#507: Dr. Adam Gazzaley, UCSF — Brain Optimization and The Future of Psychedelic Medicine

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Hello, boys and girls, ladies and germs. This is Tim Ferris and welcome to another episode of the Tim Ferris Show, where it is my job to interview world class performers from all different disciplines, all different areas, to tease out Habits. frameworks, lessons learned, tools that you can use, insights that you might apply to your own life, questions that might Enable you in some fashion. Is

Close friend. Adam Gazali. M D P H D. You can find him on Twitter at Adam Gaz G A Z Z. Adam is the David Dolby Distinguished Professor of Neurology. physiology and psychiatry at the University of California, San Francisco, and the founder and executive director of Neuroscape, a translational neuroscience center engaged in technology development and scientific research of novel brain assessments and optimization tools. Dr. Gazali is co-founder and chief science advisor of Achilles Interactive, Sensync and jazz venture partners. He has been a scientific advisor for more than a dozen technology companies, including Apple, GE, Nielsen, and Deloitte. Gazali has filed multiple palants.

Try that again. Let's try that. If I keep that one in. Gazali also. I just never refer you to as Gazali. Anyway, Gazali. I like it though. Gazali has filed multiple patents. Notably, his invention of the first video game cleared by the FDA authored more than 150 scientific articles and delivered over six hundred and seventy-five invited presentations around the world. God, that makes me exhausted just reading it. He wrote and hosted the nationally televised PBS special, The Distracted Mind, with Dr. Adam Kazali.

And co-authored the Distracted Mind subtitle Ancient Brains in a High Tech World, winner of the 2017 Pros Award. Dr. Gazali has received many awards and honors. including the twenty fifteen Science Educator Award and the twenty twenty Global Gaming Citizen Honor. You can find him. Online in several places. Gazali.com. as well as Neuroscape.usf dot edu and on social

on Facebook, Instagram, Twitter. Adam Gaz. And you can also find him on LinkedIn. He is easy to find. There aren't many Adam Gazales running around. Adam. Welcome back to the show.

Thanks so much, Tim. Excited to be here with you. I'm excited also because you have what appears to be a professional sports center broadcasting headset. Those Those who are not watching video can't see it, but I am very reassured that if this neuroscience thing doesn't work out for you, you have a compelling plan B. It was the you know, quite a way to overdo the zoom world that we live in now with this headset, but at least for this podcast I will be well heard. So thank you. And thanks to Matt Mulderwig also for his his tech enabling. So for people who did not join us. in the first conversation we had on the podcast, I wanted to mention a few highlights or just a a few topics that we brought up. So the first conversation we had, I didn't realize until doing prep for this conversation.

Because there was a a summary of our previous conversation which said Kevin and Daria Rose are moving to New York. And I thought to myself, Good God, how long ago was that? And it was 2015. So in 2015. It's been a long time and your bio has developed quite a bit since. And the title of that was The Maverick of Brain Optimization. And I'll mention a few reasons for choosing that title. And uh that that was my choice. I I don't think you would choose that for yourself. Uh we discussed many things. And I wanna paint a picture of some of the tools and types of development that you have

Explored. in your time as as a scientist. And one of those is Neuroracer, which is a piece of software that was featured on the cover of Nature. The title, as I remember it, was Game Changer and Well, you correct me if I'm wrong, I'll just try to summarize this really quickly, but the paper was able to show that a team of scientists could work with video game professionals to build something customized that targets process in the brain that's deficient in a certain population. And I'm gonna ask you to just give some numbers in a minute. But in this particular case, it was older adults and their cognitive control abilities. So some might say. Age related cognitive decline.

And then You once you've built the software you can construct a carefully controlled study, placebo controlled with neural measurements to document the mechanisms of effect and show that you can create sustainable and meaningful changes in the brain using And just as a footnote.

that cognitive abilities begin to decline around or certain cognitive abilities around what, early to mid twenties? Yeah, That's accurate. So What were some of the outcomes?

Uh The study or the paper that was It was featured on the cover of Nature. Yeah, that was uh really uh quite a game changer for for me as well. Only time has told how far that technology and that research has gone and we could dive into what it's become now. It's fun to think back. You know, that paper was published in twenty thirteen and it took five years of

both tech development to build that video game with friends at LucasArts, as well as to do the multiple research studies that went into that paper in Nature. Um Why it was so exciting was that what we were able to show was that We can improve the ability of these healthy sixty plus year olds not just to play the game, but their ability to sustain their attention in a very boring context, as well as their working memory, holding information in mind for short periods of time. And what we were showing is that we were really improving and their ability to multitask on the game to levels of twenty year olds. So it was really reversing a lot of the changes that occur with healthy aging. And we could see those changes occurring not just in terms of their performance,

But neurally. Because we recorded with high density EEG. how they responded to these challenges before and after a month of gameplay. We could then look over time six months later, and actually we have a paper that is just being accepted for publication now showing six years later that in these older adults we see some benefits, not all the benefits retain over that period of time. Which is really quite exciting. Um and opens up the possibility to really push what we can do to lead to these sustainable benefits.

What was the age range of subjects roughly or the average They were sixty and over. I think we had one that was a ninety year old, but mostly sixty and seventy year olds. And the the game, the software. was As an intervention.

was able to restore or revert some of their cognitive function to the level of Twenty somethings. Correct. Correct. Accurate. Yep, that that's accurate. And just to restate what you said. For people who might have.

Missed it. the and please again correct me if I'm wrong, but there the durability of the of effect. In other words, seeing the retention of a lot of these improvements six months later. was not because they continued to play this game on a regular basis going forward. Correct. They did not play it at all, even though many of them wanted to after the one month of training. And so that's why when we brought them back just recently, this is not published, it'll be out soon, six years later, their ability to play that game at a much higher level than they did before

was retained without any boosters and this is not a real world design because as this becomes a true treatment intervention that we want in the real world, and we could talk about where it's gone, we would not think about that type of durability as as the goal. It would be more reasonable to boost those effects over time with doses along the way. Just like if you were going to Enhance your physical performance, your strength, your aerobic ability. You wouldn't think, oh, a month in the gym and then I'm good till six years later. So the the fact that anything lasted is is sort of mind boggling to me as a as a neuroscientist, but um it's more of a proof of concept that, you know, these

circuits and these abilities when they change can be enduring, but in the real world implementation, it would make much more sense to in a personalized way. boost these effects along the passage of time. For those not involved in scientific research. What would you compare

being the cover of nature too? I mean, is it comparable to winning a an Oscar for Best Director or Best Picture. I mean that's that's how I've in some ways thought of it because I don't have perhaps other Comparables, but I I know you're very Self effacing and humble.

when we talk and also just in general, but It's a big deal. Uh it is not a small accomplishment. And I'm just wondering how you would describe that or compare that to give people an appreciation for what that represents. Yeah, it's it's sort of around as big a thing can happen as a scientist and probably if it happens at all will happen once in a lifetime. You know, having a paper in in nature of science, those are like the pinnacle journals in the world, those two, the the twin towers and having a paper in them is

incredibly rare and and exceptional. And then having a a cover story is just a once in a lifetime. And you know, my friend uh Mic Mickey Hart, who's a musician who's the the drummer from The Grateful Dead. He he always jokes that oh that's that's a cover of Rolling Stone. That you know, so everyone sees it through their own eyes. But yeah, to me I think it's like it's like a Grammy and it's like a mixed feeling about it because you get it and it and it changes your life and it did. You're like, oh that means that that was the pinnacle of my life. And everything after that is like just not as good. Like it's not gonna happen again. And I have tried again and we've had some really great papers over the years, but in all likelihood that's the only time that's gonna happen in my life. Well,

Never say never. Never say never. I'm gonna try. I'll keep trying now. So a few other things I'd love to note. The next is that You I think are very ambitious

And calculated at the same time. So on one hand You might say That you not just enjoy, but look for risks that you can take, say related to the video game connection, because you don't want to be You personally and then I I think maybe by extension.

