Transcript

Rafaelle:  It's easy to try and change the way an individual thinks, but it's a lot harder to change a society or an economic system, especially when there are power structures involved, and there are people who are benefiting from the way things are currently being done.

We see this symptom reduction, but we're lacking information and we're lacking That generalizability piece, which is going to be a really essential next step in approving psychedelics as, as a treatment for a lot of different mental health conditions.

John: Welcome to Human Science, a podcast exploring the human element behind the science that shapes our everyday lives. We're powered by Labfront, the go to tool trusted by researchers looking to automate their studies and transform real world data into health insights

I'm your host, John Drummond, and our guest today is Rafaelle Lancelotta, an expert in psychedelic research and harm reduction, or as they like to call it, benefit enhancement. Rafaelle shares their personal journey with psychedelics and their passion for inclusivity and social change in the field. Join us as we explore the potential benefits, challenges, and the future of psychedelic research.

So everyone, please welcome Rafaelle!

Rafaelle: Thank you.

Rafaelle's Backstory

John: Awesome. Well, Rafaelle, we're gonna dive into a lot of stuff. Psychedelics, psychedelic research, harm reduction, all sorts of regulatory hurdles. It's gonna be a really, really special episode for you and for me, as psychedelics has played, I think, a very big part of both of our lives. So I was hoping though we could start with a little bit of a backstory of Rafaelle.

Rafaelle: Sure. I was raised in a pretty conservative household, I was raised Catholic, and, in the late 90s, early 2000s, there was still a lot of stigma around, being neurodivergent, being queer or transgender, and, and I think for me, during that time, also, really.

Dealing with a lot of grief around death. I had a lot of family members pass away in my early childhood whom I was close with. And all of those factors combined led to not having a lot of the deep support and social connections that I think would have made a big difference in my life. at that time.

And psychedelics didn't necessarily replace the need for relationships, but I think that they helped me connect with myself at a deeper level, and I think gave me a lot of hope for something in the future they also helped me connect with the things that were really important to me, and helped me preserve a sense of self that I think was able to survive until I was in a better position socially and financially to, really be myself, and to find the people in my life that were going to be really supportive and, eventually, come out to the world, come out to myself. So, my interest in psychedelics comes from, how they've played a role in my life, but also seeing how psychedelics have been both really positive in some people's lives and also have caused problems in other people's lives.

My research with 5 MeO DMT was partially fuelled by personal interest, but the thing that really inspired me to dive into doing that work was, one of my best friends died, as a result of an overdose with 5 MeODMT so just seeing that, psychedelics used irresponsibly, although psychedelics can be these incredible tools for healing can be really positive experiences for people, can be life changing.

I also have seen psychedelics be used irresponsibly, or be used by people who didn't fully understand what they were doing. I saw a lot of harm come from that. So that's been a big motivation for me. To, to be engaged with research, to be engaged with education, and to, to pursue research that hopefully can help serve populations that don't really have the kind of social support that we see in a more heteronormative population and, having research that is more aligned with being inclusive and being in community integrated, I think that also becomes a vehicle for social change. That is ultimately at the core that is my passion is, is social change and how can we all be more healthy and happy together, living our best lives, ultimately.

Journey Into Psychedelics

John: Thank you so much for the vulnerability there, and, and really just also the, the transparency too. But before we go too much more into the the research side and hopefully the future of what you want to be working on, I hope you I would love just to touch a little bit too on how did you know to begin exploring psychedelics as you were in that moment of not knowing who to turn to or where to go and what to learn about?

Do you remember that pivotal moment where you're like, oh, maybe psychedelics can offer me some type of understanding or healing?

Rafaelle: Yeah, growing up Catholic, I had a very strong spiritual sense growing up. And I had a lot of mystical experiences just attending church.

And I think when I experienced a lot of these deaths in my family, I didn't find that the religion was providing for me what I needed in terms of support or a conceptualization of how do we process this kind of loss and grief?

