]. Ultimately the grand-father of rationality, Plato, was anything but a positivist. [0] I use the term mysticism mostly because I lack any better term. Evaluative intuitionism is probably the most correct technical term but it has historical roots which I dislike because it was constructed around the single intuition of what is Good, and I believe that we need a wider range of evaluative terms to adequately describe our experiences.
  • sitkack 3y ago
    Can one be a rationalist and still believe that, “the universe if fucking lit” and marvel at how wonderful it is? I believe being rational allows one to really experience the depth and breadth of the place we are in. Bleak utilitarianism is why so many reject applying themselves to a deeper understanding of the world, willfully ignorant in a way to manufacture wonder via a lack of comprehension. It starts early, with the sexist trope of Eve plucking an Apple from the tree of knowledge and getting us kicked out of the garden eden. Bullshit. I agree with the OP, the trip is the point. Travel, see the universe.
    • mistermann 3y ago
      > Can one be a rationalist and still believe that, “the universe if fucking lit” and marvel at how wonderful it is? I believe being rational allows one to really experience the depth and breadth of the place we are in. Based on observations of the Rationalist community over the years, I would say that it is possible as a rationalist, but not as a Rationalist, in that they tend to believe our knowledge of reality is limited to that which is endorsed by science.
• LoganDark 3y ago
  > it may be worth considering non-rational, transcendent experience as a fundamental psychological need. This speaks to me for sure... Ever since I was little, I've had trouble identifying with humanity. Even though I was born into this body, I never really identified with it, never really felt like that was "me". I wanted fantasy instead, I wanted to be a creature instead, something with fur and paws and a tail. It's gone far enough that I have DID and multiple such creatures live in my head with me. But I can't have it. I don't hallucinate. I don't even dream of creatures, not even daydreams. I only dream of humans. I only dream of reality. My dreams aren't an escape from anything, they are just more of the same. My imagination isn't an escape from anything, because it's not real. It doesn't look real, it doesn't feel real. It's just a tease. And this hurts. There is some sort of deep, existential pain that I feel whenever I am reminded of this. "Species dysphoria". If anyone had trouble understanding gender dysphoria before, boy do I have a concept for you. I don't know what is wrong with me. I don't know what caused me to dissociate from the body. It's supposed to be my body, it's supposed to be one with me, it's supposed to be me. I'm supposed to be comfortable in it, and it's supposed to be under my control. But it's not. It's not me, it's not comfortable, and it's not under my control. I blame some of it on autism and ADHD. Being autistic deprives me of control over the body, and ADHD deprives me of the ability to override that. But I also blame it on the lack of proper fantasy in my dreams. I think, that because my dreams have never truly been an escape from anything... that I'm missing something that I'm not supposed to be missing. In other words... "transcendent experience as a fundamental psychological need". And I haven't had any. I am incapable of it. I've tried writing stories. I've tried roleplaying. I've tried to make myself more comfortable in the body, through actual physical comfort, or from expression of this "otherkin" identity. But nothing seems to help. Nothing actually feels like it means anything. I'm just not getting it. I just feel trapped. Trapped in this body. Trapped in this reality. I don't know what to do about it. I don't know what I can do about it. I've tried LSD, tried ketamine. I like LSD, and still use it somewhat regularly. But it still doesn't do what I want, or what I need. It's a recreational activity for me, but it doesn't seem to help with anything deep inside. Stimulants like dexedrine used to help, but every time I try them after a couple months' break, they either barely help at all, or they help for a few weeks and then my tolerance skyrockets. The depression is the lack of any hope that this will ever change. The depression is this deep discomfort with myself, my body, my life... and the fear that it will be this way forever. That I will never get what I am seeking, and that I will never be able to fix what is broken inside, either. I've talked to doctors about this, I've talked to therapists about this. I'm getting a neuropsychological evaluation in a few months. I'm trying to help myself, I just don't know if there is anything left to try. The best I can do is get recognized. Any thoughts or suggestions would be appreciated, of course.
• Xenolato 3y ago
  Counterpoint: Religion has mechanism which force you to life with depression. See the notion that suicide is illegal/bad. Also most old people I know are religios and still are depressed. Religion overall has very little effect on people. How many are religios and still break all rules. Alone hating on other people, being racists etc.
  • omginternets 3y ago
    No objection. There are pathological cases of religiosity.
• theGnuMe 3y ago
  The simplest metaphysical thing to be amazed at is that we are all conscious and ascribe theory of mind. Be amazed. Also we are all connected evolutionarily as well and we evolved with other organisms so the whole planet is basically connected. That we have paleolific components of our brain and we can use meditation to calm them. All great stuff that doesn’t require the psychedelic. Also recognize that We are social animals so human connection is vitally important. I can regulate your behavior via mirror neurons. Religion is community at its heart.. but maybe we need an abstract idea of god to foster that community.
• frays 3y ago
  Very well written statement. > Importantly, this tracks with what we know about the protective effects of things like religiosity against depression. As such, the qualitative experience of the drug might not be something we can (or should) do away with. I would even go as far as suggesting that an absence of transcendence in one's life is precisely what causes a large segment of people to become depressed in the first place, and that perhaps drugs are helpful only insofar as they produce a transcendent experience. Fantastic point and so well written. As someone who experimented in my late teens/early 20s, I wholeheartedly agree with this. The experience changed me in a positive way and has helped make me who I am today.