This would also apply. But you don't want to be the scientist who is simply building on whatever came before In an iterative incremental approach. Like is it fair to say that you are looking for groundbreaking discoveries or

groundbreaking development of tools. Is that a fair statement? I've always been motivated, I mean, since I was a little kid and when I thought about science and you know, thinking about the giants and history whose names, you know, you still remember, you know, millennia later. Those were my heroes, not the baseball players or musicians. It was always those scientists and Looking at their accomplishments, what got me so excited about going into science in the first place. And when you approach science in that way, you realize that

Wanting to do it is only a piece. Of the puzzle of getting there. And even having the ability and skill to do it is still only a piece. It's a convergence of those things. And time. frequently, other events that are outside of your control that all lead to like a moment where you get to make a contribution. At that level.

And that was always my dream, but it doesn't mean it's going to happen. To sort of answer your question directly, in in order to get there, I tended To think about the research that I wanted to do from that perspective. And not just because I wanted a big claim to fame, because not that that's not not a great goal, but My real goal is to make make a meaningful

in humanity in in the world and and help people. And I felt that in order to do that, you really have to sort of step out of the box, so to speak, and not be iterative and do the thing that takes a little bit more fearlessness and a little higher risk. And it's okay to fail, but if you don't try, then you know, there is no chance that you're gonna make a difference at that level. And so that's how I've always approached it. along my career and I now that I've had some successes in it, you get even braver, I would say.

Yeah. And I want to give a a few more examples of the types of tools and work that you do within your lab. I'll first just read a quote from our first conversation asking, and the it was in response to me asking what makes your lab unique and uh please feel free to fact check this, but I believe it's accurate. The question you ask yourself is, how can we use our expertise or methodology, our perspectives to not just understand the brain, but to try to develop novel approaches to enhancing it?

And then validating that our approaches are actually effective. Question mark. that I believe was in the first episode. And In the process of Of following that question, you've, for instance, studied how electrical currents

can enhance brain function in non-invasive approaches with things like TDCS. And This is I suppose as as good a place as any to segue to a a new addition to your bio. Which

Refers to this FDA. Clearance. of a video game. What is that?

refer to. My goals have always been to not just have A super long C V with lots of recognition and awards and which is often what scientists even my My great friends who I respect dearly are building. I I wanted to

Do research that then leapt off the page and became tools that would enter people's lives and and make it make a meaningful difference to them. And I quickly realized that I could not do that within the the chambers of academia alone. I had to leave and not necessarily leave, but I had to cross over. I had to find a way to move technologies and invention and discovery from the lab into the real world in order to do that. Yeah.

involved working with industry in some way. You don't really produce scalable products in labs and academic labs. It's just not structured for that. And so the Neuracer technology, the video game and and really the methodology behind it, which was a a patent that I filed at UCSF that is now issued. It took six years to issue that. With that technology, I co-founded a company called Achilly Interactive. With friends from the video game world. Matt Omernick, as well as uh Eddie Martucci, who was working with a group Pure Tech Ventures in Boston. And we started this company, Achilles Interactive, to move

That technology and the nature paper wasn't even out at the time that we formed the company. Beyond A prototype. And an academic exercise that leads to a paper, even a paper as good as a nature paper, that that wasn't the goal. The goal was to turn it into a product.

that would be a medical device that can actually serve as a new form of medicine beyond the molecular medicine as what I now think of as an experiential medicine or digital medicine that could lead to improvements in attention. and different clinical populations. And so over the last Seven years plus we we've now At Achille.

We've built a better version of Neuracer. Better meaning that it has highers of art and music and story and interactivity and feedback loops. And usability. But re preserves the same underlying architecture, the same mechanism that is defined in the patent that was in Neuracer is in this game called Endeavor R X.

And over these many years, Achille has sponsored research at academic universities to validate this video game, this child of neuracer as a clinical tool, as a treatment in numerous populations. So studies in autism and depression. A D H D, multiple sclerosis have been published now. Oh. converging on the same conclusion that this game can improve attention abilities in

these different populations. So even if there's a different reason why an individual has an attention deficit because they have you know, a sensory processing disorder as a subset of autism, or they have depression. We see the same benefits, which is really exciting because you get that really broad effect. And so to go back to where where you introduced this, A study was done at a Duke. I was not even an investigator on that study, which is that's the dream, right? That you create the technology and then other colleagues and other independent investigators validate it. So this was a study at a Duke by

A really great clinician scientist, Scott Collins, and it was a really unique study methodologically because it was A multi Sight. double blind placebo controlled trial. With a video game and children with ADHD. So three hundred and fifty kids, years, millions of dollars, a big actually not the type of studies I like to do at all, uh, but a big important study. It's called the phase three trial. So it's a pivotal trial. It's the it's the type of study you do that you pre-submit to the FDA.

All your design elements, your outcome measures. It's like a baseball player, you know, sort of pointing into the distance saying, this next shot is gonna be this home run and how that's so much more meaningful because you call it in in advance. That's what you do in these studies. You have to like pick your outcome measure and what you expect to see before you even do the study, because that's the most statistically rigorous way to show that this is a true effect. And that's what was done in this study, that we the hypothesis was that the sustained attention of these children, which is very impaired beforehand, they have ADHD. So sustained attention is vigilance in a really boring environment. It's designed to be boring, this test, that that would improve. in response to this video game compared to another group of children with ADHD that's playing a different video game. And so that study took years and that hypothesis was confirmed that those children did improve the other

Group, the other game didn't change at all. And so it was specific to this game, Endeavor RX. And with that finding, We uh as Achilles presented to the FDA the results requesting approval for clearance of a medical device. So it's actually a class two medical device to treat inattention in children with ADHD. And that took many years. Just a point of detail if folks are interested in this. It That's known as a de novo pathway. There's two pathways through the FDA for either a drug or device. One is de novo, meaning it's completely new. There's no predicate. It's essentially establishing a new category of treatment. And the other is the predicate, the 510K pathway, where it rests on a previous history. And so it's much faster to get approved through that pathway than the de novo, the new pathway. And so Because there had been no video game and no treatment of this type, it

Ever cleared by the FDA. It was a de novo pathway, which made it a lot longer and more rigorous of a review process. But we found out during COVID, just in the summer of twenty twenty, that the game was cleared. Uh so this was one of those small uh blessings, as my friend m Michael Pollen said, uh a silver lining in the in the pandemic blanket. And so what we found was as we went through this process, the FDA was willing to clear this as a treatment for inattention in eight to twelve year olds. That's what the study was done on with ADHD, which was just an amazing result after a decade of journey from Neuracer to this.

Because now what we wound up with was the first ever FDA clear digital treatment for children and the first digital treatment for ADHD and the first video game for any clinical condition. So it was a long journey and I wanna give all the hundreds of people at Achilles and Neuroscape credit. as well as the independent investigators like Scott Collins for for all the work and pushing it through. But now we have an entirely de novo treatment of this type out there for for kids. This is exciting to me on multiple levels. One is that as you mentioned, it's de novo, right? This is a In a sense, in in several senses, sort of establishing

And validating a new category. Right. I mean that's uh new category of of treatment or intervention. One question that pops to mind. Is

what the underlying mechanism is, or if you can explain why the Game. Endeavor R X. seems to be effective in multiple populations. Mm-hmm.

You named a few, depression, ADHD. Autism or certain types of autism. Mm-hmm. Multiple sclerosis, we've now. Multiple sclerosis. Mm-hmm. What is the

even though these conditions manifest and present in very different ways. In a bunch of respects. What is the commonality or why is it effective? Why is the intervention effective across these different conditions? Yeah, it's a great question and and a complicated longer answer it would probably be required to really

Break it down, but To just give you know at least a basic understanding of how that's possible, it really is through the window of cognitive neuroscience that that makes sense. If you look at the pathology of those conditions, it's It's more confusing and elusive of why they would be connected to have a common treatment lead to benefits across them. But from a cognitive neuroscience perspective, which is my background over the last couple of decades, is that there are common underlying networks, neural networks in the brain that subserve different abilities like attention, memory, decision making, emotional regulation, on and on.

