A Discussion with Ernesto Londoño, Author of “Trippy: The Peril and Promise of Medicinal Psychedelics” – Psychedelic Alpha

Hardman: In the book, you mention that you came across Yale Medicine psychiatrist and psychedelic researcher Jordan Sloshower at your sister’s engagement party. Given that you came from a ‘just say no’ upbringing, did Sloshower’s interest and work in psychedelics change your opinion to the point where you sort of thought: OK, maybe this is something that I could try?

Londoño: He planted the seed in my head and I immediately recognised it as a really good story idea. I think I remember him especially saying that veterans were starting to go on these retreats. So when I went to Brazil it was one of the ideas that I had on my list of things to look into and to do, and I think that’s what may have sort of sparked my personal interest later on.

But yeah, I thought it was interesting that somebody of his calibre and expertise was really interested in the subject and I think that may have given me a little bit of licence to feel like this was something that was maybe not as crazy as you might think at face value.

Hardman: I think that’s also an interesting thread you pulled on there where you said, ‘I thought this could be a good story’, because throughout the book there’s this kind of tension between you having your own experiences—which seemed quite transformative for you—and then also following the story and reporting for this book. I remember one scene when you’re speaking with Ronan Levy of Field Trip and you said this will be ‘both a real therapeutic intervention and a journalistic exploration.’ What was that like? Deeply reporting the book whilst also participating? I think at one point you said it was like sleeping with one eye open.

Londoño: It was really hard. I think I underestimated how hard it would be when I started planning a year’s worth of reporting and mapped out the retreats and experiences I would document as a participant and at times merely as an observer.

I didn’t really grasp initially how hard it was going to be to both enter into that state of vulnerability and introspection that I think is the reward of putting yourself through these experiences, but also being kind of vigilant and attentive to what was happening around me and thinking: How is this going to work as a chapter in the book? Do I have a focus? Which individuals do I want to gravitate toward? Who may have the most interesting perspectives? Or, who may say something distinct from the rest of the material I’ve gathered?

It was exhausting, and I feel like I was always frustrated by the extent to which I was missing out on pieces of each experience. There was a part of me that wouldn’t completely surrender and enter into that state of tender introspection that I think happens when you’re on a retreat.

And there was the part of me that was also frustrated by just missing a lot of stuff that was going on around me because I was sleep-deprived and a little groggy! But at the end of the day I let myself off the hook and walked away both having gained a lot of personal insights, but also having recorded a lot of valuable material for the book.

Hardman: In the first retreat you attended, Spirit Vine, you seemed quite uptight not only around the drug side of the experience but also some of the exercises that the founder, Silvia Polivoy, was making you work through. She asked you to recall a childhood trauma, but your initial reaction was that you didn’t have any. You also said that you had weaned yourself off your blood pressure medications and replaced them with a garlic supplement ahead of the retreat. Then, when you first drank the brew you were sitting there thinking, ‘Is this what a stroke feels like?’ It’s very visceral, how you recounted that experience.

Throughout the book there are signs of physical safety concerns as well as ethical transgressions. Talk to me about these red flags and some of these safety issues you found on retreats, and whether your opinion of those changed as you wrote the book. I know… big question!

Londoño: I think there’s a pretty broad spectrum in terms of safeguards and the experience and integrity practitioners bring to this work. One of the big takeaways of the book is that in this era, to a great extent because of prohibition and the very messy history of drug laws and perceptions about drug use, we find ourselves in a world in which the most vulnerable people for whom this is appealing oftentimes find themselves in the care of guides or practitioners who have the fewest safeguards, and sometimes no integrity. I feel fortunate that my initial entry point into this was at the retreat in Brazil: Spirit Vine. I felt I was in the care of somebody who ran a very tight ship and was very thoughtful and careful about how she screens participants and how she monitors how everybody’s doing.

But I soon realised that it’s a Wild West out there and that Silvia’s retreat was maybe the exception rather than the rule in terms of safety, thoughtfulness and standards.

