David Erritzoe – Kinfolk

On the mind-bending potential of psychedelics.
Words by Tom Faber. Photography by Annie Lai. Styling by Kingsley Tao.

David Erritzoe arrives at our meeting on a fold-up bike, perfectly coiffed and turned out in navy, ready to talk about drugs. As the clinical director of the Centre for Psychedelic Research at Imperial College London, he is at the forefront of a new wave of scientists researching the therapeutic potential of psychedelics. Their early results have indicated that psychedelic compounds, such as psilocybin [the active ingredient in magic mushrooms] could work as powerful treatments for a range of mental illnesses including depression and addiction.

Sitting by a canal in the bright winter sunshine of Hackney Wick, near his East London home, he navigates deftly between two languages to speak about psychedelics: the meticulous doctor with a deep knowledge of brain imagery and psychopharmacology, and the believer who speaks of the near-religious experience his trial participants undergo, using terms like “oceanic boundlessness.”

It has been a long road to be able to study the effects of psychedelics legally. After promising initial research in the ’50s and ’60s, these compounds were demonized and criminalized in the ’70s, putting a stop to all research for 30 years, before finally beginning to open up over the past decade.

Erritzoe had his curiosity about psychedelics piqued when he was doing a study to understand the longterm effects of MDMA [the active compound in ecstasy] on the brain and found that the participants in his trial who also took psychedelics spoke thoughtfully and powerfully about their experiences. He soon moved from his home in Denmark to London and met Professor David Nutt and Dr. Robin Carhart-Harris, the group that went on to found the Centre for Psychedelic Research at Imperial College London.

Tom Faber: Humans have been using psychedelic substances for thousands of years. How did they first come to the attention of the medical world?

David Erritzoe: During the Second World War, a Swiss chemist called Albert Hofmann developed a new compound in the lab and accidentally ingested it, triggering a powerful psychedelic experience. He had created LSD, which lasts for several hours—it was probably an overwhelming experience for him. He shared his experience with psychiatrists who realized it might actually have positive mental health outcomes and therapeutic applications.

TF: What were the first medical trials with psychedelics?

DE: It was tested in trial settings throughout the ’50s and ’60s. During that same period, Hofmann also synthesized psilocybin in the lab, which is the compound that naturally occurs in magic mushrooms and truffles. In that period, there were around 40,000 patients worldwide who were given these compounds in a therapy setting and a thousand scientific publications, so it attracted a lot of interest in the science and mental health communities. The results showed psychedelics might be effective in treating depression and alcoholism, and some prominent politicians like Robert Kennedy spoke warmly about these treatments.

TF: If it looked so promising, then why did it stop?

DE: Partly because the nature of psychedelics clashed with the way medical research was was advancing at the same time. If you want to test the effect of a drug, then in theory you would prefer to simplify trial conditions, which could be by taking the whole context away, and trial it in a very clinical and controlled design and setting. This is great for testing an antibiotic or a painkiller, but psychedelics are so context-dependent that this doesn’t result in brilliant results. It can even traumatize patients. Then there were trials that were not conducted according to existing psychedelic therapy guidelines, with people being pushed into taking really high doses on their own without support. That combined with political developments like the Vietnam War and counterculture movements in the ’60s when psychedelics became popular for self-exploration. The Nixon government became increasingly critical and psychedelics were demonized. So around 1970, new UN conventions led to scheduling of these compounds across the world. This meant the compounds were classified in a way that you couldn’t conduct research on them, so nothing happened for decades.

TF: Was there a particular experiment that sparked the current wave of research?

DE: Johns Hopkins did a trial in the early 2000s that showed healthy people using psychedelics could have profoundly meaningful experiences, as significant as giving birth to their first-born child.

Hair: Katsuya Kachi. Makeup: Jinny Kim using SUQQU

He wears a turtleneck by COS and a shirt and trousers by GIORGIO ARMANI.

TF: That’s what a participant actually said?

DE: Not just one. Two-thirds of the participants rated it among the most significant experiences in their lives.

TF: What has the Centre for Psychedelic Research been studying?

DE: We’ve been trying to understand the brain biology behind these experiences and what they can tell us about consciousness, which is a deeply abstract phenomenon that nobody completely understands. We’re also looking into whether these drug-induced experiences, together with psychological support, have a therapeutic value for a range of conditions, which at this point it looks like they do.

TF: What have been your principal findings?

DE: We’ve found that the brain under the effect of a psychedelic enters a chaotic, flexible state that allows for free-thinking and a loosening up of thought patterns. This could help with depression, where people have narrowed their thinking into negative thoughts about themselves and interpret everything in a way that confirms their negative self-image.

We conducted the first trial of a psychedelic intervention for depression in 50 years and saw very promising therapeutic results with psilocybin. In our next study, we compared it to conventional SSRI [selective serotonin reuptake inhibitors] antidepressants and the results overall favored psilocybin.

TF: Would it be right to say that, unlike conventional antidepressants, psychedelics treat the causes of depression rather than the symptoms?

DE: Yes, I think so. Psychedelics seem to dive deeply into the psyche, loosening it up, changing perspectives and allowing deep material to be dealt with in a fascinating way. In our trials, we have seen traumatic things brought to the surface and reassessed in a new light. The feeling of being trapped in the rigid, negative thought spirals of depression turns into a sense of connectedness with the universe, nature, the people around you and your own emotional life.

TF: And the changes last long after the drugs have left your system.