And These networks could be damaged, influenced in all sorts of ways by many conditions due to different reasons. When it comes to our attention systems, the networks are so distributed That Any insult to the brain, I would say. I'd be s hus bold to say that any insult.

real insult to the brain that leads to any cognitive Deficit. is going to have a component of attention deficit associated with it. So if you look across all the neurological and psychiatric conditions that you could think of and Put it into PubMed or Google Scholar with the word attention or distraction.

you will find research showing that they have impairment in that. And that's just because The act of Focusing our limited mental resources on something that is a goal of ours, which is, you know, the core of the type of attention we're talking about, sustaining selective focus on something that you choose to, top down attention. That that process involves so many distributed brain areas that all these different sources

of pathology lead to decrements in that ability. And so if you have an intervention like Neuracer and Endeavor R X, which challenges cognitive control at a very high level. Do to closed loop systems in a personalized way, like the ultimate trainer, constantly pushing and optimizing those abilities over weeks and even months sometimes. Then what you wind up with is a transfer of benefits to cognitive control challenges outside of the game that's independent of what the cause of those deficits were. I think that's uh gives you a bit of a of an idea of how you can have

A How come? That sort of crosses all these boundaries because the same networks are vulnerable in all these populations. So anything that can optimize them could lead to a benefit across them. Could you for people who don't have any

real perspective or context on UCSF. Just describe U C SF. Like what is UCSF from the perspective Uh research or looking at it as an institution of science.

What is the best way for people to think about UCSF in the kind of ecosystem? Of research within the United States. It is a massive and humbling honor for me to be at UCSF myself. It was always a dream to come out here to California and work at this institution. A lot of people don't know UCSF, University of California, San Francisco, like they might familiar names like Stanford, Harvard, MIT. Largely because uh UCSF is only a medical and health center. We do not have an undergraduate campus.

There's no just engineering department. Everything's bio, bioengineering, biochemistry, but it is one of the world's premier medical centers pretty much across every domain, especially in neuroscience, neurology, neurosurgery, psychiatry, in those areas. in the brain areas is is UCSF's forte and from many perspectives. And so it's always ranked as one of the top in the country and even at world measures when it's put to the test or different evaluations. And from my perspective of being a faculty member here for now fifteen years, It's amazing. I mean, every fa every other faculty member I would meet without knowing anything about them, I'm excited because there's something about them why they're here at UCSF that I just want to find out. Um and then of course from from just a clinical perspective, like I would send anyone in my family without hesitation. And it yeah, it's just a a wonderful, wonderful place to be scientist. Yeah.

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I I wanna come back to the risk taking the concept of risk taking for a second, and then we're gonna talk about New chapters. We're gonna talk about new new areas. When I hear you talk about risk taking.

And Transing science into the world for Impact. It strikes me that on on one level you could look at some of the projects and things that you've done as

risky in the sense that there's a possibility that they do not work and they're in many senses not incremental. You're not just adding an extra five percent on top of something that's already been demonstrated. At the same time When I look at how well you've been able to recruit and how well you've been able to retain and how effectively you've been able to build and grow.

This is a leading question, obviously but Would you agree that That ambition and the willingness to take things that one might consider risky on as projects is a critical ingredient in all of those things. I just i I feel like to

to foster an environment where you can do all of those things and where people will put in Lots of hours and effort. Over a long Sustained.

the the years required for some of these breakthroughs. That that risk taking is Seems to be a critical. Ingredient Almost a prerequisite for that type of enthusiasm. That's at least my perception. But what are what are your thoughts?

I agree with you. I think that is That's part of it. And When you create An entity. I think, you know, at the time that we last talked it was my lab, it was Gazali Lab. That's like a Pretty classic way of how

labs are named after the PI and since then my lab has just exploded and and now it's not a lab anymore. It's a center, uh, where there are multiple faculty. We have now seven faculty members and I think the reason that that has happened is because of the type of risk taking that I am willing to do But also how we build we, my whole team, builds a system

of security in that risk taking because It is a long time to go without a publication when you start one of these type of studies. I mean it could be five years before you're even writing up a paper and Therefore, in order to jump off of that, you know, that bridge with your bungee on, you have to have security in the bridge and in the bungee and in the and in the instructors and the person that ties it on. And so it's a whole community effort. Two

create the platform that allows risk to be taken in an appropriate way. Right. Cause if we were just reckless, who would join that and where would be the means to assemble an all star team of staff and postdocs and students and faculty. They just they wouldn't gather. So I I agree with you. I I think that that's all tied together of what it means to take a risk to do something bold, but to do it in a way that's thoughtful and not reckless.

And you used a term just for people who may not recognize it. Uh you said PI, that is not Magnum PI. Investigator pr principal investigator, if I'm getting it right. Yeah, which refers to the the the lead researcher for a grant project. How many folks do you have within the Neuro escape. Endeavor on that team.

Neuroscape's a center. Um we just call it Neuroscape and we have over forty people on payroll now. And we also work with a lot of contractors and volunteers and that number's Well over sixty. So It's a big group and it's been a quite a change for me. as a PI as a principal investigator to become a director and to really help other scientists upcoming in their careers to spread their wings and to really take those calculated risks as well under this, you know, community of Neuroscape that we created.

You know, it's so wild, Adam, I just have to say to you think back Two. when we first started spending time together looking at the evolution of the bio. Reading it for the podcast. Just the change Since two thousand fifteen and

Seeing how much you have done since I took also my first My first step into the world of scientific research from the standpoint of funding with that very first yeah that very first check whenever it's I think it was like two thousand and twelve. Yeah, two thousand and twelve, something along those lines for Gazali Lab. And uh it just makes me so happy to see how incredibly well you've

been able to execute and not just execute as an independent soul scientist, but also Assemble and retain. Top talent. It's very impressive to me. I just wanted to say that.

Oh thanks. It's also fun. It's always a a real pleasure to talk with you, Tim, because we have we have so much history going back over a decade when we met, and I can't help but like you're doing is thinking back in those early days when you even joined us for a bit on some brain stimulation work to help us out in the lab. And just how much has changed since then. It's fun to think back, not just what the list of papers are, but the the actual journey and and what was involved in in assembling the people and The uncertainty even when we were talking over the years.

Where the It was not FDA cleared and it was uncertain if it would be because of all the challenges of g of going through a de novo pathway. So it is really gratifying to talk to you now after all these years and and see where we've come. Yeah, I remember trialing very, very early versions of Neuraser with the with the cap on. E having right, exactly the EG cap on and also having Uh, having you help I think it was my middle finger to jump, kind of dance around with the TMS apply to Ah, was it

M three. Yeah. Yeah, yeah, motor cortex, yeah. Exactly. So it's been it's been a hell of a journey, man. And uh And it's not over. So you not at all you are Yeah, I think it's fair to say. You're in a position

Where You get to pick your targets. I mean you you have done exceptionally well. You've established incredible defensible credibility. You've had Game changer.

Neuraracer on the cover of Nature, you have this Well developed. Center, right? You have Neuroscape, which is is not just up and running, but really humming, right? I mean it's It is a formidable

organization. You can really choose what you want to do and what you want to focus on. So I suppose this is as good a place as any. Mm-hmm. Could you please tell us about What the new undertakings are.

And I suppose the announcement. And we could start with the announcement and then go into backstory just to hear how you got. To this point. Or we could start with the backstory and then get to the announcement. I agree. Let's not bury the lead. We'll we'll tell we'll we'll we'll tell what's going on and then we'll we'll break it down so that everyone could enter this conversation with that full knowledge. So

Over the next couple of weeks we're in the process of you know, announcing we're going through this right now, announcing a new division within Neuroscape. I will focus on psychedelic research. So Neuroscape Psychedelic Research Division is being launched and we're Very, very excited about it. We're also Really excited that this division will have at its home

Robin Card Harris, who will be joining us as faculty At Neroscape? and will be the director of the center. And that's incredibly exciting for me. Robin is a leader in the field of psychedelics, has become a very good and trusted friend and I'm honored and and and humbled in in many ways that he is he's willing to travel across the world over from the UK to join us to be the founding director of this division within Neuroscape. He'll also be coming with an incredible position, the Ralph Metzner Distinguished Professor of Neurology and Psychiatry. Incredibly excited for him to uh start his new journey within

U C S F and within Neuroscape. And to advance psychedelic research to the next level. So that's the lead. Um and we can talk about how all that happened. Yeah, let's let's talk about it. I also want to just Note. because I find it so incredibly inspiring that Things happened very quickly.

