Rhonda: When you keep saying these reorganizational experiences, in my limited neuroscience, what keeps coming to my mind is neuroplasticity and the ability to change the connections in your brain which happen...well, as we age, that becomes worse and worse, we're unable to do that, but is that something that's also affected by psilocybin? Do we know if that part of the neuroplasticity is all effective?

Roland: I mean, it has to be, right?

Rhonda: Yeah, it has to be.

Roland: By definition. So yeah, they're going to be complex neuroplastic changes and...

Rhonda: How do you measure that? Can you measure that in people? I know you can measure them in rats, probably, but...

Roland: I don't know. It's a question of where to look.

Rhonda: Where to look.

Roland: Where the locus of those changes are going to occur. And so if you go into the phenomenology of it, people describe this altered sense of self and this touchstone experience and they have now seen and experienced the interconnectedness of all things. And so they hold themselves differently in the world, and that affects their belief systems. And that's the way they describe it, but that's just their description. And so what we don't know is surely, there must be corresponding changes that are occurring and neuroplastic changes.

Rhonda: There has to be, yeah. And this has to also relate to some of your other research that you've done on like addiction, like smoking cessation, right?

Roland: Mm-hmm.

Rhonda: I mean, to be able to like change the way you see yourself and change your personality in a way, I guess, I don't know if that's even accurate, but it's not common. It's not something that commonly happens at least after, I don't know, adolescence or early 20s or something. I don't know what the actual age is, but...

Roland: Yeah. Well, that phenomena is showing us, after these mystical-type experiences, they are enduring changes in the personality dimension of openness. And so that's just reflecting some kind of dispositional characteristic that would correlate with people. If you ask them how they've been changed, they'd say, "I'm more open. I'm free." And so there is a change in what's considered core personality or these dispositional characteristics. And personality theorists would tell you that doesn't happen. Those personality characteristics are locked in kind of from mid-20s. And if anything, openness decreases then across the lifetime. And here you see an increase in openness. So something interesting is happening there.

And then in terms of kind of the radical reorganization that occurs, there are these other potential therapeutic applications, and so one of them is the addictions. And so we've done a pilot study in cigarette smokers, 15 smokers. We embedded the psilocybin manipulation in the context of a cognitive behavior therapy for smoking cessation. And remarkably, we had 80% abstinence rates at 6 months which in the smoking world is just completely unheard of.

Rhonda: Completely, yeah.

Roland: The varenicline which is probably our best treatment for smoking, 20% to 30%, now that's an...what we don't have is a controlled group for that trial so we're running a controlled trial now. We're doing neuroimaging pre and post. We're working with Elliot Stein at the National Institute on Drug Abuse who's done very sophisticated work at looking at brain centers responsible for addiction to and an abstinence from cigarette smoking. So we're kind of probing into that. But the point here is that these kinds of reorganizational experiences, it may be possible to embed them within different treatment contexts for different disorders like the psychosocial distress of cancer patients, and in this case, for addictions. There's work going on at NYU in alcoholism. There's some work going on at University of Alabama on cocaine dependence.

And so I think this is potentially promising, but we don't want to get ahead of the data. But my guess would be that there is something about the nature of these reorganizational experiences, the opportunity for plasticity and change that can be embedded within intention and context that could have a variety of positive therapeutic applications.

Rhonda: Right. And possibly even things like PTSD, OCD.

Roland: PTSD, OCD, eating disorders, other types of...