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1:22

I'm Scott Galloway, and this is

1:24

No Mercy, No Malice. Ketamine

1:27

is suddenly everywhere. It's

1:29

also a groundbreaking medical treatment. And

1:32

for me, it reminded me

1:34

that what is essential is invisible to

1:36

the eye. Prof K,

1:39

as read by George Hahn. I

1:46

experienced ketamine therapy a few weeks ago,

1:48

and after discussing it on Pivot and

1:51

Prof G Pods, I've received

1:53

a great deal of inquiries from friends,

1:55

strangers, and media. I

1:57

wanted to let the experience settle. my

2:00

perception continues to

2:03

evolve, mature, unfurl,

2:06

and to take advantage of Daniel

2:08

Kahneman's advice to employ our slow

2:11

thinking. I was

2:13

also inspired to do some research on the

2:15

background and technology of the craft I traveled

2:17

on and the drug an

2:19

increasing number of people are using in

2:22

a variety of settings. Anyway,

2:25

here goes. The

2:29

foundation was developed as a surgical anesthetic. It

2:32

replaced PCP, yes, that

2:34

PCP, which was

2:37

effective but patients frequently

2:39

emerged from unconsciousness confused

2:41

and sometimes hallucinating, a

2:43

state known as emergence delirium.

2:48

Scientists modified the compound until they

2:50

hit on a variation that had

2:52

similar anesthetic properties but with less

2:54

risk of psychedelic side effects. First

2:58

synthesized in 1962 and

3:01

tested on Michigan State prisoners in 1964, ketamine

3:03

remains in

3:06

widespread use as an anesthetic

3:09

today. Ketamine

3:11

produces less emergence delirium than

3:14

PCP but it does have

3:16

that effect and in the

3:18

2000s, researchers started looking more

3:20

closely at the unusual phenomenon.

3:24

The dissociative state is

3:26

characterized by a sense of detachment

3:29

from reality and one's physical self

3:32

or even consciousness. Dissociation

3:35

can occur without drugs, psychotic

3:37

hallucination is a type of dissociation,

3:40

but the particular sense of detachment

3:42

from the self that ketamine produces

3:45

and other psychedelics such as psilocybin

3:47

and LSD can produce turns

3:50

out to be a potentially powerful tool.

3:53

It can enable personal growth as

3:56

well as enhance artistic and intellectual

3:58

expression. research

4:00

interest in this phenomenon opened the door

4:02

to a broader insight. While

4:05

the mechanism is not yet

4:08

fully understood, there is growing

4:10

evidence that at subanesthetic doses,

4:12

ketamine can help resolve serious

4:15

mental health conditions, including anxiety,

4:17

bipolar disorder, PTSD, and depression.

4:21

The most thoroughly studied and

4:24

accepted therapeutic use of ketamine

4:26

is for treating depression and,

4:29

in particular, treatment-resistant depression. Depression

4:33

is a modern scourge. It

4:35

afflicts an estimated 280 million

4:38

people worldwide, and nearly 18% of

4:40

U.S. adults report they

4:43

are currently in treatment for depression,

4:46

up from just 10% a decade ago. One

4:51

factors into two-thirds of suicides,

4:53

killing over 30,000 Americans per year. Antidepressants

4:58

are effective for many, but are

5:00

ineffective or bring major side effects

5:02

for others. Around

5:05

a third of patients suffer from treatment-resistant

5:07

depression. Over

5:09

the last decade, dozens of studies

5:11

have shown ketamine to be particularly

5:13

effective for this cohort. Similar

5:17

to other antidepressants like Prozac, ketamine

5:20

works by altering our brain

5:22

chemistry. It increases

5:24

the availability of substances the

5:26

brain uses for internal communication.

5:29

But beyond its direct chemical

5:32

impact, ketamine and other psychedelics

5:34

offers an additional dimension to the

5:37

treatment, the dissociative

5:39

state and the greatly enhanced

5:42

neuroplasticity that follows it. Physician

5:46

and other disorders are so

5:48

difficult to escape in part

5:50

because they change not just

5:52

our brains, but also our

5:54

minds. They influence

5:56

how we see the world in ourselves and

5:58

directly interfere with our own. our ability

6:00

to change. The

6:03

dissociative state induced by psychedelics

6:05

allows us to see ourselves

6:07

from a distance, to disentangle

6:09

our disorders from our identities.