And uh Not just quickly for within the scientific sphere, but quickly, period. If uh I remember you you know you look back at email threads and just looking at the sort of time period that transpired after you first Connect with Robin and

as everything unfolded, it was very fast. And I think that's extremely inspiring and demonstrates what's possible. Within universities that are and teams that are able to embrace this as a as a direction. I just think it's incredibly

Impressive. Mm-hmm. Yeah, I'm really really pleased with the how Rapidly we've been able to do this, especially during Covet. You know, nothing really seems to happen fast during these days. And it just, you know, it's a reflection of of the people involved, the university. And

the fit of all those things together, the people, the university, and the the research mission, which is is what I'd love to spend time talking about. That those things allowed it to move so rapidly and that it just felt Right. And made sense from pretty much every perspective. Not that there wasn't a lot of logistics and politics and and and negotiations, but the core of why this was the right thing to launch this division within Neuroscape to have Robin

Lead it, it just s makes sense. And so that With that force. All the other pieces were able to fall into place. Yeah, well like with a big enough Y, right? A lot of the other things fall in line. How did this come to be? Please share whatever

you think might be helpful to paint a picture of how and why this came together. Yeah, it's great. You know, I've never really told this story yet and um I was sort of saving it to tell with you'cause you were one of the inspirations in it, not just a friend of mine. But you know, if I go back to twenty nineteen, which is, you know, not all that long ago. Even into

uh the sort of mid and late twenty eighteen conversations that I had with friends, including you, about psychedelics as a medical tool really ignited my imagination. This was sort of converging with my own goals of thinking about what I was going to do next as as a scientist, as an innovator to To not be iterative. I've had the success with

video games as as a therapeutic tool and this was before the FDA clearance and There's so much more work to do in that domain, and we will do it. And it is it's a lifetime of effort to continue to advance that. But I was thinking about the next decade. moving from twenty nineteen into into twenty twenty and beyond. And I was looking for something that was not Brand new. I don't want to plant a new tree. Like I'll have more branches and but I'm not gonna start over from the beginning. It it had to be within the scope of where I felt my expertise slide, what I what I enjoyed doing, the methodology and the skills my team at Neuroscape. So it had a fit. in that picture. And I started exploring what that would be and when I heard

my friends talking about psychedelics. You know, I live in San Francisco and uh you know, certainly a lot of people here are have, you know, for decades. Easy to find a conversation. Easy to find a conversation. Exactly. And I I never really thought about it from a scientific perspective as a neuroscientist in that way, which is sort of says something. You know, I did an MD and a PhD, I did a full neurology residency of it, UCSF. How come never during all of that training was psychedelics ever presented in a academic manner as being a potential tool, not once, never, which is fascinating. And we know a lot of the the political and social reasons why that's true, but It's still mind blowing when you think about that, given all of the neuro education that I've had over the last thirty years. But

Once I I started thinking about it, I decided to dive in a little deeper. And the first thing was reading Michael Poland's book, uh How to Change Your Mind. I know that you're also friends with Michael and I did not know him at the time. We're close by geographically. He's at UC Berkeley and a professor there. I'm at UCSF, like right across the bay, half an hour away, but we we never met each other. And I read that book and something did change in my mind. And It's really clear what it was. It wasn't just that I saw the clinical potential of these compounds. That was obvious, and I knew that already. It was that

What happened when I read that book was that I realized that these are not really molecular treatments. They're not drugs in that classic sense of Introduce a molecule lead to an effect, right? Just pop this in your mouth and your cold is gone. Sort of like how in the infectious disease world, how we think about drugs. I realized that these were experiential treatments and experiential medicines in much a similar way to what I was doing with video games. That

It is the molecule that initiates A series of events in your brain. that leads to an experience and that experience leads to an outcome. And that outcome could be good. Or it could be bad, but it doesn't just depend on the drug. It depends on the intersection of that and you and the context around you and the experience itself.

And that was like an epiphany for me. Maybe it was obvious to others, but I I just never really thought about it from the same perspective that I was engaging in our work at Neuroscape, which is creating these experiences as medicine. And once I realized that, I was like, Oh, this is it. This is the area that I can contribute to in a unique way because of the work that I've done at Neuroscape. And also

I believe elevate this field because it is the area of psychedelic research and psychedelic science that I think is most efficient and missing in order for it to translate. Most effectively. And so with that I began a journey throughout twenty nineteen and twenty to meet

the people that were shaping this field to read the literature and really understand that the potential here. So everyone from Michael Pollan himself to Robin Carr Harris, I went to gave a talk at Imperial College, uh in Oxford in in in the UK, uh Rick Doblin. You and I talked a lot and you made other introductions and I started expanding my mind about the potential for psychedelic compounds to lead to really profound and transformative outcomes through

experience. That was the part that really captured my imagination. And Then I started really reading Robin's papers carefully, and he has a lot of them. And he is, you know, he's the most cited researcher in the field. And he, you know, he's a young guy. And I just really respected what I saw. from him as as a scientist, his own risk taking and but his rigor and the depth that he approaches a problem, the review articles he wrote.

And then I started reading about his articles on context, which is Essentially what I've been talking about, how the elements, what in the field is known as set and setting, how you enter into a treatment, what is your makeup already, what are your intentions, and what occurs during it? What do you hear? Are you listening to music? Are are there other elements of safety around you that take you through that experience to to a certain outcome. And he's written about this both at their sort of review article level, where he's surveying the field, and then from work that he's done himself. with music during treatments.

So I was inspired by his work, but I also realized that What I was seeing. Was that Everyone in the field that I talked to, whether they were Therapists or shamans from South South America or researchers at Hopkins, everyone agrees.

That this Element. Of context. That the experience itself is critical for the outcome. is universally agreed upon. I've never heard really any deviation from that.

But The ingredients that go into the recipe of that experience that lead to the most favorable and enduring outcomes. Is Oh no.

Now, there are definitely therapists that have experimented for many years with context and are experts in it. But If you're looking for prospectively designed randomized trials that have started dissecting these elements and learning who they work best for and what conditions There's almost nothing in the literature that shows that. And so once I really realized that, I said, this is an incredible opportunity to make an impact in a field that already has so much potential and to really fill in that gap that I saw. And then it was meeting Robin.

Finding each other. Sharing this passion and realizing that we could do more. Together and that Neuroscape is a perfect environment in order to do this type of work because of the effort we already had in experiences medicine. And as you said, it it seems like There's there's quite a bit of basic science that's been done. We have then the clinical trials, so advanced clinical trials, later stage clinical trials, but there is this in a sense gap.

In the middle. And There are people who will have context. That they decide or assume or perhaps on some level even test to be effective that they take through trials, but they're not doing, and this is gonna be a maybe a

primitive way of looking at it, the sort of multivariate Testing because they don't They don't have the expertise or the equipment to do so. Right. They don't have the team to do so. But

Uh you have multimodal biosensing capabilities, multi-sensory integration work. Mm-hmm. So I'd be curious. To Hear you speak to what capabilities

you're looking forward to Exploiting. In the exploration and testing of these things. Yeah. Let's dive into it. I just I just want to pause'cause we may went over it a little fast of

This sits in the middle. Between what and I I didn't really clarify that. So The reason I say it's in the middle is because on on the let's say on the left side at the beginning there's all the really Great.

basic science. This is the work that's done in a dish of like a culture of neurons or in animal models and understanding what these compounds, LSDs, you know, the the elements of cell cyber and what what they what they're doing at the level of the cell. Are they anti-inflammatory, are they plasticity inducing? Really just the basic, you know, what receptors they bind to. an incredible amount of great work in that domain. And then on the other side, let's say the right, there is all the advanced Phase two, now approaching phase three clinical trials. So these large multi-site trials with populations in need, like Who's traumatic stress disorder and depression, alcoholism, end of life treatment, addiction.

