#01 – Tim Ferriss: depression, psychedelics, and emotional resilience

1. 0:00 – 0:02

   Intro

   1. PAPeter Attia0:00

      [upbeat music]

2. 0:02 – 4:53

   Welcome, Tim's Background, and a Psychedelics Disclaimer

   1. PAPeter Attia0:02

      Hey, everyone. Welcome to The Peter Attia Drive. I'm your host, Peter Attia. The Drive is a result of my hunger for optimizing performance, health, longevity, critical thinking, along with a few other obs- obsessions I've gathered along the way. I've spent the last several years working with some of the most successful top-performing individuals in the world, and this podcast is my attempt to synthesize what I've learned along the way to help you live a higher quality, more fulfilling life. If you enjoy this podcast, you can find more information on today's episode and other topics at peterattiamd.com. Welcome to episode one of The Peter Attia Drive. I can think of no better person to begin this podcast with than my very dear friend, Tim Ferriss. Not only is Tim a really close friend, but he's also almost single-handedly the reason this podcast is coming into existence. So in other words, if you hate it, you can blame Tim. Tim has been kind of on my case for about two years to do this, and more than anything else, he's just really helped me think about how I can sort of put something together that allows me to create something that is sort of new and that isn't already out there in terms of content, but also is something that I'll find enjoyable to do and that hopefully will come across as this podcast gets underway. I'm guessing most people listening to this know a lot about Tim, but on the off chance that there are some who don't, I think it's just worth kind of giving a little bit of background on Tim. He's been described as a, quote, "A cross between Jack Welch and a Buddhist monk," by The New York Times. He's one of Fast Company's most innovative businesspeople. He's an early-stage tech investor and advisor, and that includes a number of companies that most people have heard of, such as Uber, Facebook, Twitter, Spotify, Alibaba, and at least 50 others. He's also the author of five number one New York Times bestsellers and Wall Street Journal bestsellers, The 4-Hour Workweek, The 4-Hour Body, The 4-Hour Chef, Tools of Titans, also known as Biggest Tools, that's an inside joke in reference to the podcast, and Tribe of Mentors. The Observer and other media outlets have described him as the Oprah of audio due to the influence of his podcast, The Tim Ferriss Show, which has about 300 million downloads at the time of this recording. It's also been selected as the best of iTunes for three years running. Now, I wanna say something about this episode that will become apparent, obviously, once we get started. One, we talk a lot about things that are topics that Tim and I don't really spend a lot of time discussing publicly and certainly personally. And so it's important to understand here that while Tim and I do talk quite openly about psychedelic experiences we've shared in South America, it shouldn't be taken to mean that that's what we're recommending that anybody go out and do. We're absolutely not doing that. There are physical, there are psychological, and there are legal risks among these things. And it's important to remember that in the United States at the time of this recording, psychedelics like psilocybin, which we speak about quite a bit, along with mescaline and things that we don't get into much detail around, such as ayahuasca, these are currently Schedule I, which means that they are illegal. And while we believe obviously that that designation is completely unwarranted and will likely, you know, eventually no longer be the case when the scientific community has a chance to catch up and understand the great potential of these things, really the purpose of this podcast is informational only. And while I do generally provide a disclaimer at the end of my podcast that explains that all of this information is informational, I wanna be really clear about this particular issue. We talk a lot about these things. We talk about a few other things as well, and I think even for the listener who doesn't find this topic to be particularly interesting, one thing that we talk about at the very end of the podcast that I'd been meaning to ask Tim for a while, and certainly I get asked a lot, is what are the things that you still incorporate in your daily routine? Tim has written so eloquently about this stuff and has codified so many ways to find these minimum effective doses and to optimize everything he's doing that I think people wonder, "Hey, which are the things that have really stood the test of time?" And so I actually found that last part of the podcast to be especially interesting, even for me, though I knew these things and I can see all the things that Tim does day in and day out. But to sort of have him say, "Look, if I had to pick five, these would be the five." Tim can be found all over the place, but I think the best places to see him are on his blog, which is tim.blog. You can follow him @tferriss, that's F-E-R-R-I-S-S, on Twitter, and you find him @timferriss on Facebook and Instagram. I hope you enjoy this first episode half as much as I enjoyed recording it, and there will be lots more of these to follow. So with all of that said, please welcome Tim Ferriss. [upbeat music] Hey, Tim.

   2. TFTim Ferriss4:52

      Peter.

3. 4:53 – 12:17

   Life in Austin and Starting the Podcast

   1. PAPeter Attia4:53

      Thank you for having me out in Austin this weekend.

   2. TFTim Ferriss4:55

      My pleasure. It's been a good weekend. Good view too.

   3. PAPeter Attia4:59

      Yeah. What I can't believe is in the relatively short period of time you have lived here, you've become essentially the unofficial mayor of Austin.

   4. TFTim Ferriss5:07

      [laughs] Well, I like to get involved and to explore all the various nooks and crannies of any city that I live in. And after 17 years in the Bay Area, I felt like I'd left almost no stone unturned. Have many dear friends who are still there, but many of them have traveled outside, and one of the places that was an annual migration was South by Southwest here in Austin. And had wanted to move here right after college, gotten to know it year by year with increasingly longer stays in the city before and after the festival itself, and now it's home. Couldn't be happier.

   5. PAPeter Attia5:47

      Feel like every place we went in the last three days, everybody knew you, like the owner of the restaurant would know you-

   6. TFTim Ferriss5:53

      [laughs]

   7. PAPeter Attia5:54

      ... and the coffee shop, and it was... I don't think I've drank more coffee and Topo Chico in as, as short a period of time-

   8. TFTim Ferriss6:03

      [laughs]

   9. PAPeter Attia6:03

      ... as I have in the last three days.

   10. TFTim Ferriss6:04

       Yes. Coffee, Topo Chico, and so many things here. Yeah, breakfast tacos is something I haven't yet- Explored. That's another form of religion here, right next to barbecue and bunch of other things. But it's a cozy feel. It has a neighborhood feel, and I've come to value that type of neighborhood feel and cohesion, which is something I probably wouldn't have paid much attention to 10 years ago.

   11. PAPeter Attia6:32

       Yeah. I've sort of always assumed I would live forever in California, and I gotta say, all your hard work here to get your friends to move out here, it's-- I think it's gonna pay off.

   12. TFTim Ferriss6:41

       [laughs]

   13. PAPeter Attia6:41

       I, I, uh, I think I can see Austin in my future.

   14. TFTim Ferriss6:44

       Yeah, I have a l- I have a lot of friends who are moving, and I think in, in many respects, it's defined by the fact that it's difficult to categorize. There is no one mono conversation about tech or entertainment or finance. And, uh, some people might view that as a weakness, meaning if you're looking to live in the epicenter of a certain industry, and you're in your early 20s and want to cut your teeth and live that hyperkinetic, super aggressive lifestyle while you're building your foundation for the future, that's one thing. But in my case, I much more so am placing value on the general friendliness, the cultural diversity, which is not just skin deep. It covers so many different bases here. And I enjoy the fact that you can go from a strict vegan restaurant to a deer processing plant [chuckles] to an electric scooter startup office to a cowboy boot store, all in the stretch of a few blocks. That's exciting to me.

   15. PAPeter Attia7:56

       And though I've never really bought the argument that people in New York and Southern California, which are the two places I spend most of my time, are... You know, I've never bought the argument that those are snotty, super snotty places and nobody's nice, 'cause I do think that people are actually pretty decent everywhere, including in the middle of Manhattan. But that said, it's a different level of nice here that is completely foreign to me.

   16. TFTim Ferriss8:17

       [laughs] Yeah, it is. I remember when I first moved to Austin, and I had a number of neighbors drop off cards or come to the door to ring the bell to ask if I wanted to come over for dinner, and I didn't even know how to respond.

   17. PAPeter Attia8:31

       [laughs]

   18. TFTim Ferriss8:31

       Which, which really-

   19. PAPeter Attia8:33

       You're like, "What are they selling?"

   20. TFTim Ferriss8:34

       ... told me more about myself, that I was so mistrusting, perhaps. But in San Francisco, that does not happen, as far as I know. I've never heard of that happening. Certainly in New York-

   21. PAPeter Attia8:46

       Hmm

   22. TFTim Ferriss8:46

       ... it'd be, you know, time to check your security system and [both laughing] and consider your, your avenues of getting out of the house. But here, that's just par for the course, and it's, it's really been nice to embrace that. And e-even within Texas, Austin is, is known for being very, very friendly, and I've, I've met many different people here who've moved from Houston and other parts, which are also fantastic in their own way, because of the general level of friendliness. So I'm a fan. I'm a fan. You know, I, I always thought I would be, felt the gravitational pull here when I graduated and did not get the job here that I w- so coveted at Trilogy, and it turned out being a blessing in disguise that I didn't get the job, and I think also for Trilogy, because I, I most likely would've been a terrible employee. But that took me to NorCal. Had a great stint there, but that chapter came to a close, and it was just the right time.

   23. PAPeter Attia9:45

       Well, as I said, it's been amazing to be here. Not my first time here, but each time I come, I, I like it more and more. And I guess with that said, we are kicking off effectively the first episode of a podcast that you, more than any other friend, although several friends have played an enormous role in the so-called cajoling, as I referred to it earlier, in making this happen. So if this ends up sucking, um-

   24. TFTim Ferriss10:11

       I'll take all the blame [laughs]

   25. PAPeter Attia10:12

       ... I'm blaming you. And, uh, if this ends up doing okay, I'm thanking you. But either way, I, I think this has been-- This will be fun.

   26. TFTim Ferriss10:19

       I think my customary 30% is very reasonable. [both laughing]

   27. PAPeter Attia10:23

       30% of what, right? Yeah. Now, obviously, this podcast is on some level, and, and probably on a large level, going to come down to things that I think a lot about and hope to bring to people. You asked me the other day, you know, what am I hoping to accomplish with this? And I don't have a great elevator pitch on it, but one of the things is I find myself so often having conversations with people that I think, "God, this person's so much smarter than me and knows so much more than me, and they're letting me be a sponge right now and absorb so much information from them." And so many times, I find myself at the end of those discussions thinking, "I can't believe nobody else got to hear that. What if I didn't extract everything from that correctly? What if there was more to be gathered?" And so it's really that desire to sort of have as many of these conversations as possible and be able to sort of share them in their natural state that I think is, is a large part of this motivation. And while most people sort of associate me, I suspect, with thinking about longevity, we probably don't spend enough time talking about what longevity means. But the way I talk about it with my patients is it's both enhancing lifespan but also healthspan. And lifespan is the easier of those two to understand, because enhancing lifespan just means not dying, which is not to say that that's easy, but it's conceptually easy. I think the healthspan stuff is harder to understand, and as I have come to learn in the past three or four years, I believe for most people, it actually matters more. Many people think, you know, if you helping me doesn't add one day to the length of my life but improves the quality of my life, especially at the end, that would be sufficient. And so in many ways, what I wanna talk about today is one piece of healthspan that I, I know the least about by far, but also I think is the one that we are least likely to talk about as a society, which is sort of mental health. Now, you've spoken really publicly about your interest in that. I knew a lot of this before you talked about it at TED, but can you tell me a little bit about that?

4. 12:17 – 23:43

   Tim's Depression and a Close Call with Suicide

   1. TFTim Ferriss12:17

      I can, and I'm thrilled you're doing a podcast because I do think that just as, as a bit of overlay on what you said, there is so much focus on extending lifespan, rightly so. But the equal obsession, equal level of obsession that you bring to performance and healthspan, I think creates a compelling combination that I don't find in many places. I find the combination of those interests very common, but the combination of competencies, broadly speaking, in both of those domains is very uncommon. So I'm excited to listen to other episodes of the podcast. And as it relates to mental health, I should, as maybe a introductory preamble, say that this is not a topic I've always been comfortable talking about publicly. And in fact, I would say for the vast majority of my adolescence and certainly throughout high school and college, I somehow came to the conclusion that I was just not designed to be happy, that evolution did not optimize for happiness, and I just did not have the code for happy, and that was okay, that I would be an instrument of competition. I would learn to be good at various things that were valued at colleges and then by the business worlds and so on, and that it was, it was not worth trying to be happy or to not just love myself, but really have a high opinion of myself. And in fact, that was self-indulgent and that I would just focus on being the best competitor possible and hopefully turning that into something that was not only of value to me or that I was rewarded for, but that would help other people, and that perhaps I would find some joy in the joy of other people, but that was the extent of it. And s- suffered from many different bouts of extended depression for as long as I can recall, really. And that is also something that you can spot very easily looking back at my family history on both sides. And if you look back to grandparents and great-great-grandparents, a fair amount of alcohol consumption, certainly a fair amount of alcoholism. I thankfully have not soothed myself with excessive amounts of alcohol, but you see a lot of patterns that scared me certainly, but the depression was one that I, I could just not seemingly navigate around. And the TED Talk opened with a particularly close call, the closest call I've ever had. This is not a common experience for me. But in college where I came very, very close to killing myself and w- uh, actually got to the planning stages. It wasn't just rumination about what if, I wonder what it would be like to take my life. No, it w- it was a decision that had been made, and I was already in the planning stages. And to give people the short punchline to that, which explains why I'm here today, I had reserved a book which was going to be the last of many that I had read on this subject related to suicide. It was already checked out of the Firestone Library at Princeton, where I was at the time taking a year away from, and it was checked out to some other poor student. So I put in a request to be notified when it came back into the library, but I forgot to update my address at the registrar's office. And the address that I had on file after taking this leave of absence was my home address in New York where my parents lived. And so my mom got this postcard, which was, "Dear Tim Ferriss, this is to notify you that," and then whatever it was, you know, the final solution, da-di-di-da-di-da, whatever it might have been, "The How to Kill Yourself manual has arrived. Please come to claim your book within the next X number of weeks, or it'll be released to the next person who has it on reservation." Whatever the postcard said, and I got this very heartfelt, understandably nervous call from my mom with her voice cracking, asking about it. And I lied. I said it was, I was very fast on my feet, and I said it was for a friend at Rutgers who wasn't able to get the book for a dissertation or a thesis he was working on, so I reserved it for him. No, everything's fine. But in that moment after that call, I realized how these, in retrospect, little waves, small events can be blown, or even large events can be blown so out of proportion or seen as permanent in such a way that regardless of socioeconomic status, regardless of race, regardless of gender, people can be so knocked off course that they end up taking their own lives. And certainly recently, that's been very dramatically demonstrated and tragically demonstrated with the deaths of many people, including Anthony Bourdain, who comes to mind most recently. And that's just on the, the high-profile side. But in my case personally, I realized how my blinders and pessimism in this downward spiral had led me to really only focus on my pain. I didn't realize how until that phone call, committing suicide would have been like taking 10 times the pain that I felt and imposing it on the people who loved me the most. And that was a, a huge wake-up call. Uh, so that is why I'm here today, is the lucky accident that I did not update my address at the registrar's office. And if that had not happened, I mean, I was ready to pull the trigger, so to speak, although that wasn't how I was gonna go, [chuckles] but it was all specced out. It's terrifying to think of. Really, really terrifying to think of. And I have some of my best friends in high school who you never would have suspected from the outside looking in, killed themselves. College, same story. I just know so many people who have taken their own lives, and it always came as a shock to people at least who knew them in school, for instance. They seemed to have it all together. They seemed to have the good relationship or the good job or the good grades or whatever it might be, the good family. And that's led me in the last few years in particular to at the very least want to focus on discussing mental health, different facets of mental health from an experiential firsthand basis simply to tell people if... Assuming I don't have any type of ready answer for them, you are not alone. This is exceptionally, exceptionally common, but it's the dirty little secret that so many people carry around and are unwilling to discuss. And so at the very least, I want to say you are not alone. There are millions upon millions of people fighting similar battles, and everyone you meet is fighting some inner battle you know nothing about. So do not assume that you are alone. And I think in that, hopefully people can find some solace. And then beyond that, I've spent the last few years really investigating using the contacts and network that I've developed through the books and the podcast and the tech investing to explore avenues and potential treatments or interventions that can certainly help people who are on the brink get back to stability potentially, but also to take people who are, who might view themselves as stable or normal and to mitigate against the potential of losing their footing. And then there are... We, we can go beyond that certainly. But that is the... My interest in this certainly began on a very personal level. How do I... Is it possible, I should say. Forget about how. Is it possible for me to manage this? And, uh, the type of thinking that triggers the most dangerous downward spirals is, what's the point? If I'm, if I'm constantly going to default to this negative thinking, and I'm so blessed for A, B, and C reasons, what's the point? And, uh, that is a really, really poisonous sort of toxic mental landscape to immerse yourself into and, and get caught in. So is it possible for me to somehow decrease the frequency of those types of episodes? Is it possible somehow to decrease the severity of those episodes? Is it possible to look at my quirky biochemistry, my software in a way that I see some blessings within my day-to-day, month-to-month experience that in some way counteract the tendency to view myself so harshly when the inevitable dips come? Long answer to a short question, [laughs] but that's, that's really been particularly in the last, I would say, two years, three, mostly starting about five years ago, but in the last two or three, really diverting a lot of my attention that was going to startup investing, a lot of my resources that were going to startup investing to areas that are related to this.

