The Disorder of Stuckness Obsessive-compulsive disorder is, at its neural core, a disorder of stuckness: loops that repeat because the brain's error-detection and habit systems cannot complete their cycles. The obsessions (intrusive thoughts of contamination, harm, symmetry, taboo) generate the compulsions (checking, washing, ordering, reassurance-seeking), the compulsions briefly relieve the anxiety, and the circuit reinforces, […]
Category Archives: Articles
The Deadliest Psychiatric Illness Meets the Compounds Anorexia nervosa holds a distinction no one wants: the highest mortality rate of any psychiatric condition, a death rate that exceeds many cancers in the years after diagnosis, and a treatment record that has barely moved in decades. The standard approaches, weight restoration, CBT, family therapy for adolescents, […]
The Same Molecule, Two Regulatory Universes Few facts in pharmacology are more quietly subversive than this one: the active ingredient in Adderall is mixed amphetamine salts, and the active ingredient in Desoxyn, FDA-approved for ADHD and obesity, is literally methamphetamine hydrochloride. The molecules that dominate the public's drug fears are, in slightly different formulations and […]
The Small Self, Measured Stand at the edge of the Grand Canyon, watch a rocket land, hold a newborn, hear a symphony swell, and something predictable happens: the sense of self shrinks, the jaw loosens, time shifts, and a feeling arrives that has only recently gotten scientific attention of its own. Psychologists call it awe: […]
The Field's Oldest Promise, Redeemed Long before depression and PTSD claimed the renaissance's spotlight, addiction was the psychedelic compounds' original therapeutic claim. The first golden age's most-cited studies were alcoholism trials; Bill Wilson, AA's founder, spent his final years lobbying (unsuccessfully) for LSD-assisted work with alcoholics; and the modern renaissance's founding framing, before the marketing […]
The Strangest New Job in Medicine In the clinical trial rooms of the psychedelic renaissance, a new professional has appeared, wearing no white coat and carrying no prescription pad: the psychedelic chaplain. Trained in the clinical frameworks of hospital chaplaincy and in the specific phenomenology of the psychedelic state, these practitioners sit with trial participants […]
The Bottleneck Nobody Planned For The psychedelic renaissance has a mathematics problem. Every credible protocol, clinical or licensed-service, runs on trained facilitators: the sitters of this series' guides, the therapists of the trials, the guides of the retreat frameworks, in ratios of one to two professionals per participant per session, with sessions running six to […]
The Worst Pain in Medicine Meets the Oldest Medicine Cluster headaches occupy a category that the rest of medicine acknowledges with a kind of helpless awe: attacks of periorbital pain so severe that sufferers have been documented banging their heads against walls, and that carry the highest documented suicide rate of any pain condition, which […]
Between the Stimulant and the Empathogen MDMA has so thoroughly claimed the empathogen spotlight that most people do not know it has siblings. MDA (3,4-methylenedioxyamphetamine), its closest relative, preceded it by decades, was the original "love drug" of the 1960s, and delivers a noticeably different experience: more visual, more stimulant, more speed with a psychedelic […]
The Session Most People Get Wrong First psychedelic sessions share a failure pattern so consistent that the harm reduction literature treats it as a solved problem, and yet the pattern persists: an unprepared person, in an unprepared setting, with an unknown dose from an unknown source, with no sitter and obligations the following morning, having […]