Interview with MDMA researcher Dr. Ben Sessa
As part of the publication of Psychedelic Press UK 2013 Vol.2 – the third edition of our flagship print anthology – we’ve done a series of interviews with some of our contributors. First up is Dr. Ben Sessa.
Ben is one of the five co-founders of Breaking Convention, the UK’s only psychedelic conference, and the author of several novels and non-fiction books, including The Psychedelic Renaissance. He is a paediatric psychiatrist and is coordinating Britain’s first MDMA/PTSD study. He began publishing in medical journals on the subject of psychedelics as a trainee and since then has spoken nationally and internationally to doctors in a campaign to see these fascinating substances return to the mainstream pharmacopeia where their lives began. In 2008 he became a Research Associate under Prof. David Nutt at Bristol University, where he consulted for the ACMD on MDMA before working on the UK’s only human hallucinogen study in modern times – being the first person to be legally administered a classical psychedelic drug in this country for 33 years.
PPUK: Hi Ben, thank you very much for your contribution to Psychedelic Press UK: Anthology of Pharmacography 2013 Vol.2, and for agreeing to answer a few of our questions. In your provocative article, Have We Blown It? Getting Mainstream Support for Psychedelic Medicine, you pose an interesting problem. Namely, that in order to gain support for the therapeutic use of psychedelics, one needs to be free of countercultural affiliations and, in the most professional manner, side with Establishment values in all other areas in order to gain their support for this single psychedelic issue.
It appears that what lies at the heart of the two different approaches is a medical question of sorts – cause and effect. Are the current drug laws, which inhibit medical, spiritual and recreational use, of psychedelic, a problem in themselves? Or, are they the symptom of a wider social problem. The countercultural approach would side with the latter, and that tackling the niche area of medical psychedelic research, would still leave the cause untreated i.e. Establishment moral and socio-economic policy. As someone who, self-admittedly in the article, straddles both sides, do you think it is possible to ever truly separate the medical and political questions in the manner your friend proposes in the article?
BEN SESSA: Firstly, I want to make it clear that I certainly do straddle the argument on both sides – painful though that sounds. And perhaps this is a personal issue of ‘wanting to be liked by everyone’ that I need to deal with myself! I do not want my groovy friends and colleagues on the counter-culture side to think I am simply another of those boring grey-suited establishment types who is clearly square and outside the hip group. Cos I’m not! But at the same time I see that I must be boring and square in front of many of my colleagues at work if I am going to get them to actually listen to the data I am wanting them to embrace. I am genuinely struggling with this issue.
I think that getting psychedelic research accepted into mainstream culture (especially the medical research arena and crucially the money that goes with conducting research) is more likely to come more readily if the argument is presented by someone who looks normal and says things in a relatively normal and non-hippie-like way. Trust me, I could not ask for 1.3 million pounds for a UK MDMA study off some very conservative people – the ones with the purse strings – if I did not approach them on their level. First impressions do count. That is well evidenced. One would be crazy to try and pretend otherwise.
Take for example the recent massive advances in cannabis policy throughout the world. Do you think that has come about because of hoards of hippies dancing to reggae at 4:20 gatherings calling for legalisation? I don’t. I think the recent excellent policy changes have come from the growing medical studies coming from within the profession, from conservative-looking and conservative-acting doctors who have learned how to play the game with the establishment by meeting them on their level.
Now do I think this right? No. Not necessarily. The doubting doctors and the skeptical politicians ought to be able to understand the argument whether it comes from a dread-headed hippie or a grey-suited conservative; but the reality is the former is likely to scare off most non-dread-headed people and the latter is more likely to get that audience with the establishment in the first place. This is what I am trying to do: get that audience with The Man in the first place.