   2. PAPeter Attia22:08

      And there's so much of that stuff I can't wait to talk about today because you've brought a lot of people along on this ride with you. So obviously, I can only speak from my own personal experience, but we have so many mutual friends who have also been heavily influenced by sort of a sense of awareness that you've brought to us with respect to all of these things, but also potential solution spaces that are outside of our realm of thinking. You know, you said something at the outset, which was you just thought you weren't wired to be happy, which I, I mean, I can resonate with that completely. I remember as a child, my mom would always say to me, you know, "Peter, do you just not want to be happy?" And I would, I would look at her like, "I don't know what kind of dumb question that is. Like, it's not an option. Like, you might as well be asking me if I want to be 12 feet tall, like I have some say in the matter." Uh, it's not about wanting to be happy. It's just about metaphysically not being able to be happy. And then furthermore, my thought, which was even a bit more obscure or maybe bizarre, was happiness was a bad thing because you would stop being hungry.

   3. TFTim Ferriss23:06

      Makes you complacent.

   4. PAPeter Attia23:07

      Yes. I really-

   5. TFTim Ferriss23:08

      Right. So right along with self-indulgence, there was that.

   6. PAPeter Attia23:11

      Yeah. It was like, "Mom, if I was happy, I wouldn't get up at 4:30 in the morning and run harder and faster than anybody else to..." And of course, I didn't have the... I don't think I had the mental framework to probe that idea further, which is what are you proving? Who are you proving it to? Why do you feel the need to do all of these things? But it wasn't until quite recently that I even began to entertain the idea that being happy is not a bad thing.

   7. TFTim Ferriss23:36

      Or put another way, that it's a good thing.

   8. PAPeter Attia23:37

      Yeah. [both laughing] The double negative.

   9. TFTim Ferriss23:40

      Yeah. Right.

   10. PAPeter Attia23:41

       Right.

   11. TFTim Ferriss23:42

       Right.

5. 23:43 – 34:56

   Self-Talk, Type A Fears, and Redefining Success

   1. TFTim Ferriss23:43

      Just to touch on a, a few things you just mentioned which I think are really important, the self-talk. Jim Loehr, who's a performance coach who's worked with many, many of the most famous tennis players and other athletes in the world. I s- I had a chance to spend time with him for my last book and then also for some tennis training in Florida, and, uh, he s- he spent time with one of my very close friends, Josh Waitzkin, as well, who's, who's best known for being the basis for "Searching for Bobby Fischer," for those people who are familiar. And he talks a lot about the inner voice, the most important coach and voice you ever hear is your inner voice. So I've learned to pay increasing attention to the words I use, particularly when I'm ruminating, referring to myself, talking to myself, making a note to self. [laughs] That's a long story. Inside joke, guys. Another time. And [laughs] I found myself using perhaps very unsurprisingly similar language to yourself. If I were happy, I wouldn't be doing the things that are very clearly contributing to my success, whatever that means. And not only that, but on every possible level, if I were to find joy in too many moments [laughs] or to not feel deficient or inadequate or loath- loatheworthy [laughs] , which is honestly how I've, I felt for the majority of my life. No, I don't just not love myself. Like, there's a deep sense of, well, I hate to use the word hate, but it's the right word, like loathing. Like, how could you be so stupid? How could you be so lazy? How could you be so fill in the blank? Toughen the fuck up, and you may not have control over all things, but you know what you can get really, really good at doing is absorbing pain. Like, get really good at absorbing pain. It's like, okay, if you work hard and have a high pain tolerance, maybe you can win. Maybe you can be successful. And I should put win and successful in quotation marks because they're so seldom well defined by people who use this type of language, including myself for decades. But what I've come to realize, and this, this is also a, I think, a common concern among Type A personalities who consider or are told by people they respect that they should take a stab at meditation for a period of time. There is this highly prevalent, almost universal concern among Type A personalities, by which I just mean driven, like hard-charging, head through walls. I can take the pain. Fuck it. I'm just gonna grit my teeth and white-knuckle through anything that comes my way, which, hey, let's, let's face it, that serves people very well up to a point in certain ways. They worry about losing their edge. This is the exact wording that I hear so often and the exact wording that I used with my friends when they first recommended, a few of them, Rick Rubin and Chase Jarvis, very specifically Rick Rubin, legendary music producer, although that doesn't e- it's not even a drop in the ocean of what Rick does and who Rick is. But Rick Rubin and then Chase, very, very famous photographer, also the CEO of a company called CreativeLive, which is an incredible company in and of itself. Both of them recommended meditation to me, and, and I resisted for more than a year, I want to say, because I was afraid of losing my edge. Even though what I came to realize was if you want to use your edge indiscriminately like a kitchen knife, which is only a blade, right? Like the handle is also bladed on both sides. You can continue doing what you're doing. If, on the other hand, you want to put a nice ergonomic handle on that beautifully honed blade so that you can use it as an instrument for its, its highest purposes, you can utilize different tools, meditation being one of them, and we could talk about all the different types of meditation as well because I think they do have slightly different applications, is a tool in the toolkit that allows you to build this beautiful kitchen knife instead of holding onto the blade itself, just bleeding over and over again, scabbing, bleeding, scabbing, bleeding, which is, I, I, I think day to day how many driven people experience life, whether they are financially stable or not. If they are compulsively active, if they are using the distraction of constant motion and absorbing pain and seeking pain to numb themselves so that they don't have to be in their own head any longer than possible, which is what I did for a fucking long time, pardon my French, but I mean decades. If they're able to develop other skills that allow them to... And, and I've certainly less, less than seeking happiness, I have been looking for ways to both develop in myself and help others to develop a sense of peace, even if it's 10 minutes a day [laughs] . That that does nothing, nothing negative in my book other than magnify your strengths and allow you to maybe for the first time see some of your weaknesses that are very often self-imposed, and the blind spots that have been like an invisible hand guiding your life for, in some cases, decades. I see no, I really see no downside to that. And since I've had two cappuccinos and I guess have some extra personality, I'll, I'll further extend my long-ass answer by saying my books very clearly track my priorities in some respects. You have The 4-Hour Workweek, which looked at different types of currencies, time being the most valuable non-renewable of those, and how to address a few rungs on Maslow's hierarchy of needs. And as I've moved along and suffered my own burnout of different types, not necessarily financially related, but certainly 4-Hour Chef took me out for the count. I bit off more than I could chew, in part because I was having some personal difficulties in some relationships, and I wanted to numb myself. I went back to that numbing behavior, which included taking stimulants, which included over-caffeinating, um, in addition to the, the pills and so on, using alcohol at night to wind down Uh, engaging in exercise that was far more painful and ridiculously punishing than it had to be for any type of health or performance purpose. And I crashed and burned, and that led to the podcast as a way to take a break from book writing, which led to the explorations and talking to people like Brené Brown, talking to people like Tara Brach, talking to people like Jack Kornfield, and many, many others. Th- then led to, say, Tribe of Mentors, or Tools of Titans, then Tribe of Mentors, and where I am now, where I look at this Maslow's hierarchy of needs and realize, at least for myself, let's say you cover your food, you cover your shelter, you cover da, da, da, da, da, and you get up to these rungs on the ladder where you've checked off success. You are blessed. You are hopefully healthy. Your family might be healthy, and you can meet all of your basic needs and probably have some disposable income, and yet you have trouble living with yourself. That's a fucking tragedy. I mean, it's, it's... To have deciphered how to achieve and yet not be able to appreciate is, that is just the tragedy of tragedies. It's this kind of fool's errand that could have taken five years, could have taken 10, could have taken 20, and then you see people like that who do not know which way to turn and then perhaps just withdraw into a shell and, you know, s- sit at a table with their family and look at their phone for the entire dinner over and over and over again because they don't know how to emotionally engage with themselves, let alone other people. Or you see the more dramatic cases where they're like, "All right. I thought these things would make me happy. I was told these things were the necessary ingredients for eventually solving this r- emotional Rubik's Cube that I've been struggling with my whole life, where I assumed that, poof, one day I would just wake up and have made it." Even if having made it just means y- you're not struggling with alcoholism and rent like your parents did or something like that. And, uh, and I've come to realize you don't need to, and you should not wait until you think you have all of the other pieces, non-emotional, non-psychological pieces of the puzzle together to start working on self-acceptance, a- among other things, and untying some of those Gordian knots that you have, that you might have carried for decades since your childhood. And, uh, that it is not esoteric. It is not intangible. When you start to address some of those things, it makes everything more effortless. It makes everything more rewarding, and that, I think, is a project worth tackling. [chuckles] It's a lot, but that's... Yeah, this, this depression, I think particularly among men who are very, very, very bad generally, and I'm just gonna paint with a broad brush because that makes this type of conversation a little easier. But broadly speaking, cross-- across cultures, it really doesn't matter where you go, women are generally better at social cohesion and building groups of friends who are mutually supportive, and we can look at it through an evolutionary lens, but men very often are biologically, culturally, who knows, fill in the blank, trained and maybe born to just bite their lip and suffer in silence. And I do think there are certain places for that. Look, if you're gonna be a Navy SEAL commander, waking up every morning and, like, telling th- your direct reports, like, about your really hard dream you had, probably not, like, strategically, tactically, professionally, or ethically the right thing to do when you have to go out and then risk your lives doing things that are mission critical to fill in the blank, right? So there, there is a time for that, but to make that your one coping mechanism for navigating life or, like, the sort of the mesh that is imposed on everything else, that you suffer in silence, and that the solution to that is just to get tougher, to get better at accepting pain, to use cheesy, uh, tech parlance, doesn't scale. It just doesn't scale.

   2. PAPeter Attia34:56

      You know,

6. 34:56 – 40:06

   Treating Yourself as You Treat Those You Love

   1. PAPeter Attia34:56

      when I was on your podcast the first time, which I don't know how long ago that was, it feels like it's probably been three or four years ago, one of the questions I remember you asked me, which of course you ask many of your guests, is, "What book have you gifted more than any other?" And I remember the book I mentioned at the time. It was and remains a great book, but I now have to update that answer.

   2. TFTim Ferriss35:14

      What was it, just for people who are curious?

   3. PAPeter Attia35:15

      It was Mistakes Were Made But Not By Me, which is just an amazing book on the psychology of cognitive dissonance. But of course, that now has been surpassed. There is now a new book that is my most gifted book, and amazingly, I don't-- I can't believe I didn't bring a copy to Austin to give you, 'cause I now... I probably-- I think I just buy Amazon out of this book. Like, I just have stacks of it all over-

   4. TFTim Ferriss35:37

      [chuckles]

   5. PAPeter Attia35:37

      ... like you have stacks of certain books in your place. And this book is called I Don't Want to Talk About It-

   6. TFTim Ferriss35:42

      Mm

   7. PAPeter Attia35:42

      ... by Terrence Real, who I've since reading the book and becoming obsessed with... Actually, it comes back to you. You introduced me to Esther Perel. Esther recommended the book. The book was one of a series of little nudges that ultimately led to me meeting Terry, and of course, that book has now been the book I have given most. But what you said is spot on, which is there is just this epidemic of male depression, and it's not always overt. That's the thing, right? People have this image of what depression is, but, you know, like a guy who's constantly angry or emotionally volatile, he can be quite depressed. So depression isn't always dysthymia, and I think that's where people miss this idea of how much pain people, both men and women, carry around, but how men have this more orthogonal way of displaying it that makes it get masked longer and longer. And I wanna go back to something you said earlier, 'cause it really hit home about a year ago when a mutual friend of ours, Paul Conti, made this point to me, which was, "The way you treat yourself is ultimately how you will treat those you love most." And, you know, when he really pushed me to think about that, which is, do you want to be the guy who treats his kids the way you treat yourself? And it ha- I ha- it had to be put that way for me to think, no. I mean, if I'm gonna be brutally honest, I would not want to watch my kids get treated by another human the way I treat myself, even though I think it's good for me to treat myself this way. So again, I think the challenge is, by far the, the hardest part is getting people to accept that maybe what they're doing isn't the right thing, or isn't, maybe right's the wrong word. Eh, [chuckles] it's not the best thing. It's not the optimal thing. I loved your analogy of taking the best blade in the world and not having a handle on it. I mean, it's a limited tool.

   8. TFTim Ferriss37:39

      Yeah. And there are... So I would say, just to maybe put a fine point on it, going through life merely tolerating yourself, which would've been a dream for me. I mean, I, I actively loathed myself, and any weakness, any mistake, any foible, any flaw. I was, I was and, and, and still at times am, am so incredibly violently critical in my own head that it, it is not the treatment I would wanna, uh, that I would wish on anyone I care about. That is not a state you have to accept. It is not programming that you have to accept, and there are ways to begin to chip away at that and to rewire it and to reformat, in a sense, certain behaviors that you've experienced for so long, many of them are thought patterns, self-talk, that you've come to believe they are completely unchangeable. And in my experience, and more and more the experience of dozens and hundreds of th- and thousands of other people I've observed in the last five years, it is, is patent, it is patently untrue that you have to accept that. And I think what you said is really, really important to digest and ponder, and that is, you know, how you treat yourself is how you are going to treat the people you care most about. And I think it was actually Gloria Steinem who had a quote, and I, and I don't know if this is accurate, but somebody on the internet I'm sure will fact check this, [chuckles] who said, in effect, I'm paraphrasing here, but the goal... You have to remember that the golden rule goes both ways. So we all know do unto others as you would have them do unto you. If you flip that around, it is do unto yourself as you would do unto others. And that is really, has very profound and wide-reaching implications when you really sit with it for a minute. And suffice to say, though, you do not have to accept the inner voice or the patterns that have led you to pursue success with rare glimpses of any type of inner peace. That i- that is not something you have to accept.

7. 40:06 – 55:43

   Entering Psychedelics: Tim's Mushroom and Ayahuasca Experiences

   1. PAPeter Attia40:06

      So one of the most sort of profound experiences I've had, and sets of experiences I've had in the past few years, are experiences we've shared together around certain plants that honestly I was completely unaware of and ignorant of for most of my life, had never really given them any thought. And probably much of the stuff that you've talked about, written about in the past, in particular there were two podcasts that you did. One was with Martín, and I'm trying to think who the other one-

   2. TFTim Ferriss40:37

      Martín Polanco and Dan Engel.