Amazing clinical work showing benefit. And so the middle is all of the stuff that you need to go from the basic science insights into the clinical trials. That is the middle that we're talking about is missing. How do you optimize the delivery? How do you make it personalized to the individual? How do you make it precisely targeted to those neurisms that most need to be improved? That's the air, that's the middle that I see completely, pretty much completely vacant. And that's the opportunity that excites us at Neuroscape. That we wanna explore. So I think I define that that area, that opportunity a little better. Let's let's dive into how do you do that. Um, this is a another intersection that I find fascinating and have for a long time is the role of technology

in neuroscience and not just in the research, but in its translation. A perfect example is a video game as a technology that we have now used as a research tool and now have cleared as a therapeutic. How can technology play a role in understanding the middle, the role of set and setting in inducing a positive outcome. So there there are really two ways that I'm excited about uh proceeding with that and and our team at Neuroscape is already proficient in that. So we're quite prepared for Robin to land and then you know sort of hit the ground running. Hit the ground running. And we're we're get we're writing grants. We're we're we're buying equipment. We're already we're already running, even though he he hasn't arrived here yet. And so Let's think about it this way. Here you are, you can imagine yourself

going through a treatment like this at a university. And you're taking a compound, maybe you're familiar with it, maybe you're not, let's say psilocybin, and it's a reasonably high dose, you're gonna have a pretty strong experience. And our goal is that you end up on the other side of the experience in at least The same place, hopefully a better place. Now Right now, if you were in a study with that design at a university anywhere in the world, you would likely be laying down with therapists. You would have already had several sessions, so you would have been well prepped. There would there would be that element of set. of going into this. You would have been screened for conditions that might interact unfavorably with this treatment, like schizophrenia and other conditions that we that are avoided, at least for now. And you would then ingest this and have

usually a blindfold on a an eye mask, so you it was more internal, you weren't seeing things, and you'd be listening to music. And that music would vary across site. It may not even be music that you actually like, but that is the design right now. And then after you would have the support during the session, and after the session, you would have several other therapist led meetings to help process and integrate what you went through and then follow up. And that's that's the basic uh design. And and it's a good one. And it's one that we've been really using for decades, even in the sixties, similar designs to this. And it's good methodology and it's getting better and better. What I see missing there in understanding the middle part is

The first thing is we don't really know. What's going on with the participant during the treatment itself? You're sort of a black box. Now an an extremely good therapist that has done this for forty years is picking up subtle verbalizations or body movements or changes in your facial expression and and they're able to protect you if you need it or help, you know, just sit with you as you go through some challenges. And that's as good as it gets. But That's not really scalable at any level because you can't have as many experts as there are people in need of a treatment like this. So that's the first opportunity.

And I'm going to talk about that in a moment. And the other opportunity Is a blindfold and a mask the best option? Is music really ideal? And what type of music? And what about all the other senses that we have? How we smell and feel and other aspects of of hearing that that are not being used during these treatments. Unknown. So used in in the real world of therapy, but not really studied. We don't know who they're best in. So that's the the second domain. So let's split those off. So the first domain is recording. So we have a system at UCSF we call multimodal biosensing. And my hypothesis is that with enough sensor technologies, not just looking at brain activity, but looking across the whole spectrum of physiology and behavior. So high density EEG Facial expression.

Electrodermal activity, heart rate and its variability, looking at facial expressions, body movements. doing experience sampling either through vocalizations or using joystick so that there is some degree of communication. My hypothesis is that not one single of those signals are going to tell us about the state of that individual during a treatment. But if we can collect them rapidly in real time and integrate them, use machine learning approaches so that we can look for the patterns of what's the most meaningful data, we will be able to plot

The experience landscape of an individual traveling through a treatment like this. We won't know the content. We won't necessarily know that they're picturing a the details of a traumatic event in their lives, but We I believe that we will be able to tell the Their level of arousal.

the valence of it, is it positive or negative? So Putting that together, their stress, the state of stress, their attention, whether their attention is internally directed or externally directed, as well. as hopefully even a sense of their awareness of what's going on. So real time state recording is As implemented through multimodal biosensing. That's a very high tech endeavor, but it is possible right now. It takes an

Like a real multidisciplinary team. So you're talking neuroscientists as well as people on the clinical side, bio sensor technology experts, signal processing, machine learning. It is a real challenge and it has not been accomplished yet anywhere in the world at any level that allows us to really track state. So that's the first challenge that we want to really tackle is using technology to understand the state of the person while they go through a treatment. The other side of it is starting to manipulate all of these levers of context of the setting and the set. So how do we position them through different information that presented different environments before the treatment? And then during the treatment, not just think about Music with eyes closed.

Sure, we will do that. That is the standard approach right now. But what is it like to look around you to see either light or abstract views or views of nature, to smell a forest when you see it and when you hear it, what we call multi-sensory integration, to feel low frequency vibrations through your bodies as you enter into these different environments. All of that is unexplored. And so by putting these things together, we start Understanding the journey, the journey within the treatment itself, how these little

you know, not little to the individual, but these discrete moments in time, these micro experiences along the way, how they're influenced by the context of the environment that we're able to control around the participant. And then how all of these elements add up to an outcome. To a sense of well-being or joy or mystical perspective that occurs after. So how do we connect The events that occurred during the treatment with the outcomes. All of that.

is unexplored. And that's basically what we're gonna be focusing on. There is so much room for experimentation. So many variables. It's there's a lifetime there. I I I always say to Robin, I was like, We will die before All that that you just heard is figured out. It's so much. It's incredibly exciting.

to me for many reasons. And uh just to to give a snapshot of personal experience here that raises questions, I think, related to those that you'll be exploring in a very Methodical Tech enabled way. So that you can actually measure, capture, and quantify these discrete events.

discrete changes. I recall the first time I did A five session series of infusions. This is intravenous infusions of Cetamine.

And in this case, I wasn't using it because suffering from acute depression nor chronic pain. Those are two indications, but I wanted to be able to speak to the effects and possible side effects, after effects of ketamine treatment, if I were asked, which I knew I would be asked. And What Really

Stuck out to me. Among other things, in this ketamine treatment, that it was the first time I had been seated in a chair and that video had been put on for me. And I was asked to select Uh a D V D. So it was very uh Retro in that sense. Uh but

And I was able to choose a D V D that I then used as a constant throughout my sessions. I didn't change the video because I I didn't want That's to be a sort of an uncontrolled variable. And these are these aren't I'm not pretending that these are these are really tightly controlled, but I was trying to minimize the number of of variables. So I kept this constant as this video.

