Neuroscience & Experiences: An Interview with Adam Gazzaley, MD, Ph.D.

Neuroscience & Experiences: An Interview with Adam Gazzaley, MD, Ph.D.

What follows is a transcript for the podcast HomeGrown Humans - Adam Gazzaley, MD, Ph.D. - Neuroscience - Hosted by Jamie Wheal

Topics in the interview include the following:

  1. The Connection Between Mysticism and Neuroscience
  2. Complexity Science
  3. What Is The Complex Interaction Between The Human Brain And The World?
  4. Sensync: An Immersive Sensory Experience
  5. The Research on Consciousness 
  6. Can We Trick Ourselves Into Neuroplasticity? 
  7. The Cranial Nerve Tongue StimulationPoNS Device
  8. Is Stimulating The Nervous System The Path To Accelerating Neuroplasticity? 
  9. Where Does Information Come From During Non-Ordinary States Of Consciousness?
  10. How Can We Engineer These Therapeutic Conscious Experiences?
  11. What Does Life And Your Contribution To The World Look Like 10 Years From Now?

The Connection Between Mysticism and Neuroscience

Jamie Wheal: All right, Dr. Adam Gazzaley, founder of the Neuroscape lab at the University of California, San Francisco, inventor, entrepreneur, academic, physician, and all around Renaissance man, thanks for joining us on Home Grown Humans.

Dr. Adam Gazzaley: Thanks for having me here. Really excited to talk with you today, Jamie.

Jamie Wheal: Yeah, well, it's awesome to pick up the thread of a conversation that we've been having on and off for several years. But I think that something that you're representing in the overall conversation of, where have we come from, who are we, and what do we do now, which is sort of the sustained inquiry of this program, you really sit at the intersection. You're sort of a humanitarian scientist. You've been going deeply into the most empirical and material realm, literally the anatomy and function of human brains, but you've been doing it with what feels like a deep dedication to human flourishing, how do we do this thing better? So let's just start with that. Let's just, a little bit of how you got to now, how you ended up finding yourself in this discipline, and what are some of your hopes for the research that you and your team are conducting?

Dr. Adam Gazzaley: I love that question. It's funny, I do a lot of interviewing and I knew you would ask me something completely unique, that I don't know if anyone's really asked before. That question, the reason I'm smiling is because it does strike to the thing that's most personal to me, is this intersection of science and humanity, even from when I was a kid. To back it up, when I was seven years old, as a kid in New York City, science was just immensely exciting to me, really starting with science fiction, but then science.

As I moved through my years as high school, I went to a science based high school, Bronx High School of Science, and into undergrad, I started realizing that my original love, which was for outer space, the cosmos, maybe partially inspired by Carl Sagan's piece, as fascinating as it was to me, wasn't really where I wanted to spend my life, and that inner space and things that really spoke most to what makes us human was much more inspiring. So my directionality went from out to in, and from the cosmos to neuroscience.

So throughout my career, now fairly long, 30 years in neuroscience since when I started grad school in 1990, so 30 years this year, I've really always being trying to unite the two, and I've made multiple decisions over this long period of time, when I felt that I might have been going down this spiral of reductionism and maybe losing sight on what I thought was the big picture.

It's interesting because training as a scientist, that is the process, right? We have this very reductionist process where you just keep adding more details. I always joke that at some point, if you do this long enough, you're the only one in the world that cares about what you just discovered. That's the business of science and how our empirical methodology takes us to evermore details.

What I've tried to do, in a couple of really big events over the last 30 years in my career, is to turn that around, and take a discovery, and instead of bringing us to more esoteric, detailed questions about it, to say, "How does this contribute to doing something bigger and more global?" So that's not a detailed answer, but I'd say my constant practice with myself is to reorient and say, "Are the questions I'm asking, the tools that I'm utilizing, really contributing not just to our understanding of the brain and the mind, but helping people?"