   3. PAPeter Attia40:39

      Dan Engel, that was the other one, yeah. And those were two separate podcasts, but they were very close together, if I recall. They were a couple of months apart.

   4. TFTim Ferriss40:44

      There were a few together and then a few apart. So you had James Fadiman, and then Dan Engel and Martín together.

   5. PAPeter Attia40:52

      That's right.

   6. TFTim Ferriss40:53

      And then later Michael Pollan.

   7. PAPeter Attia40:57

      Yeah. But that first wave was probably 2015-ish?

   8. TFTim Ferriss41:02

      Yeah, it was a few q- it was, it was a little bit of years ago.

   9. PAPeter Attia41:03

      Yeah, probably about three years ago. That was the thin end of the wedge. And interestingly, the thin end of the wedge for me was around something that wasn't a personal issue, but more of a societal issue, which is I was blown away by the discussion and the clinical results that they were achieving in Mexico using a plant called iboga, and using i- ibogaine as well, to treat patients who, uh, were opiate addicted. And that's something that even back when I was sort of, you know, in my residency and you would see in a city like Baltimore what the effects of heroin addiction are, and of course today it's even a much bigger issue and it's spread far beyond just heroin. So that just interested me purely from an intellectual standpoint, which is, wait a minute, we have a drug or set of drugs that are so categorically addictive to so many, for which our only treatments are at best useless, and there's this other thing that admittedly comes with plenty of risk and plenty of unknowns, but it seems to fundamentally change the way a person's brain is wired, which would seem to address the root issue as opposed to the Band-Aid. That led, of course, to me wanting to understand more about those entire classes of compounds, and that led to my very first experience with them, which I shared with you, meaning which, you know, you helped me through, which to this day remains one of the most profound things I've ever done. And if anybody's listening to this who's thinking What are they talking about? What are these psychedelic agents? Aren't those drugs? You know, all these things. [chuckles] One of the most remarkable things I remember after the first time I tried psilocybin was, I don't feel like doing that again anytime soon. [chuckles] Like-

   10. TFTim Ferriss42:49

       Yeah

   11. PAPeter Attia42:49

       ... these are the most anti-addictive compounds on the planet. [chuckles] What started your interest into that space?

   12. TFTim Ferriss42:57

       The interest began, and for those people listening who are wondering if, if we'll discuss any other tools, I think we should also discuss some other options on the table aside from this, although this is very fertile ground for discussion, so w- we can talk about meditation, some other tools, and books as-- and so on later. But the-- my interest in psychedelics began long ago with a close friend who introduced me to psilocybin, contained in what is commonly called magic mushrooms. Must have been in college, midpoint perhaps in college, and it became an annual ritual, and once a year, I would meet up with a few of my closest friends, and we would consume mushrooms. In retrospect, it was very haphazard. We were not measuring any doses. [chuckles] We would just have a big bag of mushrooms and split it up and then hope for the best, which is not ideally how you go about things. And nonetheless, despite [chuckles] the lack of controls, and I do not recommend anyone, uh, use these compounds under uncontrolled circumstances, I experienced what I began to refer to as a, as a reboot, and I, I would have this anxiety and depression plaguing me. I would go very, very deep, a- and looking back now, I was almost certainly consuming minimum of, of five grams. I'm sure I was consuming quite a, a high dose of mushrooms, which is, for those people who might read the, the writing or listen to some of the presentations of someone named Terence McKenna, five grams is referred to as a heroic dose, and that is a dose sufficient to flatten even the most resistant ego, I believe is the wording that was used. In any case, I felt this decrease or even complete removal of depression, anxiety that extended far beyond the supposed duration of effect. Let's just call it five to eight hours, and there would be this afterglow period that certainly lasted most acutely for a day or two after the experience. And I was going into this also with none of the best practices that we, we know of now in terms of preparation, intention setting, perhaps some of the preparatory steps you can take, and then integration. There's none of that, so this was very bare bones, haphazard experimentation with a few friends. Nonetheless, there were these periods of, let's just call it two weeks to two months, where I was able to finally see things clearly, appreciate all of the incredible chance blessings that I experienced in my life, and make decisions about things I viewed as serious problems or challenges or opportunities, whether it was making a decision about academics, making a decision about a relationship to either start a relationship or end a longstanding relationship. These were things I was able to look at very calmly and make decisions about. And ultimately, after I wanna say four or five years of this, had a very, very, very scary and dangerous experience, which was, again, with no sitters, in other words, no sober person supervising this, any number of things can go wrong, and o- one is people can wander around and get themselves into dangerous situations. And in my case, I ended up coming out of my trip very late at night, walking on the side of a street with cars whizzing by me. I mean, that could have very easily been the end, and that scared me enough that I stopped. I said, "Never again. Too dangerous," and I stopped. I didn't revisit psychedelics until, let's just call it, let's think about this, 10 to 15 years later when a girlfriend at the time who had v- uh, some very, very, very difficult traumatic experiences as, as a child traveled to Peru, which has its own set of very real risks that we can talk about if we would like, if you are going down explicitly for the purpose of using a psychedelic, most commonly in this case, ayahuasca. But her experience was strong enough and meaningful enough that she came back and said to me that she wished it for me because it was like 15 years of therapy in two nights. [chuckles] Now, if anyone knows anything about any of the books I've written or the way that I tend to view the world, that is a very, very effective sales pitch for Tim. [chuckles]

   13. PAPeter Attia47:56

       [chuckles]

   14. TFTim Ferriss47:56

       Fifteen years of therapy in two nights? Interesting. And I put that in the back of my mind, did not move ahead with it because of my fear relat- which I think was very-- it was well-founded. I had a, what could have been a very, very dangerous experience or fatal experience. Things had to get much worse [chuckles] for me to finally decide to reenter that world, which I did first through a guided psilocybin experience. I did not want to go straight to ayahuasca, which I, I, to this day, believe is a very, very big gun and can be very destabilizing I didn't want to go-- I didn't want that to be my reintroduction, so I did-- I had one guided psilocybin experience, which also lacked much in terms of any type of prep, integration, or post. So it, it was effective in the sense that it, it was like a returning home, and it was a familiar feeling that I came out of unscathed. I took an absurdly high dose because I didn't know what I had taken before [chuckles] . So for those people who know anything about it, I began at seven and a half and then did a booster at nine, which for me is, it is such an absurd overkill [laughs] to, as to almost defy belief at this point, which by the way is a, uh, counterproductive. Taking too much is counterproductive. It is not more is better by any stretch of the imagination. Being strapped to the icebreaker [chuckles] is not, is very rarely, uh, what someone needs. In any case, came out of it realizing that you could approach this in a safer fashion with a container, physical and otherwise, that allowed you to avoid the risk I had, that had scared me off. Then went into the ayahuasca experience about six months, perhaps six months later. Took it very seriously, had people sign non-disclosure agreements, had someone act as my proxy to try to vet people in several different countries, and ultimately honed in on someone I spent two nights with. And it was one of the most disorienting, awe-inspiring experiences of my life, without question. The first night, I was prepared for all of the sickness and vomiting and terror that I knew could be part of the experience, and it was blissful. It was an incredible first night. Second night was, without any exaggeration, the most painful experience of my life. At one point, I experienced full body seizures, so grand mal, uncontrolled, uncontrollable seizures for about, I would estimate, two and a half hours. Ended up with rug burns all over my face and hands and feet, and was completely lost. There was no contact, no footing in this reality whatsoever. And my subjective felt experience was one of being torn apart a thousand times a second, dying a thousand times a second, only to remanifest and have that repeat infinitum. It, it was beyond horror [chuckles] . And when I came out of the experience or the, the main [sighs] rollercoaster h- was, was coasting to an end after, let's call it six to eight hours, I was, I was partially detached from reality for probably 36 hours, and I had very fortunately paid someone in advance to babysit me and act as a chaperone for that extended period in the off chance that it happened, which [chuckles] ended up being the case. And the entire time, as soon as I was coherent enough to even think in English, which took a while, I thought, "Never again. Never again will I touch anything like this." And it was only six to eight weeks later, and I should mention that my intention, I did have an intention this time going in to the second night specifically, which was to let go of anger towards myself, towards other people, very s- a handful of very specific people. And I swore I would never touch this stuff again. It was just too scary, too potentially dangerous. I thought there was a real chance that I could lose my mooring from a sanity perspective and never come back. And I realized six to eight weeks later, after spending a lot of time with someone I've known forever, who I've, I've had a very contentious, emotionally volatile relationship with, lots of triggers, things I thought were beyond repair, meaning couldn't spend more than an hour with this person without feeling extreme agitation and anger well up in some fashion. And I had, I had given up on that, uh, changing that long ago. I realized, let's just call it six weeks after my two nights, that 90% of that was gone with this person, and completely gone. And to this day, it has not come back, and that has repeated itself, or I've seen that in a number of my closest relationships. The value of that is hard to overemphasize [chuckles] . It's hard to even put into words. I mean, and it's so far outside any conceptual schema in medicine or therapy that I've run into. It's, it's hard to convey in a way that makes any sense. 'Cause I've had, I've had so many people ask me, "Well, how did that happen?"

   15. SPSpeaker54:04

       [chuckles]

   16. TFTim Ferriss54:05

       I do not have a good explanation for that. All I do know is since then, having explored this both on an experiential level, having spent time in several countries working with people who are some of the best at what they do, and I, I do think I'm very, very good at vetting that. Hopefully, people believe that after looking at the books and the podcast and so on. I'm really good at getting a hold of people who are really, really good [chuckles] , and I'm very good at vetting. And having explored this space also from a scientific standpoint, it just gets more interesting. It just gets more unbelievable yet at the same time compelling. And some of the changes I have seen in people are they defy explanation by any conventional means. And I'll throw out a few examples. But before I throw out the examples, I want to make it really clear that these compounds are not for everyone. There are contraindications. Things can go wrong, and they're not a panacea. They do not fix everything by any stretch of the imagination. But for certain types of debilitating conditions, thought patterns, and fear, they are remarkable. Really, really impressive to the point that it is outside of the care and feeding and love of my family and myself and my closest friends. It is what I am most focused on furthering from a scientific standpoint, certainly.

8. 55:43 – 1:11:42

   Ego Dissolution, Mystical Experience, and Durable Change

   1. PAPeter Attia55:43

      So you and another friend who's a mutual friend of ours, so it's all this big circle of people we know, but shared an equally remarkable story with me about a single experience he had had. In this case, it was psilocybin as opposed to ayahuasca that also took him to this place of incredible emotional pain that led to a change in a belief. In this case, it was for this individual, it was a belief system around a person who was no longer alive. So someone they had lost. I will never probably forget my first experience with psilocybin for the same reason. It's interesting. I didn't know that that experience you described came from your very second time with ayahuasca. I was familiar with that story because you'd shared it with me before, but hadn't pegged it to such an early time. But my first experience with psilocybin, if not for the fact that I had that experience, I wouldn't know what the hell you were talking about right now because it seems so improbable, implausible, and impossible that something that occurs over a span of six or eight hours that is nothing more than these compounds that come from these plants could so fundamentally alter the way we interact with other people. In my case, it was very similar. It was a very important person in my life for whom I'd not had a great relationship in a very long time because I simply had no empathy. Now, Michael Pollan has written about this so eloquently, and I wish I could even half reiterate what he said because I remember him writing about it going, "That's exactly it," which is for the first time in your life, or at least for me, I'm not seeing the world through my eyes anymore. And David Foster Wallace has talked about this so eloquently in his talk, which is one of my favorite talks, "This Is Water." Every experience we have is through our own eyes. And these plants give you that ability to be out of that. And I still remember watching myself as a 13-year-old boy in this situation and for the first time ever not seeing that situation from my vantage point, instead seeing it from the vantage point of others. And that led to the most profound emotional breakdown, which again, these are very durable changes. I mean, I'm a couple of years out of this, but I truly believe that 40 years from now, I will still have this exact set of feelings about this particular individual and this particular experience. And you're right, there is-- How do you explain that?

   2. TFTim Ferriss58:20

      It's very difficult. And these compounds, many of the classic psychedelics, let's just for the sake of argument, we'll leave LSD out of the running for a number of reasons, including just the political PR baggage that that acronym carries. But if we're looking at, say, mescaline, which is found in peyote, it's found in the San Pedro or Wachuma cactus in South America, among other places, and we're looking at psilocybin found in quite a few different mushrooms. These are compounds that have been used for hundreds of years, probably millennia, by different civilizations. And you have Amanita muscaria, which was used in Europe. You have psychedelics that have been used all over the world. Psychedelics referring to, and there are different ways to try to define this term, but mind manifesting is what the word refers to if you look at the etymology. But I would say experientially, one of the defining characteristics of psychedelics, and we probably will talk about, we might have a chance to talk about MDMA later, which is in some way can be used for many of the same conditions, but I wouldn't consider a psychedelic simply because psychedelics provide what is often referred to at high enough dosages, ego dissolution or a controlled death experience where you cease to exist as the subject who is viewing your experience of reality.

   3. PAPeter Attia59:55

      That is so powerful that I, again, we talk about it with these sort of, in this sort of banal way, but until you experience that, that statement is so difficult to comprehend.

   4. TFTim Ferriss1:00:06

      It is. Imagine if you will, and there are different analogies or metaphors you can use, but imagine if your whole life you have been the protagonist, at least in your own mind. You are the primary actor in the play of your life, and you've always been the primary actor in the play of your life. There are other actors, of course, all these people you've ever met. And for the first time, you realize that it's a play, and you're sitting in the audience, and you're the playwright. You're the person who has the ability to look at it from every perspective And you can change the lines of the primary actor, that person known as Tim in my case, that person known as Peter. If you want to change their lines, you want to change their backstory, you want to change the stories they tell themselves, you have the ability to do that because you're sitting in the audience as an observer of this person who is known as Peter or Tim. And this is similar to the type of experience that people can have through meditation. And they might describe it as instead of being outside standing in the storm, you're standing inside looking through the window at the storm. Or you are, instead of being inside the washing machine, you're zooming out 18 inches so that you're looking into the washing machine and you're observing what is happening as opposed to being tumbled by it. And in fact, the, the states achieved through psychedelics and in very experienced meditators, although I'm convinced that you can achieve this state pretty quickly through meditation, it doesn't have to take 20 years, is remarkably similar f- as best we know, or there are some similarities I should say, neurophysiologically in the sense that both seem to not necessarily deactivate, but decrease activity in something referred to as the default mode network. And this default mode network, and Peter you may do a better job of explaining this, Michael Pollan does a fantastic job of describing this in his book, How to Change Your Mind, which I recommend to everyone.

   5. PAPeter Attia1:02:12

      Yeah, we'll link to the book. We'll also link to your interview with Michael recently, which was excellent as well. Even if people say they're not quite ready to read the book, uh, at the very least they should invest the time and listen to the podcast.