At a pretty young age, I started just looking for other forms of spirituality and that's where I started to study Buddhism. and Buddhist philosophy, and what really attracted me to that was there's a spirituality or a religion that's basically atheist, you know, there is no, God in the Catholic sense,

And, the spiritual practice of Buddhism, really just of meditation and even the, the concept of, you know, reincarnation and some of those more esoteric parts of it just felt a lot better to me, like a lot more realistic, a lot easier to kind of sit with the mystery of life. I started to really teach myself meditation because I didn't have access to a meditation community at that age. And I was also really into reading. I did a lot of reading and, I was fascinated by US history and literature and one tome of literature that I really loved was, was beat writing, just the beat poets.

I loved the sort of blend of political activism, the freedom of expression, the counterculture that was associated with that movement and with those writers and thinkers.

I was also kind of curious, did these people do drugs? That was part of the beat, movement. And it was also, I guess, part of the hippie movement, but I felt they were a lot more grounded, it wasn't just all peace and love, it was really like yeah, we've had these enlightening moments, but now we become obsessed with, how do we change the fabric of society?

How do we change relationships? And how do we change the way that we function as people? And that really captured my imagination. As I was getting more involved with learning about Buddhism and reading the beats, who are also very interested in, Eastern spirituality, psychedelics were, were a part of that reading and that writing and, and so for me, it inspired me to think well, maybe if I have experience with psychedelics, I can learn a bit more deeply about meditation and about how my mind works and who I am and how do I want to push against, oppressive forces in society and how can I be myself, how can I be different even if it's not necessarily what is expected of most people. That was really the pivotal moment for me. It was the convergence of, of all these different things.

Psychedelic Research Today

John: It's so well articulated. Thank you for that. I just love hearing about the beat writers who are a little bit more than just the, the peace and love hippie movements of let's smoke weed and chill.

Yeah, and it really it's almost a beautiful analogy to how I think of almost you now doing psychedelic research. You're embracing the peace and love but you're also like let's bring in the scientific method here and then figure out a way to like integrate this into society. So well, well said.

I was thinking we could start with A little bit of where we are right now with psychedelic research. Maybe let's not go too deep into where we've come from, but a good foundation of where we are right now. Maybe some pros and cons in your mind of everything that you're dealing with on a day to day.

Rafaelle: Yeah, that's a great question. So the, where I see things right now is we have clinical trials that have established that psychedelics in a controlled setting can be really effective for improving symptoms of depression, anxiety, you know, depression as a chronic treatment resistant condition, anxiety specifically related to end of life anxiety or anxiety related to, chronic illness.

I think that psychedelics have been shown to be helpful in those conditions. And we're starting to see research with PTSD, with MDMA, for example, which some people would consider psychedelic as, you know, maybe psychedelic adjacent and intactogen.

We also see a lot of research with ketamine as well as, as a powerful tool to help treat, various mental health conditions. I think while we're seeing the benefit of these substances, and we're seeing that they can be useful in treating symptomology. Because we've applied this very medicalized and very, focused scientific method, we've also not had enough attention on the context and on the things that are surrounding the, the people, both people who are, in clinical trials, but then also the general population.

Why is mental illness rising, despite having all these different kinds of treatments and all this research and we, we understand so much about the mind and pharmacology and we have all these, pharmaceutical medications.

We have, cognitive behavioral therapies and we have a lot of these different tools that are, are really focused on symptom reduction. But, the thing that has been missing, and I, and my theory on this, and I think there are many other mental health professionals who would agree, is that we lack a focus of the context that people are in.

It's easy to try and change the way an individual thinks, but it's a lot harder to change a society or an economic system, especially when there are power structures involved, and there are people who are benefiting from the way things are currently being done. In terms of psychedelic research, to bring it back to your question, we have shown under a microscope or in, in these really controlled settings where we have participants who are very highly selected. We see this symptom reduction, but we're lacking information and we're lacking that generalizability piece, which is going to be a really essential next step in approving psychedelics as, as a treatment for a lot of different mental health conditions.

John: Yeah, it's, it makes me think, as you said so beautifully, that the powers that be, you know, it's like, is there, is there a suppression level going on, you know, like, hey, we want to keep this status quo. I don't know if we want all this, understanding of yourself and healing and then the questioning that often comes with that.