Trust me, I would have loved to see the psychedelic sixties and the Stonehenge festivals of the 70s change hearts and minds, but here we are 50 years later and for all their wonderful, colourful hollering the hippies have not moved things forward much – not in terms of mainstream acceptance. Sure, the underground psychedelic scene is swelling and that is cool. But that is preaching to the converted. The vast majority of people do not readily engage with or identify with this scene. All I am saying is let’s therefore try another approach – the rather sad and boring conservative approach. It might just work. And as I said in the final chapter of my book, that way we may be able to slip transpersonal issues in through the back door.
PPUK: You recently wrote a book entitled The Psychedelic Renaissance (2012). Can you tell us about the book and why this is a prescient time for it to be published?
BEN SESSA: The idea of the book is to showcase some of the recent advances in psychedelic research. I do give the inevitable and often-repeated stories of Osmond, Leary, Huxley, Kesey, Lilly, Hollingshead etc etc but the chapters I am most proud of are the ones that showcase what has been going on in the medical research community in the last ten years. I try to include as many of the contemporary studies as I can. It is great that even since the book was published it is already slightly out of date in this respect’; the volume of emerging work is now so prolific!
And throughout the book is this similar theme of my own personal struggle of ‘hippie versus doctor’, because I think this issue is vitally important in this, our second bit of the psychedelic cherry. I wonder in some respects whether we have actually needed this last 40 years hiatus. Developmentally perhaps the LSD experiment of the 60s was supposed to fail. Maybe Leary et al had to do what they did: Popularize the drug, kill the research, turn a generation of conservatives against psychedelia etc. Maybe now this second time around we can reflect on the sixties with a less acute, more meditative opinion about the true value of psychedelic healing properties. It’s like we needed LSD to become ‘grand-dad’s drug’. I’m glad that LSD is associated with the last generation; that frees up the current generation of kids to mess around with their RCs, become maligned for it etc (as their forefathers were with LSD), whilst us older people, again, slip LSD into mainstream scientific research through the back door. Does that make sense?
PPUK: In a recent article you wrote: “We must not let the archaic irrationally biased argument against clinical MDMA continue to stand in the way of developing this medicine for the benefit of patients.” As a leading researcher in this field, where do you think the irrational arguments come from? And, why do you think they originally came about?
BEN SESSA: Sad to say it, but as with LSD before it, I think the rave generation’s embracing of ecstasy ruined the medics’ opportunity to develop the drug as a medicine. I say sad because I was out there with them raving (I was 16 years old in 1988, a DJ and very much a product of that generation). In the late seventies and early eighties, like LSD before it, MDMA research was progressing well; with real clinical efficacy and no adverse effects for patients, until it leaked into mainstream culture in the late eighties, became misused recreationally and then casualties appeared. LSD took exactly the same path. LSD was going to be the next big thing in mainstream psychiatry in the 1950s and early 60s. But once it crept out of the clinic and people failed to take care of dosing, set and setting then some real problems (and causalities) appeared. More so, even, with MDMA than LSD; the latter of which is considerably less toxic than the former.
The media love a scare story. And – I think – they love to build up then break down the counter-culture. Nutters dressed in neon colours, wearing face masks, dancing on top of speakers with white gloves on and flexing to the fat ones (we’ve all been there) make excellent news stories when it all goes wrong for them. Our society loves to polarise people into good and bad. I don’t think the general public can accept seeing a party of 5000 entirely happy and positive people sharing the same good vibe. There must be a counter balance. They can’t be all be good, surely? There has to be a bad side to that level of communal unity. So they jump on any negative aspect they can – in this case the potential dangers of the drugs. No one by then wants to listen to the few doctors who are prepared to stand up for clinical MDMA. And before you know it (helped along by some tragic and avoidable deaths of young people) the drug and the whole rave scene has become public enemy number one.
It was the same at the end of the sixties. Grof et al, who had done some fabulous work throughout the sixties with LSD therapy very quickly became pariahs by the early seventies. OK, they remained respected and revered by a select small group of followers (and by the many hippies who cared not about being isolated and maligned) but many great doctors with much sympathy for psychedelics were forced to distance themselves from the whole scene in the 1970s. Tragic. We have lost so many important years of knowledge and expertise. Especially in the field of nursing. The role of the psychedelic nurse in the development of LSD therapy in the 1950s and 60s is often over-looked. It will take a long time to build up that body of expertise again. Much respect to Annie Mithoefer!