I think one thing that often happens in the psychedelic space is that when people find healing or catharsis or answers, there’s a tendency to protect the broader field and enterprise at all costs and to not draw attention to things that may be used or weaponized to create tougher drug laws. To me, it was important to be very honest with readers about what I was finding and what I was concluding, and to not become part of this ‘code of silence’ that I think to some extent is a feature of the psychedelic renaissance.

I think readers will walk away with a clear, sobering sense of what’s available to them if they’re able to navigate this field carefully and thoughtfully. But it’s also a cautionary tale. And oftentimes the people who are really struggling and dealing with depression or severe PTSD are not equipped to be very discerning and very careful about what ends up being their entry point into this.

Hardman: It’s a big concern and I agree with you in terms of that ‘code of silence’. It’s really worrying. When that off-duty pilot tried to turn the engines off on an Alaska Airlines flight two days after he took psilocybin, a lot of people in the ‘psychedelic space’ or industry appeared to try and explain away the potential role of the psychedelic. ‘There’s no way he could have had psilocybin in his body after 48 hours’, some suggested. But that ignores things like post-psychedelic derealization, which we know can occur. So these knee-jerk reactions are concerning, to me.

When you’re looking at these retreats, I found it interesting just how deep-rooted their commercialisation seems to be. When you tried to look for a more ‘authentic’ ayahuasca experience, for example, you found out about such offerings in the remote village of Mushu Inu via an Instagram ad… and booked your spot via a WhatsApp chat with an organiser.

I knew about these very commercial operations, like Rythmia. But from what your reporting suggests, even these more ‘authentic’ experiences have been commodified, in some cases.

Londoño: I see this often where people, once they get a taste of this, have a temptation or an inclination to seek the ‘purest form’ of these rituals. In some ways, I feel like it’s a mirage. If you actually drill down at the history of ayahuasca use, in particular in the Amazon, what is happening now is a relatively new phenomenon in terms of people drinking ayahuasca in a group setting for therapeutic purposes.

If you look at the history of the Yawanawá tribe in Brazil, for instance, or the Shipibo, it tended to be elders who had very deep experience in navigating these experiences. One thing that was really interesting and that I think gets lost in these conversations is when you look at indigenous use of ayahuasca, they don’t understand it or talk about it as an inherently benign substance. It was used to seek advantage. It was used to seduce women. It was used to sort of outsmart rivals. So there’s a heaven and hell kind of nature to their understanding of this mysterious brew and the realms it opens for them. I think we’ve reimagined and commodified it in a way that strips away that dark side and places it in a very Western understanding of trauma and mental illness and healing, and also neurology. I think to indigenous people our desire to understand this through a scientific lens feels strange and reductive.

But on the other hand, I think there’s something really wondrous and special about how these communities, newer generations of indigenous people in the Amazon, are rediscovering and reimagining these traditions. Even though what is happening now feels somewhat novel and certainly commercialised, it’s still a new era of how they are engaging with these substances and these traditions. And for them it’s something that is very precious, something that is very special and something that has become a glue to keep these communities healthy, in touch with nature and deeply bonded among themselves.

I thought long and hard about this, and about what it means for outsiders to come in with money and play a big role in shaping the way these substances are being used in indigenous communities. But it also is the world as it is, and I just wanted to be transparent. I didn’t want to pretend like I had sort of mysteriously gained access into these private, sacred indigenous realms. This is increasingly open and commodified.

Hardman: It’s a really interesting thread. I remember in one scene you were talking about how shamans can deliver both curses and miracles, and often end up trading in both. It’s interesting how this might be lost by Westerners who are presumably focused on the miracles.

The last section of your book looks at how psychedelics are appearing in the West… ketamine clinics like Field Trip, studies at the VA, and so on. This brings a whole new cast of characters to your book which, taken together, represents a “dazzling array” of psychedelic enthusiasts, as it’s called in the book’s blurb. You have a Republican veteran, self-described visionary entrepreneurs like Ronan Levy, a militant leftist who came to run a branch of Santo Daime, and many different indigenous people.