So, I'm just thinking, too, in your and I lived experience, it starts as a recreational, but now you've chosen as a career path to go into the clinical to see maybe how you can move and groove in there. From the perspective of harm reduction, is there anything that our listeners and people who are curious about psychedelics and psychedelic adjacent substances can be aware of and learn more about that?

Advice for Starting with Psychedelics

Rafaelle: Yeah, I would like to say that I think that drug use in general It operates on a continuum, there are people who can benefit from using drugs that are not in a formal prescribed, arrangement.

And then there are people who need drugs to be prescribed or given in a very controlled setting in order to get the benefit out of those substances. The harm reduction perspective is educating and knowing oneself enough to know or to recognize that point between, I can take a psychedelic with friends or a loved one, and I can get benefit from that.

And knowing the difference between like, wow, there's a lot that's coming up for me. This is a really big process. And it would be really helpful to have someone who not only understands how psychedelics work, but also has a really solid understanding of mental health and can help hold space for such a big process that would be really burdensome in, more lay relationships, right?

I don't really think there's that much of a binary as much as an understanding between these two ways of using psychedelics. In terms of harm reduction, specifically for people who are curious about psychedelics, or interested in using psychedelics, I've, with, several other folks who've been part of,numerous research teams, we've done several studies, that have been survey studies and have essentially been epidemiological studies, studying how people in the general population use psychedelics.

And even though there has been bias in terms of who, responded to these surveys, I think in many of them they were white, heterosexual, young men. But, done, we've also finished a survey study recently in LGBTQ individuals, so we have more variability there. In these different studies, we've asked questions about, what are the main things that people are doing to enhance the benefits?

And so, we talk about harm reduction, but we have been using the term, benefit enhancement more than harm reduction because people who respond to these surveys and It seems to be a theme in the general population regarding psychedelic use that there aren't that many harms that people experience with psychedelics.

Like we see difficult experiences, we see sometimes people have to take time to process what's happened in their psychedelic experiences, but we don't see harm in the same way that we see it with, for example, methamphetamine or heroin or, or like cocaine or tobacco use disorders. With psychedelics, the harms are mainly, not really getting much benefits from it.

So, when we talk about benefit enhancement, some of the big things that people talk about is, preparing a safe space to have the experience, having the experience with trusted friends or loved ones, in some cases, preparing music for the experience, not having distractions during the experience, being well informed about the substance they're taking. And that means, knowing what dose to take, knowing that the substance is pure, knowing how long does this, this substance take effect for so that they can plan to have that time set aside. And, in some cases, using with a guide has been rated as something that really helped people.

We've seen that people who use these harm reduction strategies report having bigger mystical experiences, lower rates of challenging experiences, and more meaningful experiences that, have effects for much longer periods of time.

So, as people use these harm reduction strategies or benefit enhancement strategies, we can see that there's a great impact on the long term effects that psychedelics may have for those individuals. So I think that we can translate those insights to clinical research. yeah, so that that's how I would see that, interplay between recreational and clinical.

John: I love it. And I love the forward facing terminology there of benefits enhancing. rather than harm reduction. It just seems actually so appropriate to be, you know, where the state of psychology has been for so long and just medical research is like, what are the symptoms? Let's diagnose you, rather than hey, how can we, talk about some benefits and looking forward more to the optimistic sides of what you have in your future.

You touched on a little bit to the, the marginalized populations right now and getting more diverse research right now in the field. Can you touch on maybe your own personal experiences and really why you're advocating so hard for the LGBTQ plus communities and really bringing more inclusivity into this field?

Bringing More Inclusivity to the Field

Rafaelle: Yeah. Psychedelic research has, and, the mental health field in general has historically been focused on, people of that are privileged, are affluent because they have had the resources to engage in that kind of work and that's good, but I also think that in a society where more and more people are needing support and needing help, and, we're living in a world where, mental health It should not just be for the wealthy or the privileged.

It should be something that works for a wide range of people. It works for everyone who seeks help in that way. If we want to say that, psilocybin is really helpful for depression, we can't only look at white, heterosexual, middle, upper class people and only see it be effective in those populations.