It's amazing how far away you can get from that, even if your intentions were very much grounded on that at the beginning. I see some of the smartest people I know drift from that without even realizing, and then maybe never returning. So that's my answer. It's really a constant reorientation of, is my commitment to scientific discovery making an advancement to what it means to be human, to the quality of our lives, and it's not a trivial thing to connect to us, but it is my ultimate personal mission, which is why I was smiling when you ask that.

Jamie Wheal: Yeah, I just came across a quote from Einstein this week, where he said, and I think he was speaking about John Wheeler, his colleague at the Manhattan Project, on the theories of relativity, and he said something to the effect of, "All theoreticians are tamed mystics." That sort of speaks to ... That just came to mind as you were describing that.

So when we think about that, if you've got Carl Sagan on one side and Oliver Sacks on your other shoulder, what are the great ponderings and wonderings from you as a youngster, reading science fiction, thinking about the cosmos, to being in the wet labs, vivisecting rat brains, to MRIs and scopes. If there is one, and I imagine there is for you, what is the thread that connects that mystic wondering?

Dr. Adam Gazzaley: Yeah, I'd like to believe there was a clear thread, and there are certainly themes, even over the last 30 years, that I've been consistent with. Brain as, not as isolated modules, but really as a network. That's, on the neuroscience side, something that's been continuous. The fact that our brain is also not some solid structure that is basically either staying stable or diminishing in its robustness but plasticity, is something, for the last 30 years, I've maintained as a constant thread.

I would say that the new parts of my work now, and my life, weren't there at the very beginning, in the 1990s, when I started doing research under the microscope. So I started under the microscope, and then as you summarized really quickly, moved into human-based cognitive neuroscience. A lot of what had changed for me as a scientist over 30 years, going from what I'd describe as molecular anatomical neuroscience, to cognitive neuroscience, to now, as I describe myself, as a translational neuroscientist, where everything is directed not at just understanding, but translating into approaches that make our lives better. So I'd say I'm on my third part of my neuroscientific career.

I would say a lot of what changed for me, even over the last 20 years, was related to nature photography, which is a passion of mine now, or it has been for 20 years, which really made me think about things that I hadn't focused on scientifically as much, but being in nature, and trying to find beauty and aesthetic joy from nature experiences and then share them, really made me think a lot more about things like attention, and perception, and empathy, and compassion, which were not part of my research, but then changed me as a person, and now has actually, finally, started uniting with my scientific research.

So it was sort of this convergence of my life as a scientist, as a New Yorker with no nature exposure, with this newfound love of being in nature, and photography, and that aspect, and then trying to ... not necessarily trying as, like, I need to accomplish this, but being cognizant of the convergence of these elements in my thinking, and hoping that they would come together in terms of my work, which is really just happening now.

Jamie Wheal: Well, it's really happening now because behind you is one of your own images, right?

Dr. Adam Gazzaley: Yeah, yeah. From two weeks ago.

Jamie Wheal: Would you just share it with us ... Yeah, well, where is that strange geology?

Dr. Adam Gazzaley: Yeah, this is from Bryce Canyon. Which is, if you haven't been there, any of your listeners, it's so worth a visit. It's really so otherworldly, as can see. I like this image. I've done a couple of photo shoots there. This one, to me, captured the grandeur and the oddity of it, but also felt more intimate, which is sort of hard to actually capture both of those things, in my experience. I've been wrapping around the world for a decade now, with my wife, doing both public speaking and nature photography, and it's been an amazing journey to see the world.

But now, as we all know, that's not possible, and it's sort of cool. It's one of those COVID gifts I like to think about, in that my wife and I said, "Hey, let's start exploring the U.S. again." For me, it was a return to that. So we rented an RV, hit the road, spent nine days, from Death Valley, Zion, Bryce, and the Grand Canyon. This is just a month ago, and got right, deep, deep into nature. So this was one of the creations from that trip.