Did you encounter tensions between these groups, or people who felt uncomfortable with sharing space with those that have quite radically different world views?

Londoño: I actually found the opposite. I think especially in the United States, when we find ourselves in a really polarised and almost tribalized moment in our politics and our culture, one of the really fascinating things in the reporting is the lives I saw intersect.

One of the reasons I ended up opening the book with the church in Austin, founded by Whitney Lasseter, is it just kind of blew my mind to watch this Republican veteran who just weeks earlier had come close to putting a bullet in his brain, put himself in the care of a woman who has a bit of a wild and chequered past. She once made a living as a stripper and was a crack addict. It felt like an unlikely pairing.

When you think about the future and the movement to broaden access to psychedelics in the US, one thing that’s undeniable is many, many players are hitching their piece of it to the veteran mental health care crisis and it just became unavoidable recurring theme where everywhere you looked, people saw veterans as really helpful allies. And there was no shortage of veterans who were interested in these treatments.

But I found that these spaces and these rituals actually dissolve the kind of barriers that keep us from being around and getting to know people that are very different from us. In that sense, I think it’s potentially a pretty healthy thing.

For instance, Silvia, the woman in Brazil who runs Spirit Vine, used to host a group of Israelis and Palestinians who drink ayahuasca together once a year. She did that in collaboration with an Israeli who’s deeply steeped in peace-building movements. I do think there’s something really interesting about that. Psychedelic experiences induce periods of expansive and disruptive thinking, and in doing so I think it gives you a chance to see other people and to really sort of revisit questions or issues without the baggage that we ordinarily bring to them. So, in that sense, I think they can play a very useful role in bringing people together, breaking down some of those walls.

Hardman: It’s certainly something that seems to be gaining a lot of interest of late.

In many cases, you stayed in touch with the individuals and groups you met throughout your reporting. Like in the VA study, you checked back in with one of the participants, Chris.

For many people that attend these retreats, they have a time-bounded experience and then they’re just sort of cast back into their usual life with all of the associated triggers and stressors. Did you get any sense of what aftercare looked like in these different settings, or what good aftercare looks like?

Londoño: That’s a great question and it’s one I think about a lot.

A lot of these places have some version of integration guidance, or an app or Zoom meetings. But I think for the most part, when you sign up for a retreat you get whatever you’re going to get when you’re there. Then you’re thrust back into the setting, the relationships and the world that traumatised you and that can be really, really hard.

Some people have the wherewithal, the tools and the support structure to make sense of the experiences and make any changes that feel smart or healthy in the aftermath of a psychedelic retreat. But for some people, it can be really destabilising. It can feel like your mind has been blasted open, your notion of your place in the world feels like a blank slate, and I don’t think we do a very good job currently in the marketplace when it comes to giving people a road map and guardrails to navigate what comes next and to catalyse whatever benefits were gained during the intensity of a retreat.

It’s one of the things that I think the field needs to really grapple with. When you walk in on day one, you’re almost always asked to sign a ‘hold harmless’ agreement. Once you walk away, the guy may have had the best of intentions, but they kind of wash their hands of any responsibility for you and you’re on your own.

So that was one of the things I wanted readers who may be sceptical but interested in this to really think about: What kind of tools and what kind of support would I have on the back end of these experiences? I think it’s really important for people to really wrestle with that question and to think very carefully about what they can do to prepare for what comes next, especially if things were to go wrong and you were to face a period where you feel worse rather than better in the days after these experiences.

Hardman: And this is something that healthcare systems need to prepare for as well, right? How to prepare all sorts of healthcare professionals to assist people in navigating these challenging experiences or, as you say, to make the most of an experience they might have had.

We’re seeing a new type of psychedelic user emerge, one that is taking psychedelics in the hopes of treating their mental health issues. This strikes me as very different to many of the contexts of psychedelics use we have seen thus far. Across indigenous, counterculture and rave scene use, I can think of support systems like the knowledge of elders or specific harm reduction efforts. I worry that the person who read Michael Pollan or saw a news article about psilocybin offering a ‘brain reset’ and decided to eat a few grams of mushrooms doesn’t have an equivalent safety net. So I think that in every setting, from retreats through to personal use, we need to prepare for this. It’s something that worries me.