PPUK: Harm reduction has become the evidence-based standard bearer for analyzing the prospective legislation of drugs. Do you give much credence to the cognitive liberty argument? And what do you think are its relative merits/drawbacks?
BEN SESSA: As a scientist, whose work is driven by an evidence base I have enormous support for harm reduction. The truth is that drugs like LSD, MDMA, cannabis and psilocybin are considerably less toxic than alcohol and cigarettes. Even the most stalwart politicians who support the drug laws admit that (e.g. Home Secretaries of successive generations from both political parties). But the problem is that despite knowing this they still support the drug laws. Why? Very complex. As my friend in the article would say, this is because politics is unashamedly not evidence-based. It never has been. (If it were would we really be using arms in Syria or elsewhere? The evidence for wars – of any kind –was means of bringing about social stability and peace is flimsy to say the least but we still fight them). So it is very frustrating as a scientist when I see others (politicians) not using the same, rational, unbiased, non-judgmental scientific scales to assess risks, measure outcomes and plan policy.
But this is where I come back to the idea of the grey-suited conservative voice being a useful tool: Ideally the straggly hippie ought to be able to adequately deliver the message that cannabis is safe. But unfortunately society doesn’t see it that way. They need to hear it from the newsreader in a suit to believe it. It’s not a level playing field. Very frustrating for me as a scientist. And deeply offensive for the hippies!
Regarding cognitive liberty – I think this is a strong argument. I like it because it has political clout. This is what worked with the ayahuasca churches and the peyote churches in America. It will be a long shot to imagine it working in the UK (where we lack an indigenous population who have a claim to these drugs as sacramental) but it’s worth a shot. I strongly believe people should be allowed to experience a wide range of different mental states and levels of consciousness. I believe these drugs can be taken safely for the betterment of individuals and the wider community. It is indeed a human rights issue to deny people this.
PPUK: Finally, in the recently published Breaking Convention: Essays on Psychedelic Consciousness, there’s a transcription of the MDMA debate you chaired at BC 2011, in which the question of publication bias in scientific journals comes up. Concerning psychedelics, how prevalent is this problem? And how does it manifest?
BEN SESSA: I think the issue of publication bias in favour of publishing articles in high impact journals that claim a positive effect and lead to the marketing of a drug (i.e. SSRIs) is very real and a serious problem. But I don’t think submitted articles about psychedelics have been unfairly excluded – not by the evidence of recent years publications! They are appearing everywhere.
However it is vitally important that psychedelic article submissions are of high quality and have rigorous scientific methodology – like all submissions that get published. I peer-review articles for two high impact journals and I have approved and seen accepted almost all of the pieces (all on psychedelics) I have been asked to review. I think the standard of many psychedelic submissions is excellent. Authors / researchers know they are gong to be scrutinized by the general public and their medical colleagues so they go out of their way to produce stellar research projects with very few holes for criticism. Some of the research that has come out of Hopkins, for instance, in recent years has been so beautifully designed and well thought through.
On the other hand there is no place for meager trip reports or reams of anecdotal personal experiences in medical journals – they may have their place elsewhere – but it is important that high impact medical journals stick to well-designed randomised placebo controlled studies. They are the gold standard against which we judge the success or failure of proposed active treatments. I think psychedelics – even when tested under such stringent conditions – can perform excellently. So there is no need to use a lower value yard-stick when measuring their efficacy.
We will get there eventually – with a sober presentation and a meticulous approach to rigorous, indisputable data – and then, then I can grow my hair again. (If there is any left by then!)
Thanks very much Ben! To read Ben’s article – Have We Blown it? – you can order the print anthology here.