And I'd never in a deep psychedelic experience which you can certainly have with ketamine at sufficient enough doses. I've never had the experience of w attempting, even attempting to watch video in these states. So to observe how the imagery

And this isn't, I suppose, on some level surprising because internally generated imagery can certainly have a tremendous effect, but To observe. how the imagery affected the experience, how the music on the video affected the experience. How closing my eyes or opening my eyes while being exposed to this external stimulus affected my experience.

was very new, right? It was very novel to me. That's not what usually happens if you are in a supervised setting, certainly within a u university context, right? It's it's more or less what you describe. It's like okay, I've holds on, lay down. We have pretty good evidence to suggest that this at least doesn't interfere with reasonably good outcomes. But there's so much fine tuning. And

Assumption testing. That can be done. And then you will be doing. It's it's incredibly exciting to me. That's great to hear. Yeah. When I first

Started putting the meat on the bones and saying, okay, this is this is something exciting. Robin's interested. I have my leadership at UCSF is behind me, you know, creating this. I felt nervous because this is a new feel to me and it has a lot of history, right? There's a lot of therapists that have been doing this for decades and obviously the indigenous cultures around the world have used these as as not just mental health tools, but as r religious and spiritual. And I wanted to dive into that part and Determine if anything that I

Have just said to you is offensive to them. You know, it I it I just was was curious. how it would be received because it is very, very different than How these

Experiences are often delivered throughout throughout history. And I was really surprised to find that, especially on the multi-sensory stimulation side. Therapists that I talk with were Really receptive to it, that they thought that this is actually what they mean when they say shamanism. It is this act of Environment.

tuning and creating to help guide that journey and they feel that they're maybe pretty good at it'cause they've been doing it for a long time, but they were certainly open to having data that they could reach for that would give them more fine tuning and also recognizing how hard it is to train people that are new to this. And that if there was a library of stimuli and and evidence of who it works and how it works and also their ability to know what's really happening inside an individual's mind. They were very, very uh activated by that. Now, I'm sure that won't be true for everyone, but that was really reassuring. And and the last point I wanna make on this was

My my big goal here is not to say we don't need therapists anymore. We don't need humans in the loop. We have enough technological advancements in terms of sensor technology and machine learning and artificial intelligence that we're good. We we just need you to take this step into the box and come out fixed. And I I really actually do not believe that that is the future we will or should have. I think that what we're doing here is building a set of tools, really sophisticated, informed, data driven tools that will allow a therapist or, you know, any practitioner in the space to be more effective at helping They're patient. That is what I hope and believe will come from this long journey and that technology will be what it always should be. Is it just another human tool? So that's where I hope and and do believe that we will end when we go through this research approach. Looking at

Achele and Endeavour R X. for a moment because I I'm tying these things together in my own mind. I'd love for you to stress test what I'm about to say in treating not just children with ADHD, but patient populations or populations with Autism. Uh with

Depression. These different conditions and talking about How it is possible. that a single intervention can be efficacious across multiple conditions. This conversation or related questions

Translates quite well. Two the study of psychedelics. And certainly Robin Carr Harris talks a lot about the default mode network and How and why? It appears that some of these compounds

are therapeutically effective. Or at least. Appear to be. The data suggest that they are Effective.

across a pretty wide range of conditions that most Or many people would assume. Or not. related at face value. Right.

different types of addiction, including alcohol use disorder, opiate use disorder. That's opiate use disorder forthcoming at Hopkins. And Then you have PTSD. You have treatment resistant depression as well as major depressive disorder. There are people looking at

O C D. And The assumptions of which Or the one of the assumptions underlying the the cross. Efficacy is that perhaps

There's this commonality. this common kind of neurological correlate with the default mode network that there's a sort of r a rigidity associated with these various behaviors that is attenuated So I'm just In my own mind observing sort of a similarity.

Between the software development and then the testing within psychedelics you'll be doing. The Do you envision looking at how much like

is automatically There's an adaptive component. where you are able to determine over time for a single subject. A sequence of experiences

That is Adaptive in some way. Mm-hmm. Does that make sense? So you you mentioned this earlier and just in case some listeners didn't catch it. Endeavor RX adapts to the user, right? It's kinda like a personal trainer who increases the weights in certain movements over time. So you have progressive resistance and

Therefore greater adaptation. Do you think that that is an area you'll be exploring or that you would like to explore how you can adapt a series of psychedelic experiences for an individual to be customized. Undoubtedly. It was really, really a great statement and question that I want to just take a moment and unpack from my perspective because

I think you know, as we as we've had this conversation People could be lost of wait, are you building video games? You're working on psychedelics, like where where are the threads here? It is the same. Thing. that we're talking about all along. This is the power. of experience

To change the brain, what what in neuroscience would would be known as experience dependent plasticity. Whether that experience occurs With or without a molecule, it has the power to transform you. in an incredibly profound way. And it could be positive or it could be negative. That is what PTSD is, right? You could just witness something so horrendous that your brain functions differently from there on out, right? That is the negative side of this story. That is what I have been working on, how to build experiences. We do a lot of work with virtual reality now, multi-sensory experiences, I believe will have even more profound outcomes and more transformative effects. And we don't

put any compounds on board, right? That's that's what Neuroscape basically does now. Now Expand the conversation. And we're talking about these psychedelic compounds and there's a broad array of them. So we won't break them all down and they're all different in some way in in the effects they have, but they really have these two features that are most fascinating to me. One is that they they shuffle the deck, right, in many ways. They they break down the the rigid sort of frameworks that you

go into the experience with. And that is a combination of changes in default network and also many, there are many networks in the brain, big, big large scale networks, and their interaction leads to you and leads to your consciousness. And so those are shifted, leading to the opportunity to reform them. Adam, let me just pause here for a second. When you say they lead to you, that means your conception of self. Like when I say I am Tim That is that what you mean? From every level, your your ego, your your reflection of I your identity, but also your position in space and in time and your relation to other elements of the universe and the world around you, all of that. is fluid. More fluid.

And that is because these networks that may dictate your own reflection of who you are or how time is passing or how you perceive light or sound or touch. Or distorted from the norm, thus allowing a a complete re discovery of

of you and and the world around you. That's One very profound piece of it. And the other is that they induce neuroplasticity. And Robin talks about this all the time when he presents his work. And that is also incredibly fascinating because it's not just that these compounds enrich or change an experience, which they clearly do, they also are plasticity inducing, meaning that the changes that occur have A greater potential to endure.

Now this would be really a bad thing if you have a negative experience, which is I think part of what has occurred over the last half century. is realizing that in an uncontrolled environment that you may be threatened while on a compound like these, the effects can be way worse than if you were not on them. So this is the you know the Yin and yang, the the plus and minus that everything has is that We now realize that the experience, since that is what evokes the outcome, needs to be positive or at least.

Not that suffering can occur, but it at least needs to be nurturing in a way that leads to a positive outcome. So I just wanted to make that connection is that it's really about experience. and large scale neural networks that cross multiple domains and plasticity. And that is the common feature that unites all the work that we do at Neuroscape, whether it's non-invasive brain stimulation, new approaches to neurofeedback, video closed loop video game technology, or now psychedelics. So Just to put that together, because you you made the leap between Endeavor R X and this work. And now to just answer your question more specifically about closed loop systems. So

Pause and just make sure that everyone's on the same page with that. So probably what makes Endeavor R X so unique, as well as the dozen other video game technologies that we have at Neuroscape from Meta Train to Engage, Labyrinth, we just had a paper on, Body Brain Trainer, they're all closed loop.

And what that means Is that real time data about your state. And it may be very simple data, like your performance data, how fast or accurate you are. feeds into A processor, a computer that

Records that data. makes a decision about it and then updates your environment. the challenges that you're experiencing, the stimuli, the rewards that you're being exposed to. And it goes on and on, constantly adapting. That's why I made the analogy to a personal trainer. Imagine going to a gym and having a trainer that has access to every aspect about you in the moment and also this ability to change things so

subtly to just push you to the next level. That is what this closed loop system does. Now we've been doing that for a decade with all sorts delivered in virtual reality and on tablets, and you know, some of them are Eyes closed, meditative experiences, others are rapid fast paced action experiences. But that's what we do now.

Let's talk about psychedelics. So I described to you a system where technology enables multimodal biosensing. So we can understand your state in real time. And I described us having the ability to change what you see Here. Smell.

And feel. And so we have the two sides. We have the ability to know what's going on with you and we have the ability to shape your environment. What we didn't talk about is what you just said. Creating a closed loop psychedelic experience. That is the goal here, that we can. Have, let's say a therapist Sitting in front of a

patient or participant in a research study, having access to this data, maybe they have to, you know, if you want to be science fiction here, picture them in virtual reality, watching a four dimensional representation of your experience, of their patient's experience unfold to see are they in high stress? Are they Are they suffering now? Okay, it's okay for them to suffer, but only for 15 minutes, because our data shows that after that, then it starts becoming more likely to cause harm than to help. And so they're watching this unfold. And then they have these tools, right? They can say, Oh, this is the time. Where it's worth to move out of this high stress. Deep internal attention, high arousal, high awareness moment.