6:13

Patients report being able to

6:15

face deeply buried traumas without

6:17

suffering and to acknowledge unhelpful

6:19

patterns of behavior without defensiveness.

6:23

Over the past fifteen years, interest

6:26

in psychedelic-assisted therapy has renewed

6:28

and accelerated. Michael

6:31

Pollan's 2018 book, How to

6:33

Change Your Mind, catalyzed popular interest,

6:35

but general awareness was just catching

6:38

up with the science. Because

6:41

ketamine can be more effective when combined

6:43

with therapy, some doctors

6:45

have opened specialized clinics where

6:47

ketamine experiences are integrated with

6:49

therapy and other treatments. A

6:52

few weeks ago, I visited

6:54

one. I

6:58

had been considering ketamine therapy for a while.

7:01

I struggled with anger and depression and thought it

7:03

might help. Also, I

7:05

was curious. Similar to

7:07

Burning Man, ketamine therapy is something I have

7:09

planned on doing for several years, but

7:12

I always find an excuse to not go there. I

7:16

was wary that something unwelcome would surface.

7:19

Before trauma or demons lie in

7:21

my subconscious, I've managed to mostly

7:23

suppress them, and I'm down with

7:25

that. Let sleeping dogs lie. But

7:29

here we go. At

7:32

Kooia Wellness in Austin, the first

7:34

step was a detailed interview about

7:36

my medical history. The

7:39

onboarding process was both comforting, they

7:41

take this seriously, and

7:43

a bit disconcerting. See above.

7:46

This is serious. I

7:48

was approaching the experience as a more

7:50

cerebral form of the Space Mountain ride.

7:53

Except at Disney World, the screening is only that

7:55

you'd be at least 3 feet 8 inches tall.

7:58

If you had to meet with a doctor, I'd be happy to talk to you. and

8:00

go over your medical history at the beginning

8:02

of the line, you'd be more pensive while

8:04

you waited your turn to ride. The

8:07

clinic felt like the Austin Regional

8:10

Office of Birkenstock, or the HQ

8:12

of a successful scented candle manufacturer.

8:15

Groovy, but well-funded. The

8:18

first thing you encounter is a purposefully

8:20

distressed shoe cubby that sets the tone,

8:23

as everyone is barefoot. My

8:25

guide, John, was out of

8:27

central casting to lead a yoga retreat, or

8:30

an angry professor's ketamine trip. He

8:33

was about as chill as one could be

8:35

while still maintaining an air of competence. I

8:39

had an additional intake with a medical

8:41

director, an attractive woman in her sixties.

8:44

I had trouble focusing for the first few

8:46

minutes, as she had a Tammy Wynette-like wig.

8:49

It looked good, but she could have been the

8:52

offspring of Sophia Loren and Beyoncé. I

8:55

immediately summed her up as a rich

8:57

housewife who, after the kids left, got

8:59

bored, depressed, decided to get a degree,

9:02

and convinced some rich investors to fund

9:04

her adventures in ketamine. But

9:07

here's the thing. I

9:09

was wrong. Dr.

9:11

Sheila Newsom was the

9:13

captain of the baseball team at West Point,

9:16

served her country for four years as

9:18

a paratrooper, got a medical

9:21

degree from the University of Texas, and

9:23

built a hospital in Africa. At

9:27

sixty-three, Dr. Newsom

9:29

underwent gender transformation and answered

9:31

a call to help people

9:33

suffering from suicidal ideation via

9:35

ketamine therapy. Jesus

9:38

Christ, an amazing athlete who served her

9:40

country and later in life felt a

9:42

calling to be her true self while

9:45

helping others. So

9:47

the first unlocks from ketamine were

9:49

before the ketamine. I

9:52

am judgmental, and there

9:54

are so many remarkable Americans. Just

9:57

as grit is a combination of resilience and

9:59

forgiveness. I'd like to think

10:02

American is a mix

10:04

of opportunity and acceptance. The

10:06

two are force multipliers for one

10:09

another. I worry

10:11

that America, for the first time

10:13

in our history, is becoming less

10:15

accepting, less American, but that's another

10:17

post. The

10:19

trip room was what you would expect to

10:22

find in the home of a Gen Xer

10:24

who, after his kids are asleep, takes an

10:26

edible and retreats to a room with an

10:28

oversized sectional, a flat screen and no sharp

10:30

edges, speaking for a friend. Dr.