   6. TFTim Ferriss1:02:23

      And by the way, I would not suggest that anyone jump out and tomorrow go on Craigslist to try to find [laughs] a shaman to take you through some experience. Even if you felt like that was an inevitable step you ultimately want to take, there are some things that I would recommend first that can by themselves be exceptionally, exceptionally useful. So to come back to it though, it's the ability to for the first time view this ego that refers to itself, in my case as Tim, who is a combination of many different things, the identity that we have had foisted upon us or conditioned into us, but also that we've created for ourselves by the stories we tell ourselves, that we've always told ourselves. "Oh, my, you know, my wife always does this. My dad always does that. I always do this. I never do that." These stories that we've told ourselves for so long that we've come to accept it as just a fiber in our being, to look at it and realize that you can reformat almost every part of that, or you can take trauma that you experienced as a child and for the first time ever recontextualize it as an adult without emot- to look at it with a, a level of emotional calmness so that you can finally close that s- that, that circle is difficult to describe. So I, I don't want to try too hard to put words to something which by definition, if we're talking about mystical experiences, which is a, uh, a corollary to the durability of these effects. Let me restate that in English that is a little easier to understand. When you look at, for instance, studies that have been done, research that has been done at whether it's Johns Hopkins, NYU, or other places, and I've, I've gotten to know the team at Johns Hopkins quite well, and I've huge amount of respect and admiration for what they've, they've done and continue to do. In many of the studies, whether they're looking at terminal cancer patients and end of life anxiety, or they're looking at lifelong smokers who came into a study specifically to look at how psilocybin could be used for the cessation of smoking, uh, the duration of effect, the durability of effect is very closely linked to something that you, that you could refer to as a mystical experience. And it turns out, as you would hope, there are different types of scales and measurements one can use to determine if something is a mystical experience or not. And there's some debate about this, but there, there are ways that you can assess whether something qualifies as a mystical experience based on looking at the historical accounts, uh, and writings of people we would consider mystics. And one of them is ineffability, [laughs] the inability for someone to verbalize their experience, that the words somehow do violence to the experience or don't do it justice.

   7. PAPeter Attia1:05:38

      Pollan gives a great example of that in his book. I, I believe it was Michael Pollan in his book, How to Change Your Mind, about, uh, you take somebody from, you know, whatever, 1,000 years ago, put them in a time machine, bring them to Times Square. Let them hang out for five hours, shoot them back. Can they describe what they saw? Not really.

   8. TFTim Ferriss1:05:56

      Right.

   9. PAPeter Attia1:05:57

      They could say that it was big, loud, and bright, but other than that, they couldn't explain what a car is. They couldn't explain what a building is or a skyscraper because the vocabulary hadn't even been developed. And that to me is like the greatest example, albeit somewhat glib, of th- this idea of being ineffable, uh, which is you and I can sit here and talk about it in shorthand, but it's very difficult to explain to one of our friends maybe who hasn't experienced this. We... A- and, and when you, [laughs] you know, again, it's, it-- these things sound so, so goofy when you say them, like these experiences, y- seeing yourself from outside of yourself. You know, if someone hasn't experienced that, I, I can understand why they would look at you a little funny and say, "Okay, intellectually I understand what you mean by that, but why would that matter? Why would that be profound? How would that disrupt your ego?"

   10. TFTim Ferriss1:06:47

       It's very difficult to convey, and I would say that What I've experienced and what I've certainly seen and heard other people experience in their reports to me and in writing in book- various books that I've read is the importance of the felt experience, and that in some senses it's not that you have a psychedelic experience. You have three realizations. You bring those realizations back to this ordinary reality. You take certain actions based on those realizations, and based on that intellectual legwork, your life changes. It is not something strictly in the domain of words and thinking and just thinking harder and working harder. In other words, you're not taking the things that got you here if you've achieved anything professionally or personally, the pro and con list, the spreadsheets, the, the logical arguments. It's not that you just get a better set of those things that you bring back. It's that you are finally able to see and experience and feel something like empathy deeply for the first time for someone you've never felt it for, or you feel love for yourself truly for the first time, and you think, "Holy shit," like, "That's what's been missing. I've never even felt that. And if someone had asked me what does self-love feel like, I wouldn't have had an answer for it." These are the things that really stick, and I think given the plasticity of the mind or plasticity of the brain that allow, as one researcher put it to me, you to instead of going to the top of the ski slope and then taking the tracks that have been worn, and of course, the deeper the tracks get, the harder it is to kind of hop out of them as you're skiing. But to get to the top and to have four fresh feet of powder fall on the entire mountain so that you, you, you have the ability to choose an entirely new path, an entirely new record to play. It's hard to verbalize.

   11. PAPeter Attia1:08:52

       But one way to think about it for me has, has allowed me to come to grips with this because there's a part of me that has sometimes thought, like, "This is too good to be true. It's gonna go away." This newfound empathy I have for person X or this reduction in this horrible negative emotion I've had, that's gonna go away in six months. And, and, and I, and I've thought of something which is when you look at the opposite of that, which is how often is a person's life changed for the worse based on one event? And the answer is all the goddamn time. A child could be abused once, and that can change their life forever. And again, we're not gonna go into that now because that is its own topic. But so many of the horrible habits that we carry into adulthood are really because we never became adults. We are basically adaptive children who are taking on a set of behaviors to protect wounded children, and sometimes those wounds occurred very acutely. And so in many ways, these experiences with psychedelics, if administered correctly in the correct setting with the correct integration, can act as the exact opposite of a wounding event. In other words, with something that is so acute and so poignant, you can just change the direction of this trajectory, this vehicle. Doesn't necessarily mean it's orthogonal, and of course, there's so much more to it than that. Many people go through similar types of abuse, and they don't all have the same impact. And similarly, many people can experience a psychedelic and not have the same impact. But I think when I started to think of it in that way, it started, it started to become much more understandable why this could happen, just as something horrible could alter the course of your life. And, you know, I'm gonna... One of the podcasts I've already recorded that will be coming out later this summer will be with Corey, who you and I spent a couple of days with up at Kern.

   12. TFTim Ferriss1:10:43

       It's a maximum security prison.

   13. PAPeter Attia1:10:44

       Yeah. Uh, w- when we did this, we spent this, this time up there with the five ventures. The story of Corey's life is unbelievable, and it's just a... Again, at no point in there I think is Corey using any of these things that happened to him when he was young as excuses for the road he went down. But it's impossible to argue that those experiences, many of them very acute in this moment, on this day, in this place, at this time, completely set him on a different path than he could have been otherwise. So as you said, I, I, I love the idea of the stage analogy because to me, that's actually one of the best analogies I've ever heard about how, how mindfulness meditation works, is it's the awareness that there is a stage. That's simply what it comes down to. And to be able to leave your vantage point as one actor to step back and see that you are an actor on a stage is, I think, one of the most empowering things, and that's why I sort of love this interplay between, you know, meditation and these psychedelic agents.

9. 1:11:42 – 1:28:46

   Meditation as Preparation: Apps, Approaches, and Consistency

   1. TFTim Ferriss1:11:42

      There's an interplay. There's an interrelatedness. There is a reinforcement, a mutual reinforcement also, which is why I, I'd love to mention a few things just to give people a chance to crack their knuckles and stretch for a second in non-psychedelic territory. There are a few things that I'd love to suggest to people which help you to develop the same types of meta-awareness that you can be thrust into through psychedelics that serve a purpose whether or not you ever choose to take one of these compounds. One would be certainly mindfulness meditation, and I think by the time this podcast we're recording right now is live, Sam Harris' Waking Up app I think is just tremendous. I think it does a, an exceptionally, exceptionally good job of this, and there are certainly guided meditations. If you search, say, mindfulness meditation, Jack Kornfield, Tara Brach, both Outstanding. Sam Harris also has some, some guided meditations that he's recorded. Awareness meditation, and Peter, you feel free to jump in, uh, if I, if I don't do this justice, but awareness meditation being different from, say, other forms of meditation, many of which I have used and still use on occasion, perhaps one of the more popular of which being, say, transcendental meditation, mantra-based. It is a concentration practice where you are repeating a mantra to yourself over and over and over and over again as a way to hone concentration and, although not everyone's gonna love this description, to give your psyche and self a break from the incessant monkey mind. And you really can reach a transcendent space where you feel like you are f- a point of consciousness floating if you do the 20 minutes twice a day very consistently. That is a concentration practice. If you were thinking of a candle flame and that were a, a focal point for a period of meditation, whenever you found yourself swept up in thought, you return to a, a candle flame. That would also be a concentration practice. If you're doing, uh, and there are many also within awareness meditation, there are different types, but if you're doing, say, something referred to as, I think it's sometimes called open monitoring, where you're paying attention to anything that comes up as it comes up, and there are different ways to approach this, but, uh, very often begins with the breath. So it is in some sense a, a concentration practice, but you're focusing on the breath. You're not chasing it. You're simply observing it. Then you focus on sounds, then you focus on any discomfort or weight that you feel in your body. Then you, uh, perhaps later, after 10 sessions, 10 daily sessions, p- begin to practice with your eyes open, which I'd never really done before Sam's app, which I found tremendously helpful as a bridge into then waking reality. These are all practices that help you to spot the gap between sensory input and cognitive response, right? So that you become more response able insomuch as you, you have a tiny gap within which you can choose your response as opposed to simply reflexively going through life like some type of slug that's been shocked in a Skinner box [chuckles] or something. Uh, and you, you have more optionality. You suddenly realize there are just more options on the menu than, "Oh, whenever so-and-so does this, I always get pissed off." There are more options on the menu. And that, by the way, having that basic ability, having the just the ABCs of that awareness and control will give you a tremendous advantage and allow you to get very often much more value out of any psychedelic experience. Because you will have had, let's just call it 50 sessions on a boogie board before they're like, "Oh, cool, here's a surfboard. It's hurricane season. Have fun. Good luck." Like, maybe you catch a wave. [both chuckling] Chances are your first experience is going to be getting tumbled a lot, and you can accelerate the... You can steepen the learning curve really dramatically for later getting more out of psychedelics very often if you develop some of this basic awareness beforehand.

   2. PAPeter Attia1:16:13

      I'm, uh, kind of amazed at how difficult it is for me to convince some of my patients at the importance of meditation, and I find sometimes by just telling them about my own struggles and my own journey to accept, first of all, that this was something that was beneficial even when it didn't feel beneficial, and two, to realize that you have to sort of figure out what's gonna work for you, but it's worth making that effort. I agree with you. I think that just e- even putting the apps aside, it's different people have different ways of explaining things. And I remember a math professor I had in, in college, and this was early. This might have been like, I must have been... I was either a freshman or a sophomore, but he said something that always resonated with me, 'cause now you were sort of getting outside of like, you know, rudimentary calculus and stuff, and mathematics was starting to get very abstract. And he said, "Look, if you're reading a proof and you don't understand it, assume that the person who is presenting it doesn't know how to present it to you. Find somebody else." And so I think that that really holds also for meditation, which is there are just going to be some people who guide in a way that you're willing to be guided. And so you shouldn't be put off if someone's listening to this thinking, "Oh, you know, every time I try meditation, it doesn't work for me," or something like that. And, and so I don't wanna sort of name the apps I went through, but there were many apps that I went through that just didn't resonate for me. You know, just the way that they talked about this didn't make sense to me. But then when you find the ones that do, and there are several that do for me, including Sam's Waking Up, which you and I have been lucky enough, along with a number of other folks, to get the beta version of that, which, God, it's been six months.

   3. TFTim Ferriss1:17:50

      It's been a while.

   4. PAPeter Attia1:17:51

      Yeah. I th- I remember Sam giving it to me in January. The way Sam explains it really resonates with me, and there are, there are others that, that do so the same. Jeff Warren is also one of the guides on Dan Harris's, no relation to Sam Harris, Ten Percent Happier. I just love the way he explains stuff. And so, you know, I would say to anybody who's listening to this who's feeling sort of bearish on meditation, try a different app, try a different guide, try a different book, try another way. Keep going till you find someone who can walk you through how to do this in a way that resonates.

   5. TFTim Ferriss1:18:27

      And the, the... I'll, I'll just mention two others, uh, since they're very easy to test. Another is Headspace. The 10 in 10 program I think is a very, very well done format for beginning this. It's 10 minutes a day for 10 days, and it's quite well done. Calm for some people who like the background nature sounds, for instance. I've used that app and many of my friends really find that to be with a female guide to be their preferred mode of meditation. And then you can meditate in silence. You can consider taking a TM course, as I did, which actually really served to kickstart a lot of my meditation because it cost money, so I had that sunk cost working in my favor. And it's effectively four lunch breaks over four days, I want to say, if I'm remembering correctly, and you have to meditate in between those sessions. So you have homework, and you are going to feel like a doofus and a disappointment and be embarrassed if you don't do those sessions. So you have someone holding you accountable, i.e., the teacher, to actually put this into practice for at least a four-day period. And that in and of itself, I pushed off for so long, for so, so long. And I remember Chase Jarvis, I'll give him credit again, at one point said, "Tim, you can afford it. It worked for me. What is the downside if it doesn't work for you? You still get to meditate with someone else for four days. Might that be worth it?" And I didn't have a good counterargument [chuckles] , so eventually I acquiesced and, and took that step, which was, uh, which was very... It was one of the first times I finally felt what... I had the firsthand experience of what meditation could deliver, which is in some ways equally difficult to describe as the psychedelic experience. When you have your first session where you've completely lost any rumination or compulsive thinking about your to-do list, and it might just be the last five minutes of a 20-minute session, and you come out of it and you just feel this serene peace that perhaps you haven't even touched on for 10 years, you go, "Oh, okay. Now I get it. If this is something that I could actually call upon reliably, that is a superpower." And for that reason, I would say for, uh, that if you're going to commit to this, commit to it like you would a workout program or a diet. You don't go to the gym once and come back and wake up with, uh, you know, six-pack abs the next morning. For me, at least, if I take a break, and there are periods when I lapse-

   6. PAPeter Attia1:21:11

      Es- especially, by the way, if you eat like we've eaten in Austin this week.

   7. TFTim Ferriss1:21:13

      Yeah, we have eaten... There's so much good food here. You have to be very careful [chuckles] about portion control. But if you want to get a taste for what meditation can do, I would say commit to 10 days. And for me at least, if for whatever reason I lapse, and there are certainly periods when I lapse. Uh, this happens to me with diet, happens, happens to me with exercise, and occasionally it's like, ah, you know what? I haven't meditated for two weeks, for whatever number of reasons. It will take me, I would say, five to seven days to finally stop grinding gears and shift into a calmer state. There, it, it, there's a certain loading phase almost, [chuckles] like creatine or something. There, it takes me five to seven days to click into that different gear, at which point I go, "Oh, yes, this is why it's so important. Now I remember."

   8. PAPeter Attia1:22:01

      Yeah, there's a great book out there called "Altered States," which I read this year that I think does a great job of parsing that concept out, which is-

   9. TFTim Ferriss1:22:10

      Is it altered states or altered traits?

   10. PAPeter Attia1:22:12

       Oh, it's altered traits, and it makes the point that it's not about the state. Thank you for that correction. We'd have had a whole bunch of people potentially going to Amazon-

   11. TFTim Ferriss1:22:20

       [laughing]

   12. PAPeter Attia1:22:20

       ... going, "I can't find this book." Or maybe they read that book does exist, and it's completely the wrong book. But that's exactly the point, right? Which is that we don't meditate for the state. Uh, the state can be pleasurable. I, to be tr- honest, I don't find it that pleasurable. I don't actually enjoy meditating that much. Sometimes I do, but, but as many times as I do, I... It's difficult for me. It's work. It's... Sometimes, truthfully, it feels like I suck. Like I'm, "Boy, it's really amazing the frequency with which thoughts keep entering my mind." I th- I forget who, and again, I, I can't remember if it was Sam Harris or a different guide who made this point, which was... Actually, I think, I think it was actually Jeff Warren, which was he described it as the bicep curl of the brain is not the cessation of thought. It's the recognition of the thought that then allows you to go back to the breath or whatever the focus is. And boy, that really... Again, that's just an example of, like, that's not a particularly, like, profound, difficult to understand concept, but it's exactly what I needed to hear, which is, don't be discouraged that you keep having thoughts. That's the exercise. The exercise is acknowledging it, recognizing it, going back to the focus, which in this case could be the breath or a sound or something like that. And so it's not about that state that you may or may not achieve. Just as some people who ex- like you and I, we love exercising, so we actually get a pretty good state out of it. I, I actually... If exercise provided no benefit, I would still do it just because of how I feel when I do it. But for many people, that's not the case, but exercise is still valuable. If you spend an hour a day exercising, it's really what it, it's hap- what it's doing for you that other 23 hours. So that's, I guess that would be the next thing I would say to anybody listening to this who's tried meditation, who has found it to be unpleasurable or uninteresting or whatever. It's like, that's okay. You're not doing it for what you experience in that 20 minutes.