Londoño: Yeah, I think there’s a lot of self-medicating happening and I don’t think these are inherently benign compounds. I think they can be very healing. I think they can shift the trajectory of your life and your emotional state. But just by virtue of taking them, does not guarantee that you will land in a better place.

Hardman: What can those working in the ‘medical model’, like the Lykos Therapeutics’ and the Compass Pathways’, learn from retreat settings?

Londoño: The medical model tends to be a solitary experience. It tends to be the patient and the therapist in the room. To me, there was so much value in the communal experience and the energy and camaraderie that is built when you’re going through this with a group of people, a group of strangers.

There was almost a reality show aspect to how you become really invested in peoples’ narratives and the plot twists you start seeing throughout a retreat. I found so much love and affection and empathy in these group settings and, to me, that was in some cases more healing and comforting than taking the compound itself. It was a big part of why I think these experiences can be really transformative and magical.

In the medical world there are forms of group therapy, but to the extent that we can draw lessons from the retreat setting and the value of going through these experiences as a group and remaining in touch with the people with whom you’ve sat in ceremony. I think that would bring a lot of value.

It would also conceivably make it a lot more affordable. Right now the MAPS model—which involves two therapists treating a single patient over several hours—is prohibitively expensive. If and when MDMA becomes approved as a medicine for PTSD, early on it’s going to be accessible to people who can afford it. So I think group settings and retreat settings, if they can be integrated into a medical setting, would probably bring the cost down. And I think there’s a good chance that it also would be a more fulfilling and nurturing experience.

Hardman: That’s the dream, right? That you can make it more affordable but also that there’s some synergistic effect of group experiences that leads to better outcomes. Some researchers and practitioners I have spoken to in the course of my own reporting have expressed that curating the participants for group sessions might be a challenge. For example, some group participants may end up re-traumatising others.

But then when you go to these retreats, presumably you just book yourself into a scheduled retreat and turn up to find a diverse group of people. Did you witness or experience any particularly uneasy groupings? Or, as you said earlier, was that actually successful in catalysing understanding and even forgiveness?

Londoño: I saw really startling versions of what you’re describing. There was this one moment, for instance, in a retreat where this guy broke down in tears and said how much regret he had for having once had sex with a woman who was passed out drunk.

It was a chilling moment. There was this silence. We all knew that there were women in the group who had been sexually assaulted and for whom that was at the root of their trauma. There was this older woman at the retreat who I think was like a wise elder figure in the group who just said: ‘We forgive you, and you can let go of that burden.’ There was something shocking and mesmerising about that moment; about the extent to which you can hold space where people were very different from you, and people who in other settings would maybe really trigger you.

But I do think it’s challenging and you want to be very thoughtful about what kind of lives or life experiences you’re packaging together and how much direction there should be among participants.

At several retreats we were instructed to listen and hold space but not be very prescriptive or directive in terms of responding to what people were sharing, disclosing or struggling with. But I also saw a surprising amount of empathy in these group settings, and a willingness to see the good in other people and to show compassion.

Hardman: It’s a fascinating topic. My last question is a broad one: After all of these experiences and reporting, as you sit here now, are you feeling optimistic about the future of the so-called psychedelic renaissance?

Londoño: I have no idea how this ends or what the five-year horizon looks like. I think there’s tremendous potential and momentum, but there are also so many things that could go wrong.

I think part of the reason I wanted to write this book was to lay out some of these red flags as I come to see them, in hopes that people who are interested in this will be more careful and better equipped to be discerning if they choose to try this. But also because I think there are a lot of legal and regulatory policy questions to be grappled with and the earlier, smart, and careful people take a hard look at what makes sense in terms of policy and regulation and safeguards, the likelier we are to reach cruising altitude.

But for the foreseeable future, I think we’re in for a lot of turbulence.