DE: Absolutely, which is very interesting, but we don’t yet know exactly for how long. A big question for us is how often you need to redose or have a top-up experience. A colleague at Johns Hopkins framed it as a kind of “inverse PTSD”—we know that profoundly traumatic experiences can change the wiring of your brain and cause long-lasting negative impacts on mental health such as anxiety, depressive symptoms and flashback nightmares. So shouldn’t it be possible that a deeply meaningful spiritual experience that offers a profound sense of belonging could have a long-lasting positive impact on your psyche and your life?

TF: How does this work on a scientific level?

DE: Everything that changes us leaves some signature in our biological brain tissue. A psychedelic experience might make changes in the actual brain wiring and how brain cells connect. This might create a window where we can reframe and reshape the way we think and live.

TF: It’s interesting that psychedelic users often talk about their experiences using religious and spiritual language. Is that a challenge for the scientific approach?

DE: Our questionnaires were originally based on the language people used to talk about their experiences, with terms like “mystical experiences” and “oceanic boundlessness.” These are very poetic and, and perhaps scientifically somewhat fluffy terms, but that’s because the the nature of these experiences are difficult to articulate. Some of these terms are provocative for scientists who come from hard-core pharmacology and want to measure everything on a scale of depressive symptoms. But these experiences are so rich that the language needs to be broader. It’s a new vocabulary for medicine.

TF: Can participants in psychedelic trials have negative experiences?

DE: If you have a vulnerable person with mental problems, perhaps severe depression or trauma, then a psychedelic experience can bring up a lot of subconscious or repressed material. This can also happen in a person without any mental illness. If that’s done in a safe therapeutic setting then it can be interesting and potentially very fruitful, which is what we see in the trials. But these people are prepared, supported and guided, to help them discuss and integrate the experience. It’s important to have someone who can ground you: You’re flying this airplane but we’re the cabin crew and we’ll help to make it all safe. But ultimately, as in therapy, it’s mainly for the person themselves to make sense of things.

“The brain under the effect
of a psychedelic enters
a chaotic, flexible state.”

Erritzoe wears a shirt by CRAIG GREEN, a vest by COS and trousers and shoes by MARGARET HOWELL.

TF: Is taking psychedelics in a clinical setting safer than doing it recreationally?

DE: In recreational settings it can also go incredibly well. If you’re out in nature you can experience a profound sense of unity which is difficult to re-create in a clinic. But if it’s challenging and people lose touch with reality during the experience, they might do something dangerous or have a traumatizing experience. This is why they need support, but that doesn’t have to be a therapist. These drugs have been used for thousands of years in different cultures, mostly very wisely. If it’s in a shamanistic setting or with wonderful friends and people who know what they’re doing, they can make a lot of progress, even with severe mental illness.

TF: Does the research suggest that certain psychedelics can treat specific illnesses?

DE: Right now MDMA, which is not strictly a psychedelic, is being used to treat PTSD, and psilocybin mainly for depression, but they might work inversely or be combined. Then there’s a powerful psychedelic compound called 5-MeO-DMT, which comes from a poison found in toads, which has been tested underground in retreats and seems very powerful for treating addiction—but that’s mainly anecdotal at this point and we need to do more testing. Personally, I don’t see them as incredibly different. I rather regard them as different doors into the same, big dark house to be explored.

TF: How does the fact these substances are illegal affect your research?

DE: It makes research much more complex and expensive to undertake, but right now regulations are loosening and the number of trials is exponentially increasing.

TF: Your center received a lot of attention around a recent study that showed that microdosing psychedelics—where people regularly take a very small psychedelic dose and report improvements to mood and creativity—is actually no more effective than taking a placebo.¹

DE: We are deeply unpopular because of those results, but nevertheless those are the results. In our trial we saw that the positive impact came from thinking you were microdosing, rather than actually taking the chemicals. Perhaps a key factor for the placebo effect being so strong is that microdosing is so hyped in many Western communities, such as Silicon Valley, at the moment, and featured in all the books and magazines. This hype together with the alternative and even anti-big pharma vibe around microdosing gives you the potential for a massive placebo effect.

TF: Do psychedelics have something to teach us about the workings of the mind more broadly?

DE: Absolutely. They already have, because a lot of our understanding of the role of serotonin in the brain came from early work with LSD and psilocybin. Anything that can change waking consciousness into a dreamlike state is interesting because it allows us to get closer to understanding complex, abstract mind phenomena which are difficult to study.

TF: What ramifications might your research have for people who don’t suffer mental illness and don’t want to take psychedelics?

DE: I think the idea of paying close attention to the context of how medicine is taken, as we do in our studies, could benefit everyone in mental health. Psychedelics could also help reevaluate the sometimes arbitrary classifications of mental illnesses we treat, as they allow a flexible reshaping of brain models and a breaking down of internalized, habitual negative states.

TF: Are there limits to what brain imaging can tell us about the human mind?

DE: There’s close to nothing but limits; we’re only scratching the surface. Though the field is getting better, we can now look at the brain with radioactive imaging, magnetic images and measure electrical activity, and by combining such techniques in the same experiments we try to achieve additive value when investigating the brain. AI might begin to help by letting computer systems understand brain patterns. But there’s still generations of development to get closer to understanding the mind. We’ll probably never completely understand this thing that we all run around with inside our skull.

( 1 ) Microdosing—the practice of taking a low dose of a psychedelic drug in an attempt to improve creativity and productivity—has become wildly popular in Silicon Valley. Founders and entrepreneurs can avail themselves of the services of a “trip coach” to help them experiment safely.