   13. TFTim Ferriss1:24:11

       I would also add, and this just, just occurred to me, because I think you're, you're in some ways alluding to this, that in my experience having observed hundreds of thousands of listeners and readers attempt or not attempt, succeed or not succeed with different forms of meditation, it's very important, and this applies to many, many different things, including physical exercise as far as, uh, as I'm concerned. But the good program that you follow, I... Let's, let's lower it even further. The consistent program that you follow is better than the perfect program that you quit. So if you're having trouble following a meditation program and you've committed to doing it daily, which is a, a very important commitment in the beginning, keep lowering the bar. If you think 20 minutes is too much, do 10 minutes. 10 minutes is too much, do five minutes. If concentration meditation is too difficult, use a guided meditation. And I recall at one point there were, there were two things that I recall having been said to me. I think Tara Brach mentioned the first. I could be misattributing, but I, I think it was Tara Brach who first said this to me. Her book, "Radical Acceptance," by the way, ties into everything that we're talking about beautifully. It had a huge impact on me and has had a huge impact on many people. It's the type of title that's gonna scare off a lot of people 'cause they think it's gonna be a bunch of woo-woo, hand-wavey stuff. There's a little bit of woo in there, but it is a incredibly good book, uh, "Radical Acceptance." Uh, if you have any type of emotional patterns or thought patterns that seem to control you as opposed to the other way around, this is a worthwhile book. And her guided meditation's very good, but we were chatting. I had her on the podcast, on my own podcast, and I believe it was Tara who said, "The repetition, if we're doing the bicep curl, isn't the 20-minute session where you sit perfectly without having a single extraneous thought occur. The repetition is when you get distracted and something comes up, and then bringing it back to the breath." So you should be happy when that happens because that is the work.

   14. PAPeter Attia1:26:25

       Mm-hmm.

   15. TFTim Ferriss1:26:25

       The work isn't doing it perfectly every time.

   16. PAPeter Attia1:26:28

       It took me three years to understand that.

   17. TFTim Ferriss1:26:31

       Yeah.

   18. PAPeter Attia1:26:31

       Three years of frustration and, "Am I doing this right?" And, you know, "Why can't I stop thinking?" And, and just all of this misunderstanding. But boy, once you get what the bicep curl is-

   19. TFTim Ferriss1:26:45

       It's freeing, and y- it makes the pass-fail bar lower, which for many of the people who most need meditation, which I think has a brandli- a branding problem. Like, it should be called, you know, emotional non-reactivity training or something that sounds very appealing to, you know, Type A driven people. [laughs] Emotional non-reactivity conditioning program, there you go. Or just warm bath for the mind might be appealing to other people. But meditation as such is, it's a word that's become... It's so overused and unfortunately could use a, a rebrand. But for the time being, meditation and a successful meditation session should in the be- in the beginning be as easy as possible to fit into your life. You need to stack the deck, particularly in the beginning. And, uh, TM, transcendental meditation, was very good at instilling this in the training, for me at least. They said, "If you say the mantra once in a session, that is a successful session." You have 20 minutes to say a two-syllable mantra once. That's a successful session. And you might even drop it further and say, "You know what? Th- this is the goal. This would be miraculous, but if I just sit for 20 minutes with my eyes closed, that's a successful meditation session." And sometimes I've honestly wondered how much of the benefit comes from some of the mental practices versus just sitting still and breathing with my eyes closed. [laughs]

   20. PAPeter Attia1:28:14

       Well, that's actually really interesting. That, that, that gets to something w- I wanna talk a little bit about, which is the study of psychedelics. But while we're on that topic, it's, it's hard to sometimes study these things because of these performance biases, right? It's hard to disaggregate the effect of just sitting there for 20 minutes. And luckily, some of those experiments have been done, which is, you know, you take a group, and instead of saying the control group just doesn't do anything, maybe you have the control group sit in silence for 20 minutes, and then you can sort of disaggregate those things.

   21. TFTim Ferriss1:28:46

       Mm-hmm.

10. 1:28:46 – 1:34:20

    Funding Research and the Katharine McCormick Story

    1. PAPeter Attia1:28:46

       So Tim, you've spoken with me quite a bit about your interest in funding science, and that goes back to even before the discussion of psychedelics. But very recently, you've made a pretty large commitment. Are you comfortable talking about that publicly?

    2. TFTim Ferriss1:28:58

       I am. I am very, very comfortable talking about it publicly. I have almost entirely redirected not just what I would have invested in startups, but a multiple of that into scientific research. So I've made the commitment for me, which is by far the largest commitment to not just science, but even a- any given startup that I've ever made financially, and that's a million dollars, a minimum of a million dollars over the next several years. Several meaning three or four. And I expect I'll exceed that $1 million amount with primarily a focus on psilocybin and MDMA. But that could extend to other compounds, which, which I also find to be understudied and that have been, in some ways, shelved for decades for primarily political and not scientifically justifiable reasons.

    3. PAPeter Attia1:29:58

       When we started talking about this, when you were thinking about it, I remember one of the stories that you really liked was a relatively unknown story in the world of philanthropy, unless you dig deep in the annals about a woman by the name of Katharine McCormick. That, that story really resonated with you.

    4. TFTim Ferriss1:30:14

       It did.

    5. PAPeter Attia1:30:14

       What was it about that story?

    6. TFTim Ferriss1:30:15

       Oh, well, you should, you should tell this story because I think it's, it's so noteworthy on a number of different levels. But what struck me was how, if timed right and if thought about intelligently, where you're focusing on points of leverage, how even a single person with relatively moderate amounts of investment, and moderate is relative, right? But let me rephrase that. How, how someone or a small group of people, if concentrating on points of leverage in furthering, in this case, scientific studies, can really bend the arc of history in a way that most people would find unbelievable. Because when folks think of, say, pharma or bringing a new drug to market in the largest scale senses, it's billions and billions and billions and billions of dollars. But that story was appealing to me because on, on many levels, but I'd, what I'd love to do is have you tell it, and then I will, I will point out the, the, the parts, if this were a Kindle chapter, which parts I would highlight to go back to, to remind myself of certain things. But why don't you tell the story, because it's such a great example of what one person or a small group of committed people can do. I'll leave it at that.

    7. PAPeter Attia1:31:47

       Well, it can be probably be read about more eloquently than I can restate it, but the gist of it was Katharine McCormick in, I believe, the early '60s or late '50s met a gentleman, I believe his name was Gregory Pincus, if I'm not mistaken, and-

    8. TFTim Ferriss1:32:00

       I thought... I think that's right, at a, at a dinner party or a cocktail party.

    9. PAPeter Attia1:32:02

       Yeah, yeah. And, and basically he explained to her that he was pretty convinced he could chemically synthesize hormones that could be served as a birth control pill or serve as a birth control pill for women.

    10. TFTim Ferriss1:32:14

        And she was no dummy herself. She went to, it was MIT?

    11. PAPeter Attia1:32:17

        Yeah, I believe so.

    12. TFTim Ferriss1:32:18

        And had been involved with also funding housing for additional female students so they could attend.

    13. PAPeter Attia1:32:24

        Yeah, and her hypothesis was if we could create a birth control pill, we could completely change the interaction that women can have with education, with work, with the family balance, et cetera. Now, we take this, we listen to this story today and we think, "Well, what's the big deal? Like, so what? She funded the research for the birth control pill." But the reality of it is at the time, again, I can't remember, I, I must have the dates wrong, but certainly it was long enough ago that this was viewed as an absolute no-go. I mean, there was simply, you know, birth control was such a taboo. And what's really interesting is she decided to fund something that was incredibly risky that no pharma company was willing to touch with a 10-foot pole because it was viewed as just a way to sink money into a bottomless pit that could never achieve the regulatory approval. And using, again, a relatively small sum of money, and I believe in today's dollars it's to the tune of about $25 million she sunk into the work of this guy, Pincus, and I, and one other gentleman whose name is escaping me.

    14. TFTim Ferriss1:33:29

        Over the span of some- something like, what?

    15. PAPeter Attia1:33:32

        About a decade.

    16. TFTim Ferriss1:33:32

        About a decade, yeah.

    17. PAPeter Attia1:33:33

        Yeah, maybe eight years. And when you... My favorite graph that I ever saw, which was kind of the holy shit moment, was the graph of the number of women in graduate schools, professional school, law school, business school, whatever, pre and post the introduction of the birth control pill. And it's, you don't get to see a lot of hockey sticks, you know? As, as one of my friends once put it, [chuckles] it's really cool when the data don't need statistics to be analyzed. [both laugh] It's not like, "Well, there was a statistically significant increase in the rate at which women entered the workforce." No, no, no. Like, you, you didn't even have to say the words statistically significant. It was a step function change. And I don't know, I just, I, I thought that was such an interesting story, and I remember when you and I were talking about this a while ago, I, I don't know even know why I told you this story, but you, you seemed to really grip to it.

11. 1:34:20 – 1:43:19

    Why Psychedelics Were Scheduled and Where the Science Stands

    1. TFTim Ferriss1:34:20

       There were many reasons for it. I think partially being at the time in Silicon Valley and surrounded by venture capital, I saw some of the stupidest, I don't know how else to put it, just [laughs] stupidest non-viable ideas raise tens of millions or hundreds of millions of dollars. Uh, let's just stick with-

    2. PAPeter Attia1:34:42

       Philanthropic dollars or for-profit dollars?

    3. TFTim Ferriss1:34:44

       No, I mean for-profit.

    4. PAPeter Attia1:34:45

       Okay.

    5. TFTim Ferriss1:34:45

       Startups repeatedly. I mean, you just saw dozens and hundreds of examples, uh, over time of this. And it struck me that we find ourselves in a unique time, which I suppose is something that goes without saying, every time is a unique time, but in the sense that long ago, this is worth discussing for a quick second, psychedelics, specifically LSD, were through the controlled, I think it was the Controlled Substances Act, scheduled, put into the, the Schedule I class of drug classification, which means high potential for addiction, no, no known medical or no medical application, no demonstrated medical application, putting them in the same class as heroin.

    6. PAPeter Attia1:35:33

       And to be clear for the listener who might not appreciate that, even cocaine is Schedule II.

    7. TFTim Ferriss1:35:38

       Right.

    8. PAPeter Attia1:35:38

       Which means it still has potential for addiction that everybody acknowledges, but it does have at least one viable medical application, which is it turns out to be a pretty good local anesthetic in the nose, [laughs] which is ironic, of course. [laughs] Um, but it therefore does have a medical use.

    9. TFTim Ferriss1:35:54

       Right.

    10. PAPeter Attia1:35:54

        And it's used routinely in ENT surgery.

    11. TFTim Ferriss1:35:57

        So if these compounds are so useful, if they can have some of the effects, without guarantee, of course, it's not batting 1,000 every time. If you have 100 people at random who are using these, some with direction, some without, you're not going to have a perfect record. But if, if even some of the time the effects can be achieved, the outcomes can be seen that we're discussing, how did these compounds, including LSD, end up in this category? And there, I, it's a, it's a multifactorial problem, and it's hard to say there's one, uh, causal agent. But there, there are a few things that happened at the time. Number one, many people don't realize pollen gets into this. It's really fascinating. But LSD 25, wh- which was first isolated or synthesized by Albert Hofmann, was developed on the part or on behalf of a pharma company. It was later used-

    12. PAPeter Attia1:36:50

        It was Roche, correct?

    13. TFTim Ferriss1:36:51

        I, I want to say it was Sandoz. Um-

    14. PAPeter Attia1:36:53

        Oh, you're right, you're right. It was Sandoz, yeah.

    15. TFTim Ferriss1:36:54

        And then it was later used in a program that, uh, if I'm remembering correctly, was CIA-led called MKUltra, where it might be used as a truth serum for interrogations and things of this type. or to confuse and [chuckles] sabotage enemies of the state, and it got out into the wild. [chuckles] And then the adventure began, so to speak. And LSD was widely distributed, and at the time, you had parents who had never experienced psychedelics. We were going into the Vietnam era, and we had a number of characters come onto the scene in very high-profile ways. One of them being, and he cannot be, even though he is often given the blame, I don't think it's, it's fair to do this unilaterally, but Tim Leary came onto the scene. He was at Harvard, as was Richard Alpert, who later became Ram Dass. And the things exploded at Harvard, and they, they were both, I believe, fired. I don't think they resigned preemptively because psilocybin was given to an undergraduate when it was only supposed to be administered to graduate students. And at some point, Leary decided that science was too slow and that the way to affect cultural change was to have tens of millions of people. He had a specific number in mind, and that that would effectively lead to a tipping point where all these positive effects on society would be inevitable. And if you, if you think about the cultural setting, you have a lot of young people being told to, to drop out of school, to resist war efforts, and all of that made a number of figures, including Leary, very high-profile targets that could not, in some ways, be ignored by the administration. And so Nixon famously said, "Timothy Leary is the most dangerous man in America." And you had parents who could not in any way conceive of the experiences that their children were having on these compounds. And that, along with dozens of other things, was a recipe for political crackdown, which is exactly what happened. [sniffs] What you have now is you have parents who are, well, in many cases, certainly products of the '60s who have had psychedelics experiences. You have people who are in positions of power or in regulatory organizations who have, in, in some cases, experienced psychedelics. You also have studies now being conducted, even though it's, it's with great difficulty because of all of the approvals and DEA oversight and so on that's required, that are going back to the dozens and hundreds of studies that were performed before the, the crackdown and rescheduling and applying more rigorous scientific standards. And that is combined with a number of, as you mentioned earlier, epidemic-level problems that we're experiencing that are costing, I would have to imagine, billions upon billions of dollars, namely opiate addiction, depression, PTSD, right? If you add up the costs associated with those three, if we want to be a little crass about it and just look at the profit loss, it makes a lot of sense based on the data thus far to explore some of these compounds. And that's part of the reason why, for instance, in the case of MDMA and PTSD, the FDA has granted MDMA breakthrough therapy designation, which means that not only is the process expedited for ult- ultimately phase three trials, that the FDA is, in a sense, a collaborator. So instead of saying, "All right, your methodology is approved," and I'm going to apologize in advance, this is not-- phase three trials are not my area of expertise. So if I make any-- if I misspeak, I apologize, and certainly feel free to correct me in comments somewhere. But the FDA is effectively a partner who helps them to navigate the entire process instead of saying, "Your methodology is approved. See you in three years, and you're going to get a pass-fail." Which is a precarious position for any compound, let alone something that is, is currently scheduled the way that MDMA is. And we don't have to get into it right now, but there's also something called the Special Protocol Assessment, SPA, which should hopefully, if the stars align in some ways, which I think they, they very well might, give MDMA a very high probability of ultimately being prescribable, uh, with and used in supervised settings. It would not be a take-home drug, in other words. But PTSD, and specifically with respect to, let's say, returning war veterans or victims of sexual abuse, is a, it is a highly bipartisan issue, or I should better say it's a nonpartisan issue [chuckles] . It's very hard for someone to say, "Fuck the vets." [laughs] So the risk of, of that getting shot down politically, I'm not going to say is zero because it's never zero, but it's-- there are more attractive targets. If you're looking for re-election or looking for press time, there are safer targets to go after to achieve that than this. And then within the scientific community looking at psilocybin, which there are at least two entities right now that are presenting phase two data to the FDA, and I'm optimistic that within the next year, at least one of them will proceed into phase three trials. Psilocybin has, has shown remarkable efficacy, at least based on preliminary data, for end-of-life, or I should say event-based depression in people with terminal diagnoses, terminal cancer diagnoses. And that may end up getting extended to major depressive disorder, which is to be continued [chuckles] or to be determined. But I've, I've already helped to raise funding and also applied funding myself to a study that's, that will be looking at treatment-resistant depression at Johns Hopkins utilizing psilocybin. And that means, I believe, by the book, depre- chronic depression that has failed at least two interventions. or two other treatments

12. 1:43:19 – 1:55:18

    MDMA, Psilocybin, the Default Mode Network, and Clinical Bottlenecks

    1. PAPeter Attia1:43:19

       Are there other agents, Tim? I mean, loosely speaking, and this is a gross oversimplification, and we will probably get into a few of these, time permitting. Certainly, as you said, MDMA has really shown pretty remarkable efficacy in PTSD.