10:34

Newsom joined John and me in the

10:36

opium den, grasped our hands,

10:39

and prayed, which I

10:41

found oddly comforting. For

10:44

some reason I requested a weighted blanket. I'd

10:47

never used one nor really knew what it was,

10:49

but it just felt right. John

10:53

and I did some breath work,

10:55

and then Dr. Newsom injected me

10:58

with eighty-seven milliliters of ketamine. Shit

11:02

got real, or unreal, pretty

11:05

fast. I felt heavy,

11:08

but not uncomfortable, wary but not

11:10

anxious. With the

11:12

blindfold on, I was in the sphere,

11:15

Vegas immersive theater, only this was to

11:17

the sphere what the sphere is to

11:19

a black and white television. Walls

11:24

of red numbers and symbols bumping

11:26

into and absorbing each other as

11:28

the sheets of imagery expanded and

11:31

contracted as if they were breathing.

11:34

The visuals took on a

11:36

sentient feel and turned to

11:39

emotion and experiences that then

11:41

liquefied and poured over my

11:43

consciousness. I immediately

11:45

felt a sense of wonder for

11:47

a drug that could inspire this

11:49

depth of hallucination, this

11:51

fast, without the feeling of being

11:53

out of control. Then

11:56

things got weird. Imagine

12:00

your brain is a

12:02

tightly wound knot of

12:05

experiences, emotions, visuals, and

12:07

neural pathways your consciousness.

12:11

Ketamine loosens the knot and

12:13

unfurls everything, including

12:15

material that's there but

12:18

not previously visible. The

12:21

strands of the knot then separate from

12:23

your physical self and all things. People

12:27

have described it as floating through space. For

12:29

me, it felt like a

12:31

different dimension where there was nothing physical,

12:34

just my being. My

12:36

thoughts and perceptions were untethered

12:38

from any organic or inorganic

12:41

material. A

12:43

friend who several years ago urged me

12:45

to try K therapy described it best.

12:48

It's as if your life is an

12:51

ocean and you can see some stuff below

12:53

the surface but it's not clear. K

12:56

drains the ocean so you can

12:59

walk along the floor and see

13:01

everything in sharp relief. Recognizing

13:04

that my senses and emotions,

13:07

i.e. perception, were the only

13:09

real thing was overwhelming and

13:12

for a few moments unsettling.

13:16

How was my perception formed? Jesus, this

13:18

is me. And what does me really

13:20

mean? Similar

13:24

to when I was a kid on a long

13:26

road trip with my mom, I'd ask myself over

13:28

and over who am I, who am I, and

13:31

then feel faint. I'd

13:33

tell my mom, she'd tell

13:35

me not to think about that kind of thing. Ketamine

13:39

doesn't care what your mom says.

13:43

Trying to wrap my conscience around

13:45

itself and understand my being, my

13:48

soul felt overwhelmed.

13:52

Or panicked like being too high,

13:54

been there. Just

13:57

overwhelmed. A

14:00

couple images kept resurfacing. First

14:03

and foremost, I have specific pictures

14:05

of my boys that I'm fond of and

14:07

they appeared square in front of me. Except

14:10

they were in 4K, high def. I,

14:14

similar to most parents, think

14:16

my boys are the most beautiful things

14:18

ever created. The

14:20

depth of commitment and love I feel

14:22

for them felt impossible.

14:26

Impossible in a good way. As

14:29

if it was a secret that would only be

14:31

revealed to them when they had kids. The

14:35

images were just so illuminant and

14:38

the emotions so strong. Their

14:41

mother appeared as well and

14:43

she produced entirely different emotions. At

14:46

first a surprise, who is this? Then

14:48

a sense of relief and joy. When

14:52

I was 10, my only hobby

14:54

was skateboarding. I bought a

14:56

skateboard at Big Five for $3. It

14:59

was a piece of pressed balsa wood with steel wheels.

15:02

We had to check our skateboards in at

15:04

the beginning of school to the principal's office

15:06

and then retrieve them when school was over.

15:09

Anthony Fadal and his friends would mock me

15:12

and my board when he and his crew

15:14

picked up their dogtown and zephyr boards. My

15:18

mom's boyfriend, Terry, was

15:20

leaving on Sunday and left

15:22

a UPS box on the dining table. In

15:25

the box was a new Bond

15:28

skateboard with AC500

15:30

trucks and Kona wheels. This

15:34

board cost $45 which

15:37

might have well meant $45 million for

15:39

my mom and me. The

15:42

feeling of surprise and joy

15:44

when I realized this was

15:46

mine was similar to

15:48

the emotion that registered when the image of my

15:50

wife came into view. This

15:53

relationship is mine? Really?