And bring it out. And in order to do that, what I'm going to do. is move them into a forest where they could smell pine and hear a waterfall and feel low, you know, frequency vibration across their body. And that will ease them out. And then we'll have another day where we can go deep again. This is the closed loop. We're using real time data and it can be done Just with machine learning itself and a processor or human on board like I just described. That's how we could create personalized experiences that are targeting those

Aspects of their brain function that need to be improved, whether they're suffering and they have a pathology, or they're just trying to enhance and elevate their minds. Just imagining. an electro facilitator with a uh within some type of minority report like virtual reality grabbing stimuli, adding them or subtracting them, combining them like the sweetest chef adding ingredients. It's quite a picture. It's quite a picture. And it's I mean you see and you say science fiction, but I I think these things are

may end up being closer than people. Anticipate. And Furthermore, I just want to say that The

research you'll be doing, the experimentation. Brings up. I find this tremendously exciting. So many challenging questions. I'm not gonna say problems, but so many challenging questions. For instance, you just alluded to this, but when does it make sense? Two.

increase or expose someone to increase stress. Mm-hmm. N of one. Actually it's more than N of one because I have Friends who would who would share this

That Many of I'll just speak for myself, Many of my most imp positively impactful. Experiences with psychedelics that had

positive durable effects. were very challenging experiences in safe Environments. And so determining like what the dose

What the appropriate dose of distress is. If there is one. is such a fascinating question. Yeah. Because there there is a point where The dose makes the poison and all of a sudden someone comes out and they're destabilized for two weeks. Or potentially longer, right? So Where how do you thread that needle? It's very hard to

Even if Sorry to to wrap down, but please go. But even if An experienced say indigenous

Healer could intuit. That's it. And do it effectively. While that is incredibly impressive. It does not.

Increase. The Availability. Of psychedelics is a therapeutic tool because that is a spider sense or some innate

or trained ability that takes a very long time to develop. Uh so you can't just copy and paste it. But if all of a sudden, like you said, you have this library of data, you have evidence to suggest where the tipping point is and when you should introduce that forest. I mean. H the the implications are really staggering.

Yeah. I won't even repeat it. You said it perfectly. It would be silly. I mean that that is exactly What what has excited me here? And and then when I found out that those Therapists and indigenous shaman. They were like, Yeah, we would like to know that data too, you know, like even the experts. But the ability now what I'm really lit up

By is talking. To those. individuals allying with them and saying What and I've done this several times now, and it's so much fun to say, okay, you've been doing this for 40 years. When you're sitting in front of front of someone, How do you know if they're suffering?

And When do you decide to help them out, to like lay hands on them or to introduce some scent, which is what they do. And you know, they will talk about and I'm taking notes. They'll be like, Well, I could see their face change. I'm like perfect. I could record facial expressions pretty easily with either a camera or an electrode. They'll be like, Well Sometimes they vocalize. also very, very accessible to to us right now. And so that's what's really

fun about designing these research studies is not doing it from some academic halls and some and even resting on the scientific literature itself, because a lot of this is not recorded. in papers, but it's out there in the world in true life wisdom and expertise that's been accumulated over, you know, sometimes centuries, but finding those nuggets and then using the tools that I described and doing very carefully controlled research studies that would be accepted by even the most conservative of regulatory agencies or professionals out there to move this forward and as you said, to make it accessible. There is not nearly enough experts in the world for all the people in need. I mean, not even by an order of magnitude. So we have to figure this out, or this is just going to be, you know, a tool for the elite, right? And and just won't have the access that we need it to. One thing I really appreciate.

about you is And with respect to this area. I wouldn't say in particular, but it's a good example. You have spent incredible amount of time. And I know this because we've had so many conversations over the last few years. with practitioners

who operate with different compounds in many different environments with different populations in different geographies. And uh you have As you mentioned, not sequestered yourself in this ivory tower of

literature is your sole source of input. And one challenge Within the psychedelic community is that there's no such thing as a psychedelic community. There are, in fact What I would consider factions in a sense. I mean you have kind of the the scientific group

You have no By scientific let me qualify. You have scientists, people who are actually doing the work. You have

Uh well educated folks who are secular who succumb to a certain degree of scientism, scientism. I'm not sure what you would call it, but those who aren't really scientifically literate but view it dogmatically almost like a religion. Then you go all the way to the other side, you have people who might

embrace indigenous traditions or some hybrid, say neo-shmonic approach along the lines of Or Western psychotherapeutic approach along the lines of, say, a Leoseph or a Stangroff. And There's a lot of friction. Amongst these groups. I'm uh

Not surprised on one level because humans are humans and there's a lot of kind of tribal Impulse. Readily available at any moment, but To what would you attribute people? thus far in your experience from these many different worlds, and there's a whole spectrum.

Being open and interested in the work that you're doing. Because my experience has been that very often The scientists don't really Want to Embrace.

indigenous or facilitator wisdom and view it as hocus pocus hand wavy woo woo. Superstition. And then on the flip side you have the people Who are on the not necessarily indigenous side. I actually find a lot of the indigenous very people who have a lineage of this

But sort of in n the neo shamanic space are very dismissive of scientist and view it as overly reductionist. And missing the point on some level. Long question, but why do you think people have responded so positively? To you.

I think because At the Fundamental level. Everyone recognizes That this is experiential medicine.

And that is how I I start the conversation. I don't know the best experience to to lead to the best outcome. And I'm not approaching this. In a very rigid way. of this is the approach that I think is gonna lead to the best outcomes. I'm just suggesting that thinking about this as a drug. from the point of view of molecule leads to effect. You take this

Antibiotic. The biotech killed, you're better. That's not what we're talking about here. We're talking about the creation of an experience that is Undoubtedly induced or accelerated or enhanced.

Buy these compounds. But The nature of the expression Experience leading to outcomes. I think everyone agrees upon that basic framework.

So if you enter the conversation with that as the ground truth. I think that there is a lot more likelihood of reaching at least, you know, a common A commonality of of view that don't we want to understand the experience more? Don't we want to be able to Guide. Some of it's just language. The word control, which we use in science all the time, is not a a particularly warm

Word. When it comes to you know to to a person's life who's suffering. So yes, okay, but the word guide is a lot more favorable. Now we're sort of many times, not all times, talking about similar things there. We're not talking about pushing you into this place. We're talking about presenting you with options to enter this place. And, you know, so some of it is just being really very careful about language, understanding the person's perspective that you're talking to, being respectful of the amount of time and expertise they have, and then just returning to the ground truth that this is an experiential medicine and there's so much more we could learn.

In order to help more people. And that is where I find that there's a great commonality. Well Adam, I couldn't be more excited. I'm going to ask you in a minute. Yeah. What

the future looks like and how people can help. Certainly and where they can find you. And I have those notes in front of me, so not that you would need me to remind you of your own URLs. But yeah, before we Sort of wind. to a close for this conversation.

Is there anything else that you would like to Say. Two my audience to request of listeners question you would like to pose, anything at all that you would like to say before we Get to

The question of next steps and how people Can help if they would like to help. Yeah, I mean just at a high level. I would just like to remind everyone that to keep a an open mind. Uh you might have heard things that we've talked about that are completely in your your wheelhouse that you're just like so fired up. Like that's exactly what I love. And and others that might feel threatened by it or that it's distorting the real value of these

medicines, but I I just encourage you to keep an open mind and realize that the underlying goal here is That there is so much suffering in the world, and we have done such an atrocious job of addressing that. If you look across the fields Of cardiac health and infectious disease, despite the fact that we're in a pandemic now. We've done so much better than we have in terms of mental suffering. And the idea that there's a magic brain pill out there that's gonna fix it is just not gonna happen. It's not true of these compounds either. We have to be really creative in how we think about. treatments and how we use science and technology to get there. So I just encourage people to keep an open mind. You don't have to agree with everything you've heard, but the need is great and the opportunity is here now.