    2. TFTim Ferriss1:43:32

       It's, it's, it's wild. [chuckles] It's one of those similar to the graph you mentioned, uh, related to McCormick.

    3. PAPeter Attia1:43:37

       Yeah. It's just not subtle.

    4. TFTim Ferriss1:43:38

       It, it's not subtle. It's-

    5. PAPeter Attia1:43:39

       You don't need the P value to see the difference.

    6. TFTim Ferriss1:43:41

       No. No, no. It's-- I think I'm getting this right. Anyone interested can certainly look up MAPS, uh, you can find them at maps.org, who have spearheaded a lot of this. But I believe that psychotherapy alone, something like 27% effective at reducing the scale measurement, and I'm ad-libbing a little bit here, but let's just say that there is a rating of zero to 10 for determining the severity of PTSD. Anything above a three is PTSD, something along those lines. This is a bit of ad-lib, but I think it's something between 20 and 27% decrease to below a three, so they were no longer-- they would no longer be diagnosed as having PTSD with psychotherapy alone. I don't remember the timeframe. Uh, when psychotherapy was combined with MDMA, it was something like 70%. I mean, it's just not subtle at all.

    7. PAPeter Attia1:44:29

       So [chuckles] which again, we could spend just two hours just talking about the role, the relationship of trauma and psychological damage and, and how MDMA can help with that. The other thing, of course, which we talked about very briefly earlier, was iboga and ibogaine in the treatment of opiate addiction, which probably has the worst success rate amongst societal epidemics that are being treated by conventional means. I mean, there really aren't great options for, for the individuals with, with opiate addiction. And then of course, psilocybin, as you said, on end-of-life depression, major depressive, along with smoking cessation. I heard it's even being looked at now for alcoholism.

    8. TFTim Ferriss1:45:09

       It is, and there are a few predominant classes people can look at when it comes to psychedelics. I believe you have the, there are the tryptamines, and then the phenethylamines, I believe it is. But we don't have to get into all that, partially because I'll just embarrass myself. But coming back to the default mode network, which I think is worth returning to for a second, which listeners might recall is this collection of different parts of the brain that appear to be active when you are doing nothing. What does doing nothing mean? And this was discovered, I believe, in part when scientists were doing calibrations within fMRI machines. They said, "All right, just do nothing. We want to get a baseline."

    9. PAPeter Attia1:45:49

       Mm-hmm. And this is the part of the brain that just keeps lighting up.

    10. TFTim Ferriss1:45:51

        Yeah. [chuckles] What the hell is going on? And it appears to be highly activated when people are engaging in any type of self-referential thinking. I, how does it affect? So not only, like, think about fear, but what makes you fear? What makes you fearful? Okay, boom, and then default mode network seems to light up. Any type of temporal projection, in other words, thinking about the past, thinking about the future, seems to also light this up. And, uh, Pollan does a great job of, of digging into this in the book, and a number of people have written about this in very eloquent terms. Uh, Robyn Carhart-Harris out of the UK is one of them. But to, to just pose a question that I think is something that's being explored currently, if, say, anxiety is being stuck in the future and being depressed is being stuck in the past, what happens if you're able to temporarily suspend or deactivate that system to some extent, and to give yourself that witness perspective so you can look at yourself without being yourself? [inhales] And the implication if many of these psychedelic compounds are able to achieve that is-- and even Tom Insel, who I think is the former head of the National Institute on or of Mental Health, NIMH. If you look at OCD, you look at different types of depression, different types of anxiety, and so on, these are nice-- these are very cleanly separated out in some type of, uh, what is the, the term for this desk reference that people use for-

    11. PAPeter Attia1:47:23

        The DSM. Yeah.

    12. TFTim Ferriss1:47:24

        DSM. In the DSM. But they may all be slightly different species of the same thing, which is why, uh, something like psilocybin appears to be LSD, very similar story. Mescaline, probably very similar story at high enough doses, can be used for anything that appears to involve obsessive thought patterns or behaviors. That includes alcoholism, it includes smoking, it includes opiate addiction, and there are, uh, studies that are, uh, seeking funding right now, I know at Johns Hopkins, related to opiate addiction through the lens of psilocybin treatment, which I'm very, very interested in. Eating disorders like anorexia. These may in fact be very interrelated phenomena and conditions. So you mentioned a few that are... LSD, I think, is off the table, not for scientific reasons, but for political reasons. It's just too loaded. There's too much baggage. And let us not forget that the media plays a very large role in how politics respond to things. And in today's day and age, I, I j- I'm, I do not have a high level of confidence that LSD, since it was once painted as the villain, is not... It's too seductive, I think, in a clickbait world to not fall into the same bear trap in, in, in a way. So psilocybin, then you have MDMA, which is thought by, referred to as some people as an anactogen or an empathogen. This is not, probably not scientifically too granularly accurate, but it appears to tone down, that's not a scientific term, [chuckles] but tone down the amygdala and fear response that we have to, say, recalling or reliving traumatic events. And it allows us to people, say with PTSD, who have seen their friends' heads blown off or had to blow other people's heads off, whatever it might be, people who've been raped, et cetera, to, in some sense, clean up a very messy experience that did a lot of damage, and to help people to heal themselves in non-verbal ways. This is really key, right? We-- It's, it's very, it's very hard for many people to talk their way out of something they didn't talk their way into.

    13. PAPeter Attia1:49:56

        That's so well said. I mean, you said in one sentence what I, what I tried to say in, like, 20 sentences a while ago about the experiences that can cause pain can be so jarring that it should be at least acknowledged or considered that equally jarring chemical experiences might be necessary to put that new powder on the slope.

    14. TFTim Ferriss1:50:18

        Definitely. Uh, so you have MDMA. MDMA, I'll be honest, I was, I, I was biased in some ways against MDMA for a long time because, A, I didn't have much personal experience with anything chemically related to MDMA. I had a fear associated with it because of research which I think has since been largely debunked in terms of risks for people who are predisposed to depression, for instance. It was also at one point viewed as, and, and is still used recreational as a party drug. And I've, I've, I've really been swayed to the other side. I'm very bullish on MDMA as a therapy. I think that it is extremely... It's, it's an extremely powerful and flexible tool that does not entail the type of perceptual distortion that some of these psychedelics do. Which is not to say I am not bullish on psychedelics. I am, but it requires much more sophisticated training to administer. So MDMA. Iboga and ibogaine-

    15. PAPeter Attia1:51:25

        Going back to MDMA-

    16. TFTim Ferriss1:51:26

        Yeah

    17. PAPeter Attia1:51:26

        ... I do think it is important to point out if anybody's listening to this thinking, "Well, of all of these compounds, MDMA is pretty easy to get," and, you know, it... You can get it packaged in other things, and it's ecstasy, et cetera. But this goes back to intent, setting, and integration. I really do not-- I am not convinced that just taking MDMA, going to a party is somehow going to unwind any of these problems. I mean, this really-

    18. TFTim Ferriss1:51:51

        Yeah. I would go further than that, and I would bet against it.

    19. PAPeter Attia1:51:53

        Yeah.

    20. TFTim Ferriss1:51:53

        If someone gave me 100 grand and they said, "All right. This person is gonna take MDMA and go to a party 10 times, what is the likelihood that it's going to fix X longstanding problem?" I'd, I'd go $100,000, every single dollar against it.

    21. PAPeter Attia1:52:08

        Yeah.

    22. TFTim Ferriss1:52:09

        I would short it. And I know people, in fact, who have used MDMA recreationally and then used it in supervised settings, and it is as if they are taking a different drug.

    23. PAPeter Attia1:52:22

        Yeah. That, that just can't be overstated, and I, I'm not just saying that 'cause I'm a doctor and I'm s- supposed to say something responsible. But I, I mean that regardless. It's, uh... And, and that for me is the urgency around this stuff. It's I, I think about, I think about myself, frankly. But I think about my patients, and I think about a lot of my patients that would benefit from these things that I've experienced or even things that I haven't experienced that I've seen people experience, and I, I ju- I've never had such a sense of urgency around this. I mean, prior to this, the most urgency I ever had was waiting for PCSK9 inhibitors to come on the market when I read that first paper in The New England Journal of Medicine about 12 years ago on the discovery of this type of... You know, these, these individuals who had missense mutations in that enzyme that lowered their LDL significantly. But boy, the [chuckles] the anxi- the, the anxiety might be the wrong word, but the anticipation I had for that class of drugs, which anybody listening to this is probably falling asleep thinking-

    24. TFTim Ferriss1:53:16

        [laughs]

    25. PAPeter Attia1:53:16

        ... "That's... You're an interesting guy if that's what was keeping you up at night, waiting for that drug." But, but this takes it to another level, which is almost nobody I know has not been traumatized on some level, and it doesn't always have to be something that is so obvious. So, so, you know, we've all been traumatized. We've all sort of been hurt. We're all dealing with these things. And yet I feel how quickly can these things go through this regulatory pathway to get into the hands of people who would know how to administer them? I certainly wouldn't, right? Even if these things were legal today, that's only half the battle. It's can you create enough practitioners that know, you know, how to select the right patients and how to apply the treatment? 'Cause this is in many ways harder than any other treatments we have today. You know, people talk today about the importance of combining psychotherapy with antidepressants, but that's really the tip of the iceberg compared to this stuff.

    26. TFTim Ferriss1:54:08

        And it's, it's also tricky from a commercial standpoint insomuch as part of the reason these compounds haven't been picked up like a football [chuckles] and run to the, the end zone by big pharma is that many of these studies only involve two or three sessions with psilocybin.

    27. PAPeter Attia1:54:29

        Yeah.

    28. TFTim Ferriss1:54:30

        A naturally occurring molecule. In these cases, it's synthesized, but there is a lot more money to be made in something that you can charge an arm and a leg for that you have to take on a daily basis or an every other day basis indefinitely, as opposed to [chuckles] two or three times with some pre-work and post-work with durable effects in many cases. That, that's financially an unattractive model to many people, and I think it's a mistake. There are some for-profit companies out there, or I should say startups, who are going after this, and, uh, I'll be very disappointed if they try to make their money on the molecule by blocking other people from doing, uh, research or manufacturing and good manufacturing in GMP facilities and so on. Uh, rather, I think they should make their money on the services, on the therapy. Uh, so that's, that's maybe a separate discussion.

13. 1:55:18 – 2:07:42

    Ibogaine, Opiate Addiction, and Self-Compassion

    1. PAPeter Attia1:55:18

       Now, why has ibogaine taken the longest track, and why is that still The one that seems to have gained the least traction for testing in the United States. I've spoken to a number of people, philanthropists who are really interested in this opiate addiction problem, and yet they are understandably not interested in funding research outside of the United States.

    2. TFTim Ferriss1:55:40

       Yeah.

    3. PAPeter Attia1:55:40

       And basically their view is until the DEA and the FDA allow for a similar pathway, we're not interested in funding this, and I worry that there's a bit of a stalemate there. Is that, is this, is this thawing?

    4. TFTim Ferriss1:55:52

       [sighs] I don't think it is yet to thaw. There are some researchers, and I'm blanking on names, I apologize, but there are a number of researchers who are doing very good work looking at ibogaine and have been studying it, iboga and ibogaine, uh, in the United States. Part of what makes ibogaine tricky, if on one end of the spectrum you have MDMA, which again, I, I don't consider a classical psychedelic, but as a tool that can be applied to some of the same conditions, what makes MDMA attractive is general low toxicity, relative ease of administration, short duration, if we're looking at, I wanna say four to six hours, let's say, maybe a little bit longer, four to eight hours. Ibogaine falls on the opposite end of the spectrum. Now, I-- before we get to what puts it on the opposite end of the spectrum, I should say I know people very directly who had family members who were heroin addicts and, say, prostituting themselves, I mean, on death's door. If they weren't going to die from an overdose, they might die from getting shot in the street. And in a, in a case like that where nothing else has worked, including some, say, alternatives like methadone, I've seen cases where ibogaine has worked.

    5. PAPeter Attia1:57:08

       I mean, don't the practitioners of this offer that at one year the recidivism is only 20%?

    6. TFTim Ferriss1:57:15

       I don't know the exact numbers, but that's, given what else I've seen with these compounds, it w-wouldn't-- I don't find that unbelievable. Uh-

    7. PAPeter Attia1:57:27

       Yeah, and that, that, if I'm recalling, that's only with two weeks of, of intervention. Now, these are people that are put into a, you know, a very heavily supervised detox environment where the, the iboga and the ibogaine itself are administered over a, a one-week period outside of the, you know, pre- and post-integration. So I think the entire therapy, if I recall, was about six weeks.

    8. TFTim Ferriss1:57:49

       There are, they're in many different formats, and I know people who have been involved with running some of these clinics. And, uh, certainly there are people like Gabor Maté who have, who have looked at opiate addiction very closely, but ended up, as I understand it at least, looking at ayahuasca and others for helping people who are addicted to opiates. Ibogaine is very -- it's, it's unlike some of the others, such as psilocybin, in that it acts on a whole slew of different receptors. And let's discuss what puts it on the opposite end. So it, yes, it can have these seemingly miraculous effects on opiate addiction. And part of the reason for that experientially, as I understand it, and I've never gone for a full ride ibogaine or iboga psychedelic experience, and I have no desire to, it is very unpleasant. It is very long. So it can last, as I understand it, and people can feel free to correct me, but 24 to 36 hours. That is a long time. And, uh, many people experience a full review of their lives and a controlled death experience whereby they get to see from the beginning of life, almost like a slideshow, the decisions they've made, how they've hurt themselves, the other people they've hurt, how their addiction has affected things. And what Gabor Maté would, how he might frame it is instead of asking why the addiction, ask why the pain. And the addiction is often a response, almost inevitably, but often a response, I'll say often, to some type of trauma or pain. And if you don't address that in some fashion, allow people to reintegrate that somehow, the likelihood of recidivism is very, very high. So just from a phenomena- phenomenological [chuckles] perspective, which is fancy way of saying some subjective experiential standpoint, many people report that. Biochemically, and there are people who are looking at, for instance, using a metabolite of ibogaine, noribogaine, which may mitigate some of the risks, and this is, this is p-part of the reason why ibogaine hasn't taken-

    9. PAPeter Attia1:59:56

       And, and the risk, I think we've stated explicitly-

    10. TFTim Ferriss1:59:58

        Cardiac, cardiac risk

    11. PAPeter Attia1:59:59

        ... are cardiac, yeah, cardiac a-

    12. TFTim Ferriss2:00:00

        Yeah

    13. PAPeter Attia2:00:00

        ... arrhythmias.