15:58

I also had some anxiety around the table. things that

16:00

were on my mind, bothering me. I

16:03

don't think K is good at sorting and these things

16:05

were only there as they were present at the moment.

16:08

I had said something stupid at a conference earlier

16:10

in the week on stage and had been an

16:12

asshole to someone the same week. They

16:14

both kept coming up and confronting me. There

16:19

is an increasing body of research

16:21

showing that ketamine therapy can do

16:23

wonderful things for people suffering from

16:25

trauma, depression, and addictions. However,

16:28

I would not

16:30

recommend doing this recreationally

16:33

or outside a therapeutic environment.

16:36

It is intense. What

16:40

has struck me is the benefits of

16:42

the session have mostly occurred well after

16:44

the session as I process the

16:47

experience and what to take from it. This

16:50

is why several sessions done in a licensed clinic

16:53

in conjunction with a therapist is

16:55

a best practice. Recreational

16:58

use is spiking and

17:00

while it will be a light diversion for

17:02

most users, ketamine can

17:05

be addictive and, when abused, can

17:07

cause serious physical harm, including

17:10

bladder infections and renal failure.

17:13

Ketamine purchased from mail order pharmacies

17:15

or bought on the street is

17:17

of uncertain provenance and

17:20

when sold in powdered form is

17:22

often cut with other substances, including

17:24

fentanyl. During

17:27

my trip there was nothing new, no

17:30

discovery, just clarification and

17:32

illumination. I know

17:34

I love my boys and that their mom

17:36

is impressive, but this

17:38

was a chance to bask in

17:40

those emotions and register real reward.

17:44

Also, in the two weeks since the

17:46

therapy, I haven't had a drink. First

17:49

time I've gone this long since college. It's

17:53

not that I had a revelation that I drink too

17:55

much. Again, I knew that. I

17:57

have just sort of lost the taste for it.

18:00

We'll see. Again, the majority

18:02

of the benefit has been post-therapy processing

18:04

the experience, what I take from it

18:07

and how it will change my behavior

18:09

and perspective moving forward. Some

18:12

thoughts. Feeling

18:14

the depth of emotion for my boys gives

18:16

me a sense of purpose. I

18:19

love the notion of surplus value,

18:22

that you become a man when you add more

18:25

than you take. Instead

18:27

of a spiritual profitability, if you will,

18:30

my purpose is to love my

18:32

boys and others more than I've

18:34

been loved. I'm

18:37

almost there and it gives me a

18:39

sense of peace about aging and dying.

18:41

Note, not planning to do this anytime

18:43

soon. I used

18:45

to be terrified of death and

18:48

feeling purpose takes shape and

18:51

that it's within reach provides comforting

18:53

permission to leave. As

18:56

they say in the Navy, quote, fair

18:58

winds and following seas, we

19:01

have the watch. Unquote. I've

19:04

also come to the conclusion that the

19:07

quality of your relationships isn't

19:09

a function of that person, but

19:11

of you. Specifically,

19:14

your willingness to lean

19:16

into the relationship and

19:18

not keep score. For

19:21

most of my life, relationships have

19:23

been transactional and I

19:25

was either on the right side of the ledger,

19:27

getting more than I receive, or

19:29

dissatisfied. I

19:32

realize that my role is, among

19:34

those close to me, to provide

19:36

witness to their life, for

19:39

them to know that I notice, to

19:42

rescue them from any doubt that they matter,

19:44

that when good or bad things happen to

19:47

them, that I notice. Their

19:50

life happens and registers as

19:53

a decent man who loves them

19:55

provides witness. a

20:00

ring on a necklace inscribed with a quote

20:02

from one of my favorite childhood movies, The

20:04

Little Prince. Quote, what

20:07

is essential is

20:09

invisible to the eye. Unquote.

20:14

When I called my wife after the therapy and told

20:16

her she was a skateboard and why,

20:18

there was a long silence on

20:20

the other end. However,

20:23

I knew what she was feeling. We

20:26

didn't need to hear or see each other. It

20:30

didn't matter, as the

20:32

essential is invisible.

20:39

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