So I I thank you for for your patience in in in in listening and and going on this uh journey with Tim and I. Neurascape. U C S F dot E to reiterate. I'm so optimistic about

This new chapter. within Neuriscape and for you also. I mean, this is a big commitment for you for a multitude of reasons. And I think a lot of people will be similarly excited and galvanized by this. You have UCSF, which is From a a science medicine research perspective, as blue chip as it comes, it is not. a an institution that has been heavily associated with psychedelics in any way previously.

Your lab. Also not been associated with psychedelics previously and I Think that it will hopefully inspire many people to take a close look.

That's These tools These medicines and and research associated with it. I think it's gonna be incredibly validating. for the space and for that I'm incredibly grateful. How can people help? What are some of the next steps? Are you looking for

Financial support. What are you looking to do and what do you need to do it? Yeah, uh you know, we we need we need a lot of help, right? It it takes a village and we have great people on board already. Jenny Mitchell's is leading a site for the maps trial at Neuroscape in this in our division right now. So we we already have some early momentum. Robin, of course, is coming on board and and couldn't be more excited by by what he's going to add to this. So we have a great team and we have UCSF support, but we need a little bit more of everything. So there may be listeners that

have experience with the perspective that I just shared in terms of the experiential, the set and setting. They might have it from personal experience. They might have it as a practitioner or as a scientist, from any viewpoint. I want to hear about it. We want to be informed and as we talked about, Tim, not just based upon a literature, but based upon all of this real world data that has accumulated over time. And so that that is one need right there. Just educate us. How would you like to hear about it? Is uh hitting you on Twitter, uh is there an email that is not going to bury you? Yeah, forever. Yeah. Well on gazali.com, there's a contact site, and that would be a a great way, and I'll share with my team. And so yeah, so

You know, we want to be educated and one of my sort of Tenants is not to just think that we know everything and and in this case none of us do no one and so the contact information on there and the and the way to offer that perspective to us is is open. We probably won't be able to reply to everyone, but you will be heard and and that information will be shared and and it could it could help inspire research and and and our own perspectives. So website Gazale G A Z Z A L E Y dot com.

The next is is financial support. We have done well. We have over six million dollars in funding, which is enough to get Robin here and support it and to build out our first set of studies and to hire some great postdocs and bring on some junior faculty, but it doesn't go that far when you're talking about the type of the vision that I just described to you and and the the research objectives we have. So there's lots of opportunity. We want to build a new cutting edge facility at Neuroscape with multiple laboratories so that we can do more research more rapidly. And so philanthropic support is always welcome at any level. And again, you could contact me through there. This also contact the Neuroscape site if if that's more palatable to you, whatever whatever way you want to reach out and let us know if you would like to be part of the funding of this endeavor would be incredibly appreciated.

Yeah. Do you have a a target raise amount? That you're able to disclose, or would you prefer not to have any Specific number as a target. When I first

formulated this and then put the team together and we we brainstormed about what we want to accomplish over the next five years in terms of Building the team. in terms of having the research tools that we need. in terms of building the facilities,'cause we have space to actually create some new labs, very cutting edge labs that Bring this type of technology, but not in an intrusive way, to maintain the natural feel and the warmth. That's tricky. So there's design challenges in order to accomplish that.

our goal was twenty million dollars. So we we have a ways to go. Now adding ten million dollars right now would allow us to actually build the facility. That will unlock A massive amount. So That's sort of what I've been keeping in my my mind when I look towards what I hope. that we'll accomplish over the course of this year. Wonderful. And

Not to act as the Pro Bono Development Officer here. capable folks at UCSF for that, but I will just say for folks who who may be wondering, I have some skin in the game here. I I'm a big believer, huge believer in you, Adam, and No escape. and have been for a very long time. So I I am also through my foundation contributing some capital and I would imagine that people can donate appreciated Securities.

I. e. stocks and possibly other things. Do you know if U CSF is able to receive cryptocurrencies of any type? It's a great question. This would be a a good time to investigate that. Yeah. That is a a great, great question, and I will find out later today. Wonderful. And I know that you and I have uh the mutual acquaintance of Rick Doblin. Maps has in the past Figure out ways to accept.

cryptocurrency and in fact some of their largest donations have come from Mr. Apple, maybe? Mr. Pineapple, as as he is known. through I believe it was Bitcoin, but through cryptocurrency. So just uh be good to investigate. And if you are able to do that. Or if there's an approach to that, we can put it in the show notes at Tim Dotblog slash podcast for people who may be interested.

This just in breaking news, yes, UCSF can now accept cryptocurrencies. for Neuroscape and the work that Adam will be doing. I believe this could be a first for a major university. It's a very big deal. And I'm supporting his work if you would like to support his work through cryptocurrency. You can do that. And all you need to do is email Neuroscape at UCSF.edu. That's N-E-U-R O S C A P E at U C S F dot Edu. And they can provide you with instructions for how to do this. And now back to our conversation.

Adam, I'm excited for you. I'm excited for the the future of this field. I'm excited for your team. I'm excited for Robin and uh the people not yet determined who may contribute or join the team in some fashion. And I really appreciate you. taking the time to hop on the phone, especially looking like old man time. You have you've you've you've you have a big beard right now, which suits you. I like it. I like it. And and and for those who are wondering about the visual he so Adam has been I don't know how long you've been the silver fox. I mean you have you

Since college pretty much. Since since college. I mean you look kinda like I mean, not exactly, but like Storm from the X Men. I mean if you have perfectly white hair. Luscious locks of white hair and now you ha you have full head coverage with this incredible beard. It's a it's a great look. I like it. Thanks, Tim. Tim Tim, I just want to say before we jump off, thank you so much for your inspiration and and now your support in this, your support over the years, um, not just financially, but in every way. You've been you've been a great friend and and a great colleague to have on this journey. And It's just um buzzing right now and how how much fun I had just going down memory lane and then looking to the future. So just I know your your listeners already appreciate what you bring and you know, I have my own perspective as being a longtime friend and I just wanna thank you for always giving

All of my ideas and outlet and and your attention and then helping to share it with your listeners. So thank you so much. No, thanks, Adam. I love you and your family very much. I can't wait to give you a proper hug in Meat Space. This virtual shit is for the birds, I'm going to We'll we'll get there eventually and uh hopefully hopefully in a few months, in fact. And Can't wait until we can actually break bread.

And have a drink. Together. So thank you. Thanks again for taking the time. And to everybody listening. This is exciting stuff. Check. Adam outgazali.com as mentioned G A Z Z A L E Y dot com. Neuroscape.

Which honestly, even if you have zero interest in psychedelics, just for the other work that they've done, Neuroscape.usf.edu is well worth checking out. It is a glimpse of the future, as far as I'm concerned. You can find them on Twitter at Adam Gaz G A Z Z, which is also the handle on Instagram. And Facebook. We will have show notes for everything, including Hopefully an update on whether or not

Neuroscape and Adam can accept cryptocurrencies because Adam. makes and his team make incredibly capital efficient use of funds. They are like a Lean fast growing.

well executed startup. That is part of the reason I've been so enthusiastically supportive. and uh encourage people to take a look. And so we'll have links to everything. Yet. Tim.blog forward slash podcast. And thanks for tuning in.

Hey guys, this is Tim again. Just a few more things before you take off. Number one, this is Five Bullet Friday. Do you want to get a short email from me? Would you enjoy getting a short email from me every Friday that provides a little morsel of fun before the weekend? And Five Bullet Friday is a very short email where I share the coolest things I've found or that I've been pondering over the week. That could include favorite new albums that I've discovered. It could include gizmos and gadgets and all sorts of weird shit that I've somehow dug up. in the uh the world of the esoteric as I do, it could include favorite articles that I've read and that I've shared with my close friends, for instance. And it's very short. It's just a little tiny bite. of goodness before you head off for the weekend. So if you want to receive that, check it out, just go to fourhourworkweek.com, that's fourhourworkweek.com all spelled out, and just drop in your email and you will get the very next one. And if you sign up, I hope you enjoy it. This episode is brought to you by All Form. If you've been listening to this podcast for a while, you've probably heard me talk about Helix Sleep.

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