    14. TFTim Ferriss2:00:01

        People have and can die of cardiac events in using ibogaine. I don't know the specifics, but I believe you can screen for this in a number of different ways to minimize the risk, and then certainly you can monitor in ways, having other types of more conventional pharmaceuticals on hand in the case there is some indicator of, of a pending cardiac event or cardiac event itself. Uh, that's one of the major risks. It is one of the more potentially dangerous psychedelics. It almost certainly is bec- uh, compared at least to, say, LSD or psilocybin, for which I don't believe there is a known LD50, meaning-- Well, you could explain-

    15. PAPeter Attia2:00:43

        Yeah. No

    16. TFTim Ferriss2:00:43

        ... this better than I can.

    17. PAPeter Attia2:00:44

        Yeah, the LD50 being the dose at which 50% of a population would receive a lethal dose.

    18. TFTim Ferriss2:00:48

        Exactly. Biochemically, what I, what I was gonna say, this, uh, putting, putting all that stuff aside for, for a moment, what's so odd about this, and, uh, I'm, I'm not an opiate specialist, but I, I've had family members die from opiate overdoses. I don't even know if I told you about this, relatively recently. And my best friend growing up on Long Island, uh, also died of a, a fentanyl overdose. Uh, so I have firsthand experience with the pain of losing loved ones to this epidemic. It, it appears that many people can come out of these ibogaine treatments with close to no physical withdrawal symptoms. And I don't know how that works. I really don't. But it does seem to be certainly one of the constituent pieces of this experience that lead to the success rate that many people are reporting.

    19. PAPeter Attia2:01:42

        Which is really interesting because it's true that opiate addiction, uh, opiate withdrawal is not physiologically harmful the way alcohol withdrawal is. So delirium tremens, so the, these DTs that people get when they withdraw from alcohol will be fatal. So you actually have to manage these people with benzodiazepines and other medications as you taper someone off. You don't have to do that with opiates, but the withdrawal is nevertheless psychologically devastating. So that's interesting that you could mitigate that. I've read accounts where people talk very similarly about ibogaine the way you described, or the way I, I don't know if it was you or if it was Michael Pollan on the podcast talking about the smoker. I think it was Michael Pollan talking about the smoker who says, "You know, my lungs are just too beautiful to be insulted with this stuff."

    20. TFTim Ferriss2:02:30

        Yep.

    21. PAPeter Attia2:02:30

        And like, "I realize that and I'm not..." And it's like as silly as that might sound to someone listening to it, that experience, if profound enough, can have a, have a life-changing event that, that is durable.

    22. TFTim Ferriss2:02:39

        Yeah.

    23. PAPeter Attia2:02:39

        And that's the, the key is the durability. And similarly, I've heard these, I've read these accounts of people who, you know, have been completely addicted to narcotics. You know, the account I'm thinking of in particular was, was someone using heroin, and they came away from this thinking, "I could never stick that needle in my arm again. Like, I could never do that to myself again because I now saw this connection I have to a plant and/or another person and/or another organism." And again, I, I know that I realize that when I say that it sounds really silly.

    24. TFTim Ferriss2:03:12

        It takes us or brings us full circle in a sense also back to the beginning when I said that you shouldn't and you don't have to go through life simply tolerating yourself at best. Because there are a thousand things that could follow because, but in part, if you don't have any regard for yourself, if you think you're worthless, or if you think you're fatally flawed, if you think you're a fuckup, if you think you can't get anything right, or you just don't l- you don't have some intrinsic love for yourself, you don't see any beauty in yourself, why wouldn't you be addicted? Why wouldn't you stick that needle in your arm? Why wouldn't you smoke pot five times a day and tune out? Why wouldn't... Not to say there aren't applications of cannabis. Don't freak out, people out there. [laughs] It's an interesting space. We don't have time to get into it right now. But there are so many ways you can numb or damage yourself, which is a, in some ways, a logical coping mechanism if you have a low regard for yourself. But when you sense an interconnectedness and you suddenly have empathy, not just for other people like we've felt through our experiences, but an empathy for yourself. You look back at like the 10-year-old Peter or the 10-year-old Tim, and I'm just like, "Jesus Christ, fucking poor kid." I mean, and I can sit with that feeling and actually identify with that kid and forgive that kid and assure that kid everything's gonna be all right. It's right now, in words through this microphone, probably not gonna have the impact that I would hope it to have, but for people to feel that as if you are in the same room with that younger version of yourself can be transformative beyond anything that I could convey right now. And when you have an experience like that, as ludicrous as it might sound, the idea of injecting some type of numbing agent into your body just becomes inconceivable. In the, in the same way that it would be inconceivable, as you mentioned earlier, how you treat yourself is ultimately how you would treat others. Like, what would you like inject your son with that? You're like, [chuckles] to numb his experience of life? Of course not.

    25. PAPeter Attia2:05:20

        Y- yeah, that was, uh, just one of the most powerful experiences I ever had when I really finally accepted all of the issues I needed to accept and go into therapy was something they made me do, which was carry around a picture of me at a certain age before certain things had happened that were pivotal in sort of shaping both the positive and negative aspects of my personality. And the idea was at... And again, it just works out that way. It worked out that way for me, that my oldest son is at about that age, and just for what it's worth, looks like me. So it became a very easy way to look at him and say, "Well, that was me." And it turns out that that was the, that was the bridge to understanding. It's ve- it's actually, if you're a parent, what parent can't find empathy for their child? And that's like the stepping stone. And so to think that these agents can do that, because maybe not everybody has that luxury of having a child or having a child that looks like them at the same age when they were traumatized or something like that. I mean, it's, it's very powerful and, um, you know, it just, uh, I guess it's, uh... There are many problems to which I really honestly have no, not even the foggiest clue how to go about solving them from a practical standpoint. Like, like talk about climate change. Like we could talk about climate change all day long, and we could certainly wax philosophically on lots of regulatory things that could be done to mitigate it. But you start to realize very quickly that politically these things become challenging, and you have all sorts of different economies around the world, and they'd all have to be in lockstep. And, and, and you sort of, not to be dismissive of these things or say we shouldn't work very hard at solving these, but the solution space isn't that clear to me. And yet when you see a problem that in my mind is the single most important problem that's plaguing our civilization, and I know that's a big statement. That's a super big statement. And I realize it's also probably naive when you consider that there are many other problems going on. But unhappiness is at the root of more pain, I would suspect, than any ailment that falls in the quote-unquote physical body. And to think that we have compounds that could play such an important role that are really facing, you know, challenges in getting approved, I just find that really

14. 2:07:42 – 2:16:42

    Regulatory Path, Anti-Addictive Potential, and Training Clinicians

    1. PAPeter Attia2:07:42

       frustrating.

    2. TFTim Ferriss2:07:43

       It's frustrating, and it has been frustrating for people like, for instance, Rick Doblin, who, who heads up MAPS, who've been-

    3. PAPeter Attia2:07:50

       He's been at it since 1986.

    4. TFTim Ferriss2:07:51

       1986.

    5. PAPeter Attia2:07:52

       That's, which is just to me, that's amazing.

    6. TFTim Ferriss2:07:54

       And probably beforehand, if you take into account, I believe that that's when MAPS was officially formed, if I'm not getting my facts wrong. And we're at a very exciting time now where MDMA is being expedited. Psilocybin is certainly on its way. For people who are interested in learning more about this, I think maps.org is a fantastic place to, to look. Uh, in fact, one of the areas where MAPS could use support, as I understand it, is in taking their approach to legitimizing MDMA use therapeutically in the US to Europe. So there, there will be steps they'll take with the EMA, I think it is, which is the FDA equivalent in the EU, for hopefully facilitating MDMA use in Europe. Uh, so that, that certainly if you're looking to become involved with exploring and potentially supporting this as I am, that is one clear and present need. And it's, it's, we're also at a very exciting point because psilocybin is one example, uh, which has a lot of good research to support it, and there's a lot more being done at places like Hopkins and NYU and many other places now, may have, and this remains to be studied, but it's plausible that it could have profound applications to opiate addiction, for instance. And, uh, it, this comes back also to the McCormick story with birth control because the... I don't re- I don't recall what the first compound was that was FDA approved, but it wasn't approved for birth control. I think it was approved for menstrual disorders.

    7. PAPeter Attia2:09:39

       That's right. That was the thin end of the wedge was women whose menstrual cycles were unusually heavy or uncomfortable were the first approval.

    8. TFTim Ferriss2:09:48

       Exactly. So-

    9. PAPeter Attia2:09:49

       And that's the most important step is it's much easier to use something off-label once it's been approved than to get something approved.

    10. TFTim Ferriss2:09:57

        Right.

    11. PAPeter Attia2:09:57

        So you pick the right indication.

    12. TFTim Ferriss2:09:59

        Mm-hmm.

    13. PAPeter Attia2:09:59

        That's what's also impressed me about these organizations is just the strategic thought they've put into this, which is understanding a roadmap that is interested in the least resistance.

    14. TFTim Ferriss2:10:12

        Right. Because to, what does it take to reschedule something? If you want to take it from the same class as a heroin and put it into a class where it can be prescribed with proper supervision, medical supervision, you need to... Well, you, you, you, one of the approaches, like cocaine and the, [chuckles] the, uh, nasal anesthetic, demonstrate one clear medical application. And if that is depression in terminal cancer patients, that is a legitimate medical application, and then that entire train can get in motion.

    15. PAPeter Attia2:10:49

        That's one nice thing about where the DEA and the FDA fall out is for the most part, there's a sense that, look, once we've, as these agencies, done our job in scheduling something, we're going to put faith in the practitioner to use his or her judgment as to how much latitude to grant around the application.

    16. TFTim Ferriss2:11:06

        Right. And, and I'll also mention one thing just in case we have regulators or lawmakers, policymakers, people within the FDA or DEA who are listening, and that is read Pollan's book. Check out Pollan's book and immerse yourself in this fascinating area of research. And, and I'll give, if like a lot of people, you just don't have the bandwidth to dedicate a lot of time to this, a, uh, something that Pollan has referred to on a number of different occasions, and that is the addictive potential. So what is the addictive potential of these compounds if we're looking at, say, psilocybin specifically? We could use other examples. But if you take a rat, put it in a cage, and you give it one dispenser, a little, little lever that they can push to dispense food, and another dispenser with cocaine that it can use to dispense cocaine, it will consume cocaine to the exclusion of food until it dies in many cases. [chuckles] If you do that with food and, say, psilocybin, and it gets delivered a whopping dose of psilocybin, it will press that lever once. [laughs] And then the rat's like, "Okay, that was enough," and it goes to the food. And that rather than having high addictive potential, many of these compounds have anti, as we've already discussed, anti-addictive potential. And my God, it's, it is terrifying when I look at where I grew up on, say, Long Island, and you look at the obvious. Put, putting aside the, all of the stuff that I don't see or hear about, but the obvious among people I grew up with, among my friends who have died of overdoses, family members who have died of overdoses. These, these are, in some cases, educated people, in some cases not. They're using prescription medications. These are widely distributed, easily prescribed medications that have demonstrated incredible abusive potential. And to think that we have these molecules that can be produced at, at relatively low cost at scale that are not just non-addictive, but anti-addictive, really provide some hope that we can counteract some of these incredible epidemics. I mean, I, I... You might have been the person who told me this, could have been someone else, but was it last year that opiate deaths exceeded-

    17. PAPeter Attia2:13:32

        Yeah

    18. TFTim Ferriss2:13:32

        ... automotive accidents?

    19. PAPeter Attia2:13:34

        Yeah. For, it, it used to be that automotive accident was the leading cause of death for people up to a certain age, and I believe the age is 40, and now opiate overdose has offset that. So- You know, this isn't an isolated issue anymore. You know, for me, I think, I, I think the rate-limiting step is actually going to be training the clinicians to administer these things. I think that's going to become the bottleneck, and that's why I hope that, you know, you know... And we, we have friends who are psychiatrists, psychologists who have become very interested in this, and that to me is really heartwarming because they're actually going to be among the people who need to lead the charge on this.

    20. TFTim Ferriss2:14:10

        Yeah, and there are groups thinking about this. Certainly both MAPS and other organizations that are involved with psilocybin are thinking about this. People who have come to the table to provide some funding, like myself and for instance the Bronner family of Bronner Soap and others, certainly there are technologists who have, who have come to the table. Many of, many of them have done so anonymously, are very well aware that having these compounds legalized for supervised use is step one, and that there will be a very, very real need for training clinicians. And the wheels are already in motion with prototyping some of this. There's a, there's a group called CIIS out of California, uh, which is prototyping some, some training protocols for therapists who are licensed in various ways already, so that when these compounds are available through prescription, that there are trained clinicians who could administer. So we'll see. We'll see. I'm, I'm very optimistic, but this is where I will be applying a lot of my focus. And these problems do not, they do not discriminate. These problems, these addictions, depression, anxiety that people experience on a daily basis don't care what color you are, don't care what gender you are, don't care how much or how little money you have. I mean, given how publicly I've talked about, for instance, the content of the TED Talk that I, that I put out there on the depression, I've had people come out of the woodwork from my listenership, my readership, some of the wealthiest people in the world who suffer from debilitating depression, whose kids are addicted to heroin. And then on the opposite end of the spectrum, people who listen to the podcast who are just scraping by, same set of issues, debilitating. And, you know, for the f- in the last few years, I've, I've developed a real sense of optimism about myself and my life, quite frankly. Number one is a starting point, which I think is a starting point. Like, before you try to save the world, it's a good idea to try to save yourself. And I have come away completely convinced that many of these stories I told myself, which were crippling, were unnecessary, and that they can be wiped, and you can write new stories, new narratives for yourself. And we talked about meditation.

15. 2:16:42 – 2:25:00

    Books, Tim's Hypothetical Psychedelics Book, and Lighter Moments

    1. TFTim Ferriss2:16:42

       There's a book you introduced me to that I think we should, we should certainly mention also.

    2. PAPeter Attia2:16:47

       Is this "Solve for Happy"?

    3. TFTim Ferriss2:16:48

       "Solve for Happy."

    4. PAPeter Attia2:16:49

       Mm-hmm. Mm-hmm.

    5. TFTim Ferriss2:16:49

       Can you talk about this?

    6. PAPeter Attia2:16:50

       Yeah. So Rick Gerson, who is a mutual friend, and you actually introduced me to Rick probably about five years ago. He gave me a copy of this book, and, uh, it was one of those things that just sort of sat there for, I don't know, six months, and it was just in the queue, but didn't, you know, I didn't really appreciate why I ought to read it as soon as it was given to me. You know, something in the midst of a crisis sort of brought it to my, uh, to my attention a little more quickly, and I just devoured it. And so if, if the Terrence Real book, "I Don't Want to Talk About It," has now jumped into the number one spot of books I've gifted most, "Solve for Happy" is probably in the number two spot. And I was-

    7. TFTim Ferriss2:17:36

       Mo Gawdat.

    8. PAPeter Attia2:17:36

       Yep.

    9. TFTim Ferriss2:17:37

       I'm not sure if I'm pronouncing that right, but M-O, last name G-A-W-D-A-T.

