Psychedelics are getting more attention from researchers right now because preliminary clinical trials have shown encouraging efficacy in treatments for conditions that are usually very hard to treat: addictions, post-traumatic stress disorder and major depression, where existing treatments are not especially effective. That said, some of the early trials have been impacted by methodological issues and reports of harm by clinical trial participants, so these issues will need to be addressed before we can make any definitive claims about efficacy.

The conventional narrative is it can be hard to process a traumatic event. Any time you get close to the source of the trauma and return to it in your mind, you elicit a physiological fight or flight response that makes it hard to process your emotions. MDMA lets you stop that response so you can approach the source of the trauma in a more open way.

I’ve worked with researchers at New York University looking at psilocybin for anxiety in cancer patients, and with researchers at Johns Hopkins University looking at psilocybin in smoking cessation. My research analyzes how participants describe their experiences so we can learn how people make meaning out of their experiences. I also work with an interdisciplinary group of academics, clinical trial participants and journalists on the ethical side of psychedelic medicine to examine shortcomings in past studies and propose pathways for more ethical and rigorous research.

Microdosing is taking a sub-perceptual dose of a psychedelic substance. There’s a lot of indication that microdosing is closely tied to a placebo effect — the idea that expectations influence perceived effects. People are looking into microdosing for uses ranging from stabilizing mood to enhancing creativity to increasing general productivity, but so far there hasn’t been compelling evidence to support those claims.

Often, when you get close to the source of a trauma in your mind, that can trigger a physiological fight-or-flight response that makes it difficult to process your emotions. MDMA has been described as dampening that response so that you can approach the source of the trauma and work to process what happened to you. It’s still early days for the science. It’s not a magic bullet the way some media representations have presented it.

Since healing and wellbeing require supportive relationships and material security, no pharmaceutical solution will solve mental health problems without broader societal reforms. Overall, researchers have suggested that psychedelics might help individuals break down entrenched cognitive habits, which can support people to build healthier and more supportive habits.

One thing I find the most promising is that psychedelic experiences change the way you see yourself and how you see the world. Psychedelics have the potential to increase intellectual humility — to support people in realizing that some of their assumptions might not be as true as they thought they were. Under supportive conditions, psychedelics can help people open up a space of possibility where they can develop new ideas about the world and about what society could be. That ability to look differently at the world can be really important, especially at a time when many of the old ways of doing things are not working for us as a society.

Recently, I’ve been working on a qualitative study of the first Johns Hopkins trial on psilocybin for smoking cessation, analyzing participant reports of their experiences. The follow-up study to that trial recently received the first federal grant in 50 years for psychedelic treatment. They’re working on a continuation of their smoking-cessation research in a double-blind trial with more participants. There are signals that federal funding is opening up to psychedelic research, and psychedelic research centers are launching at universities across the country. A lot of people are excited about this topic right now.

The data is still out. I’m excited about the possibilities, but a lot can go wrong if patients are not supported in an evidence-based way. With the approaching legalization of psilocybin in places like Oregon, we may see increasing numbers of unlicensed facilitators working with vulnerable populations who might not have the appropriate training for maintaining appropriate therapeutic boundaries. Psychedelics are not a magical cure-all, and psychedelic experiences can go badly if you’re in an unsafe place or with unsafe people. I take a middle stance. I think there’s a lot of potential for psychedelics to make a big impact on society, but only in the context of broader societal reforms and rigorous, ethical, and inclusive science.

I was invited back as part of the inaugural Zora Neale Hurston Writing Fellowship to work on my book project about psychedelics, where I’m writing about the literary history of psychedelic science. It was significant to me to be invited back in a celebratory way, 16 years after I was asked to write my first psychedelic research paper as an undergraduate there. At the time, what stood out to me was that the most important experience of my life was an experience I wasn’t supposed to have. I think the invitation signals a changing cultural climate around psychedelics.

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