We need to be able to see that it is helpful in many more different types of people with different backgrounds and different life experiences .So, from a research standpoint, from a methodological standpoint, that is a pretty strong rationale for wanting to have, different representation.

Another thing that I've been thinking about in regards to why would we want to have, more diversity and more representation in clinical trials? It also illustrates more systemic factors that affect people. I think the more privileged you are, the less systemic factors are going to affect you.

Because you are just insulated either through, your identity, if your identity is not one that is, is under oppression or being persecuted, that that's going to take pressure off of you if you have financial means. That also insulates you from a lot of systemic stresses that other people have to deal with.

So, as we expand clinical trial inclusion. I think it also helps to expand awareness into these systemic problems, and it, it helps us understand that treatments are not just, I don't think they end with, well, we have symptom reduction. We have to start thinking farther than that. Psychedelics allow for that sort of examination, and they allow for a lot more story.

And a lot more, understanding of the context that people are in, because psychedelics enhance and highlight context, that is a really powerful vehicle for changing our medical and mental health systems to be more, accommodating and more effective.

John: I feel hopeful when you, when you put it in this type of context, but thinking of where we are now in terms of psychedelic, assisted therapies, speaking a little bit about what we talked about earlier, facing the systemic challenges. of economic pressure, societal expectations.

I think about all of the therapists and the researchers. It still feels like a time where you're potentially putting your reputation on the line. Even, even talking about it still, I'm like watching my words on this podcast right now, because, I'm just not sure what's okay to talk about yet, or what's, you know, safe.

So, maybe thinking about your own experience, how do you balance this tension of helping others, wanting to be inclusive, but also ensuring, you know, your career and your livelihood.

Challenges of Being a Researcher Using Psychedelics

Rafaelle: Yeah. I, for me, the thing that I think ensures the most safety in terms of career, livelihood, and professional reputation is that, I don't consider myself a psychedelic forward person.

I don't consider myself someone who recommends drugs first. In my practice and, in conceptualizing, clinical trials, I'm thinking very intentionally about what are all of the different pieces that can go into this work. So for me, I, I don't think that solution is just dose people with psychedelics.

I don't even really do, medicine assisted work right now. I do a lot of somatic focus and, internal family systems focused work with people. and really seeing a lot of benefit from those modalities.

Professionally, it's really important to understand all of the tools at your disposal and being adept at using as many tools as possible and seeing psychedelics as a tool that can be used at some specific points in therapy, but seeing psychedelics as a primary tool in therapy, it's kind of a trap.

The reality is that healing is much more complicated and requires a deep level of trust and relationship in order to really create that long term transformation and change.

And, you know, being able to just talk in terms of clinicians are already doing, and what clinicians are already familiar with, and helping them understand where psychedelics fit into that process. That psychedelics aren't replacing anything that they're already doing, but that psychedelics are facilitating certain things that, are already part of therapeutic goals.

It really helps people understand, like, okay, this is coming from a grounded place. You're actually saying we're moving in the right direction, but here are some tools that can actually facilitate the process and make it a little bit easier.

John: It's it's really again. Well said I've really been appreciating your your articulation through all of this and I wish we had more time you've touched on a few aspects of this but in my mind thinking about like the future in your own aspirations for the work you're doing but also the industry as a whole where do you see the future really of psychedelic research and psychedelic assisted therapy going?

Rafaelle: There's two things that question: One is where I want it to go and one is where it could go So I'll start with where I would like it to go. I would like to see psychedelic assisted therapy being something that is accessible to all people from all walks of life.

I think that it is important that people in many different communities, in many different walks of life, have access to therapists that are part of their communities, that share their identities. who can support them through some of the most difficult experiences of life and help them overcome some of these struggles.

Not just in the therapy office, but also in society. I hope that the process of healing is not just an individual act, but it's a collective act. It is an act that, as we become more aware of people's traumas, and as we heal people's traumas, we gain awareness of how our society has either inflicted these traumas, or worsened them through a lack of support, through a lack of resource.

And I hope that psychedelics can grow that awareness and can be a vehicle for, that process. We're also seeing right now that psychedelics are also potentially being seen as the next Prozac or the next pharmaceutical drug that can heal or, get rid of mental illness.