    10. PAPeter Attia2:17:41

        Yeah. And, and, and that's sort of pushed, uh, "Mistakes Were Made But Not by Me" into the, the now number three spot, just ahead probably of "Surely You're Joking, Mr. Feynman." It's weird. It's, it's interesting. It says something about us, the books we like to give people, doesn't it? You thanked Michael Pollan at the end of your interview, or maybe it was somewhere in the midst of it, but I thought it was at the end of the interview, for writing the book that he did because you said it was the book you wanted to read and that you wish you could have written. But you're no slouch yourself when it comes to writing books. Is there, is there anything that if you, if Michael hadn't have done that and you would've been writing that book, in addition to all the stuff we've talked about today, is there anything else that you would've included in that book that, that wasn't included? And that's hard, that's a hard, he's a tough act to follow.

    11. TFTim Ferriss2:18:22

        Oh, very tough, uh, act to follow, and, uh, I'm so pleased that he wrote the book because I have been very clearly biased in the sense that I am a... I've seen the power of these compounds firsthand, and I'm not shy about, as, as we've seen in this conversation, putting myself clearly on the side of support. I don't think they should be available at every 7-Eleven. Some people think it should be every, every drug should just be available for anyone who wants to pick them up at any time. I, I disagree with that position completely. But I am nonetheless exceptionally bullish on the scientific research and ultimately the rescheduling and widening of making these compounds available to people through qualified professionals and supervision. Michael has such a pedigree and, uh, is so widely respected as a, and I don't think he would mind me saying this, a skeptical, highly skeptical investigative journalist, that I'm, I'm, I couldn't be happier that, that he published his book before anything that I might write on the subject. If I were to write a book about or including, I should say, a discussion of psychedelics, it would differ in along the lines of Pollan's and my writing ... styles, meaning Pollan is, is so brilliant at taking the history and science and characters in a given field and weaving it into a first-person narrative of his exploration of all of those things. Much like John McPhee. I don't wanna digress. He's also just a, a hero of mine. But they're both so good at that. I would never try to out-Pollan Pollan. I'll get, I'll get my face ripped off. I c- my book would just be a poor, poor, poor imitation of, of something that he would do mast- for- m- masterfully.

    12. PAPeter Attia2:20:22

        You know, as I'm writing a book now, sorry to interrupt, it makes it that much more apparent to me when I read good books how much I suck.

    13. TFTim Ferriss2:20:29

        [laughs]

    14. PAPeter Attia2:20:30

        And I'm not saying that in a... I, that's not a negative self-talk, although it sounds like it.

    15. TFTim Ferriss2:20:33

        Yeah.

    16. PAPeter Attia2:20:33

        It's just the reality of it. It's like, look, I mean, these people are great for a reason, and it's ex- it's exactly what you said. It's like the best books are not lecturing you. They're bringing you on a journey. And when, when they can do that in really complicated topics and bring you along, and also interweave history non-linearly, that's... Yeah.

    17. TFTim Ferriss2:20:53

        Oh, it's, it's, it's amazing. But I would say, just to give you a smooch on the forehead, that much like the best meditation approach or app or teacher in the world for me may very likely drive you nuts and is not the right person for you, that stylistically some writers, some books will speak to you or grab your attention in an otherwise overflowing workload, and some won't, and that differs person to person. So rather than trying to out-Pollan Pollan or out-McPhee McPhee, for God's sake, that would be a losing attempt, I've realized that I'm not... What I enjoy doing is providing firsthand accounts of my self-experimentation followed by prescriptive recommendations that aren't intended to work for everybody, but that serve as more of a choose-your-own-adventure buffet of options that I have vetted to at least work on myself and a number of close friends who span some, uh, you know, different genders, different age groups, and so on. And that's what I did with "Four Body." That's what I've done with all these different books. So if I were to write a book including psychedelics, it would likely include experiments with other modalities, other vehicles, other tools that also produce not minutely noticeable, but profound changes in consciousness, which is really the stage upon which everything happens, right? [laughs] And in doing so, provide you with an opportunity to, to rewrite the story of your life or to gain perspectives that are otherwise inaccessible, and that might include sensory deprivation tanks. It might include neurofeedback. It might include other types of non-psychedelic pharmaceuticals. It might include-

    18. PAPeter Attia2:22:49

        Ketamine, for example

    19. TFTim Ferriss2:22:50

        ... ketamine, for instance.

    20. PAPeter Attia2:22:50

        We didn't, we didn't get to that today. That would've taken a while, but-

    21. TFTim Ferriss2:22:53

        Yeah, ketamine is a whole separate kettle of fish. [laughs] And m- I, I think my book would be more diffuse in that sense, thematically connected but with independent modular chapters that include some likely extreme [laughs] experiment that I conduct on myself and then report back and say, "Guess what? I pushed the envelope and went way too far so you don't have to."

    22. PAPeter Attia2:23:18

        Mm-hmm.

    23. TFTim Ferriss2:23:18

        "Let's dial back, let's dial that back 80%," and here's something you can try that I think has an acceptable risk-benefit profile. That's probably the book that, that I would write.

    24. PAPeter Attia2:23:29

        Speaking of your books, I don't know if I told you this story. I think I did, but if, if, if not, it's, it's worth retelling. Totally unrelated to this, but it just made me think of it. So it was like, I don't know, maybe a year ago or so, I'm in the airport, and I just remember, like, my flight was delayed and I was sort of like... A, a friend who I don't talk to that often, like maybe once a year, he called me and he's like, "Dude, I just read about you in a book today."

    25. TFTim Ferriss2:23:51

        [laughs] I think I know where you're going.

    26. PAPeter Attia2:23:54

        And I was like, I was like, "Uh, really? I... What do, what do you mean?" He's like, "Yeah, yeah, you, you're in this book. It's called, uh, Biggest Tools."

    27. TFTim Ferriss2:24:02

        [laughs]

    28. PAPeter Attia2:24:04

        And I was like, "What?" He goes, "Yeah, yeah, yeah. Like, there's a chapter on you in this book." And I mean, "Oh, do you mean Tools of Titans?" He's like, "Yeah, yeah, yeah, yeah. That's it. That's it."

    29. TFTim Ferriss2:24:13

        [laughs]

    30. PAPeter Attia2:24:13

        And just kept like... He just didn't even... And it, it was just... And he's Israeli, and he has like a, an accent, so it's like you could tell that, like, the expression biggest tools didn't mean to him what it meant to me.
16. 2:25:00 – 2:36:36

    Tim's Five Enduring Practices and Closing

    1. PAPeter Attia2:25:00

       I do have one final question that's not on the topic at all of what we've discussed. But given that we have now, between the two of us in the past two and a half hours, drank, I wanna say, 20 Topo Chicos.

    2. TFTim Ferriss2:25:12

       [laughs]

    3. PAPeter Attia2:25:13

       Um-

    4. TFTim Ferriss2:25:14

       Right

    5. PAPeter Attia2:25:14

       ... my bladder right now is probably at its maximum capacity. I think pretty soon I'm gonna develop hydronephrosis.

    6. TFTim Ferriss2:25:21

       [laughs]

    7. PAPeter Attia2:25:22

       So we're gonna have to bring this thing to a close. One of the questions I get asked all the time is, you know, people say, "Oh, you're such good friends with Tim. Like, does he still do X? Does he still do Y? He wrote about this. He talked about this. I wonder, does he still do it?" And so I was thinking, for the person out there who's sort of wondering, like, what, how has Tim evolved? When you think of all the things you have written about, when you think about all the lessons you have codified for people, what are the three, four, maybe five things that you have written about in some of your books that still consistently shape how you, uh, have continued to optimize your trajectory?

    8. TFTim Ferriss2:26:04

       So the three to five things that I would say I return to most reliably are perhaps unsexy to some people, but one would be some type of hinging exercise movement. I notice that problems crop up when these are omitted for any extended period of time. Uh, by hinging movement or hip hinging movement, I mean some type of deadlift or kettlebell swing, two-handed kettlebell swing. Very, very simple to incorporate that into an exercise program. I do not believe, unless you have some type of competitive agenda, that you need to do these more than once a week. Uh, you can certainly do them twice a week for extra credit, but kettlebell swings or deadlifts once a week prevent a whole host of issues and improve a whole host of performance factors. So that'd be one. Number two would be fasting and entering a state of ketosis for at least one week, at least once a quarter. Uh, in conversations with Peter, in conversations with Dom D'Agostino, who's a mutual friend, very impressive, not just published researcher and scientist, but also athlete himself. The intermittent use of autophagy and entering this state of, of fasting and ketosis seems to me to deliver a host of potential benefits, uh, with v- very minimal downside. I also like the, just the pure asceticism of the practice. So we have the hinging movement, like a deadlift or kettlebell. We have fasting plus ketosis, uh, for an extended period, at least once a quarter. I just actually finished my latest segment about a month ago. Number three would be some type of meditative practice first thing in the morning. I'm also asked constantly one of the questions that I ask sometimes, which is: What advice would you give your 20-year-old self? What advice would you give your 30-year-old self? And it would be meditate 10 to 20 minutes first thing in the morning. Don't do it after you check your email and do A, B, and C because you are going to fail 50% of the time. You just will not go back to it. Wake up. Right now, for instance, I have a foldable chair that goes on the floor. Uh, I believe it's called a Back Jack or a Jack Back, something along those lines, used quite often in, uh, meditation centers, right on the floor in front of my bed that faces out a window looking at a bunch of beautiful trees, and I get out of bed, throw some water on my face, sit down, and meditate. Uh, I, I would say that's number three absolutely is some type of non-reactivity training [chuckles] for 10 to 20 minutes, or put another way, non-reactivity rehearsal, which is another reason why meditation s- sessions where you're, you feel entirely scattered and you only return to the breath a few times feel like a waste of time, but they are absolutely not a waste of time, is that there are going to be periods throughout your day on many days when life is gonna just roundhouse kick you in the face over and over again, and you are going to be in that scattered state. So it is good to rehearse mindfulness in that scattered state, which is exactly what you're doing. All right, so we have the hip hinging movement at least once a week exercise-wise, ketosis/fasting, meditation would be three. Number four would be the importance of group ritual, and th- this is something that very often falls by the wayside that I forget because I've so often retreated into myself whenever I've felt pain or depression or anxiety. I, I don't want to impose that on anyone else, and I feel like I should be able to figure it out on my own and just climb back into the cave that is my brain, and, uh, this very often results in isolation where I'm just by myself, even if I'm surrounded by other people, by myself, sitting in a coffee shop by myself in my own head. Group dinners at least once or twice a week. Cooking, I have found, and this was not always the case. For people interested, you can check out "The 4-Hour Chef" for all the reasons why I find this so incredibly therapeutic. But you don't have to cook. I just happen to find it adds a new, another level of decompression. But group meals at least once or twice a week would be number four. And then if I had to pick a number five, I would say I'm not gonna use the psychedelics because we've been talking about this entire conversation. If you feel like you're having trouble making yourself happy, try to make someone else happy, and I think that that is the workaround that very often then improves your own state. So it's like if you're feeling just awful or depressed or in a funk, it's like go get a coffee and pay for the person behind you. I mean, just e- exercise some of those random acts of kindness. Think about someone who has helped you and call them and leave them a voicemail or get them on the phone and thank them for how they've helped you. And closely related to that, that ties back into the meditative practice, is if the me, me, me practice, focusing on your breath, focusing on your thoughts, focusing on your, your, your, your, me, me, me, me, is maybe exacerbating some of your problems and you feel like you're, you're having trouble escaping your own head, take a look at metta meditation, M-E-T-T-A, also known as loving-kindness meditation, and I have found that to just be powerful beyond belief. I didn't think it would do anything. I found it kind of cheesy. I thought it was kind of cliched. I wrote about this a bit, uh, borrowing from the teaching of someone named Chade-Meng Tan, who was an early engineer at Google and created a class called Search Inside Yourself, which was hugely oversubscribed by employees at Google. I think it had some insane waiting list. And, uh, this was one of the techniques he recommended. So loving-kindness, it's hyphenated, loving-kindness meditation, which Jack Kornfield has some, some fantastic examples of. So Jack Kornfield, K-O-R-N-field, and loving-kindness meditation, also known as metta, M-E-T-T-A, meditation. And, uh, there have been multiple reports, I've certainly experienced this myself, but by doing metta meditation, say, at night before going to bed, do that for a few days, and you might have the most at peace week you have experienced in years. It's, it's really something else. It's worth experimenting with. So I would say those are my five, at least the, the five that come to mind right now that I would feel very comfortable defending and backing.

    9. PAPeter Attia2:32:49

       Well, Tim, that's super helpful because I-- we managed to somehow figure out a way to spend so much time together that I... When you say those things, I'm like, "Yeah, I, of course. Like, we, that's just what you're always doing." So, um, but I think it's great for people who are listening to this who, who, who don't, you know, get to interact with you frequently, who, who, to get that little update on stuff. So you've been incredibly generous with your time, but what people probably don't realize is how generous you've been with your time off this podcast, including sending me the links to, like, which pieces of equipment to buy for the recordings and sitting down with me and giving me the, not just the 101, but the, you know, the full course on, look, do this, don't do that. Waste time and energy on this. Don't waste time and energy on that. So I really want to thank you. I can't imagine having anybody else be the number one episode of this podcast, and I, I do hope that this podcast continues beyond the, the initial 12 or 13. But even if it doesn't, this will have been incredibly worthwhile. And thank you again for your hospitality this weekend in particular. I remember I put out something on Instagram the other day about what was the over-under on how many Topo Chicos I could drink in a weekend, and I think I said it at 15 or 16. We have blown through that [laughs] so much. I can't imagine. I don't, I still don't, to this... Anyone who's listening to this who doesn't know what we're talking about, we're talking about a sort of bottled water. It's in a glass bottle, and it's a, it's a carbonated water. But anybody who's tried it will agree it's not like a Perrier. It's not, there's something different.

    10. TFTim Ferriss2:34:12

        Little touch of magic sodium to keep you coming back for more, among other things. [laughs]

    11. PAPeter Attia2:34:17

        [laughs] Anyway, Tim, I can't thank you enough for, for taking the time to be on a, a little rinky-dink podcast at this point. But anyway, it's been, it's been wonderful.

    12. TFTim Ferriss2:34:26

        Oh, my pleasure, man. I expect to see you right up there with, with [laughs] our mutual friend Jocko, uh, who you introduced me to. So thank you for helping to unleash Jocko on the internet. [laughs] And ever since our episodes on my podcast, uh, where I had you on as a guest, I've been beating the drum, uh, wanting you to start your own, because I, I think that you're just gonna do a fantastic job, and then it's gonna become one of the regular listens in, in my own rotation of podcasts that I listen to. So keep it up, man.

    13. PAPeter Attia2:35:01

        Thanks, brother. [upbeat music] You can find all of this information and more at peterattiamd.com/podcast. There you'll find the show notes, readings, and links related to this episode. You can also find my blog and the Nerd Safari at peterattiamd.com. What's a Nerd Safari, you ask? Just click on the link at the top of the site to learn more. Maybe the simplest thing to do is to sign up for my subjectively non-lame once-a-week email where I'll update you on what I've been up to, the most interesting papers I've read, and all things related to longevity, science, performance, sleep, et cetera. On social, you can find me on Twitter, Instagram, and Facebook, all with the ID peterattiamd. But usually Twitter is the best way to reach me to share your questions and comments. Now for the obligatory disclaimer. This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice. And note, no doctor-patient relationship is formed. The use of this information and the materials linked to the podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnoses, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they have and should seek the assistance of their healthcare professionals for any such conditions. Lastly, and perhaps most importantly, I take conflicts of interest very seriously. For all of my disclosures, the companies I invest in and/or advise, please visit peterattiamd.com/about. [upbeat music]

Episode duration: 2:36:36