It's a potential danger that we face. I think that it's really important that we really assess, okay, how, how are we approaching this and what is our end goal? We have clinical trials and people had their depression, improved or went into remission and we can get those drugs approved for therapy and we can have clinics where people are going and receiving psychedelic drugs.

But if we're not addressing systemic factors, if we're not also thinking about the larger scale issues, it's only going to be a band aid. And we're going to be right back in the same problem again that we had with all the antidepressants that we have already at our disposal. So it's a tenuous place there's a lot of money that's come into this, there's a lot of people who see this as a, as a big investment opportunity.

The process of healing needs to be separate from, making money and needs to be focused on really helping people. People who want to help need to be asking those deep questions about how am I helping, what does help look like, how can I listen to the people who need help.

And how can I become an advocate for those people? Not just in the therapy office, but also in our society as a whole.

John: Yeah. the commercialization of psychedelics it's a slippery slope. And yeah, how do you balance those factors? The economic side of, needing the research money and the grant money and the investor money and,yeah. Well, I, I wish you strength and I'm so grateful for, for the work that you're doing.

Rafaelle, maybe some final thoughts, just reflecting on your own journey, personally and academically and clinically. What insight, would you want any listeners to take away from this? Any message you can leave them with?

Closing Thoughts

Rafaelle: The main message that I have is, that relationship is the most psychedelic thing that there is.

I hope that people can find that human connection. It, it brings out everything in us, everything that is conscious, everything that is unconscious. And the, the basis of healing and the, the real testing grounds for healing is in our relationships. So it's in our communities. So I think the main thing that I would.

What I want to encourage people is to get engaged, you know, make friends that make you feel like yourself, that make you feel whole and accepted, get involved in activism and help push forward forward. Things that are going to help your community. Write to your representatives, vote, be engaged in the world.

Sometimes we can get apathetic, or we can get disconnected or dissociated from what our potential impact is, or we can forget that because we've been harmed in relationship, we become avoidant of relationship, or we become afraid of it. I would encourage people to, to know that, that healing can ultimately happen, in that human connection.

Psychedelics can, bring awareness in similar ways, but that the real nexus of everything is, is the connection that we have to one another and to the world. I would encourage people to know that taking psychedelics with good supportive people or, finding a therapist or a guide who is really genuinely caring and invested in someone's well being both inside the therapy or, you know, in the, drug experience, but also outside of it and in a continuous way.

I think that that is really the transformative power that we have and that these substances can play in our society and in our world. Those are some lofty goals, but I, I would like to encourage people to continue exploring that.

John: It's well said the, the power of relationships and, and finding your people.I love it. Well, Rafaelle, where can people find more of your life, maybe online, point to any work you're doing, or reach out to you and contact you?

Rafaelle: I have a professional website. It's relationshipispsychedelic.com. And, you can also see the research lab where I'm working at, cpdre.org. And I'm also a board member of the Source Research Foundation, which you can find on sourceresearchfoundation.org. That's a grant making organization. We provide grants to students who are doing projects related to psychedelics. We also have a community grants program for people who are not students who are involved in their communities doing projects related to psychedelics, and we also have a travel grants program to help fund people to attend conferences and that the travel grants program is for students, people in the field, people who are not in the field who are interested in learning more.

I also run, a forum, regarding harm reduction related to 5 MEO DMT, and that is, 5MEODMT.org. So, those are all kind of the main things. And then you can look me up on ResearchGate, for publications.

John: Awesome. Thank you so much. We will, yeah, for sure link to all of that in the show notes and I wish you nothing but continued success and thank you so much again for, for doing all the, personal and professional work you are doing on yourself to help heal others. I love that.

The relationship is psychedelic. So great. That's classic. All right, Rafaelle. Well, thank you so much for joining us on the Human Science Podcast, and we'll talk to you next time.

Rafaelle: All right. Thank you so much, John.

John: Thanks for listening to Human Science. If you enjoyed this episode and you'd like to help support the podcast, please share it with others or rate and review it. All the show notes and links can be found over at labfront. com slash human science.