Jamie Wheal: Just in your overview of the arc of your career, I mean, there's several things, but one is that the three stages of your career seem to match a lot of what they talk about in philanthropy, which is the phases of life, of learning, earning, and then returning. So if grad school was the obvious learning part, the earning was peer review publications and papers, and establishing yourself, developing your lab, and the returning is now. It matches really nicely with what you described as translational neuroscience. You're like, "Well, hey, they shouldn't just stay in the ivory tower." How does it help? I wonder-

Dr. Adam Gazzaley: Yeah, that [crosstalk 00:10:31] that connection. I love that.

Complexity Science

Jamie Wheal: Yeah. I also wonder if your perspective behind the lens when ... Also, you mentioned the idea of the brain and really our entire nervous systems as integrated systems, and how, where one region may be upregulated, another maybe downregulated, where a certain specific anatomical feature may have multiple uses, things that are adaptive, if something gets injured or harmed, other things fit in or fill that blank, the neuro-plasticity elements.

That's obviously the exact opposite of what you see in blogging headlines on social media. Whether it's the God circuit, or the Jennifer Aniston neuron, there's a very reductionist, quick-hit, here's the place, here's the thing kind of mentality to popular neuroscience.

My curiosity is, does your parallel career behind the lens, seeing natural systems, and whether that's erosion, river systems, estuaries, deltas, whether that's trees and root systems, you name it, does it ever pop to you that the symmetries and the relationship between our neural networks and our systems and the same forms are rising all around you in your life as a photographer?

Dr. Adam Gazzaley: Undoubtedly, in so many ways, more than we could cover right now, I think about it all the time. It's a conversation that I don't have very frequently, but I learned photography through a microscope, 35mm photography taking photos of neurons in the hippocampus as a grad student. That was my first camera, my first actual pictures I ever took, which is interesting. Then I wound up extending it in into nature, and I've constantly explored this connection between nature, and photography, and science, and the brain.

There's so many things to talk about. Maybe just to respond directly to the connection that you talked about, I've been doing imaging, starting with microscopy, and then functional brain imaging, structural brain imaging. The visual part of neuroscience has always been a part of my scientific focus, independent of nature photography, and they feel very similar in some ways, because they're both an exploration of nature. One side of it, the science side, is maybe looking for organizational principles, while the nature side is looking for more aesthetic elements, but they're not that different, frequently, I find.

The other thing that's similar about science and nature photography, really particularly relevant to what you said, is that they're a natural event, in some ways. They're capturing a moment in space and time. It's like freeze frame. It's like this behind me is not wrong, but it is a very limited interpretation in space and time, right? There's a dynamic event going on here, a slow one in this case, same thing with the brain, right? We take a picture of it, we freeze it, and then we tell a story about that. But that story is inherently limited by the fact that you did put constraints around it in order to share it.

So I think that what you said was really very core to how I view my science and nature photography, in that you make these decisions in order to make them digestible, sharable, and hopefully actionable, on both sides of the coin, but what you really need to constantly appreciate is that these are dynamic, interactive processes, that are evolving on different spacial and timescales that we're not always able to record and to appreciate, and that's okay. You do the best you can with the tools you have.

But not allowing yourself to believe that you are seeing the truth the way it is, is a very important practice, and I find some of my favorite scientists and colleagues, some of the smartest, often go into this false belief that they have the tool. Like, "It's single unit recording, that is the way that we learn about the brain, the neurons," and all sorts of biases around the tools and the perspective that you bring, when the reality is, they're all little glimpses of a much more complicated, and, I said, dynamic reality, that we're probably incapable of really sampling at its full complexity.

What Is The Complex Interaction Between The Human Brain And The World?

Jamie Wheal: That sounds suspiciously along the lines of quantum physics and wave particle or measurement position velocity. You can squish one thing, but you occlude the other, and it's somewhere in the foamy possibility space, rather than any false certainty. Now, that said, so we've got your love, attention, and appreciation to aesthetics and patterns, your sense of both the ephemeral, impossible to pin down nature of truth or reality, and then obviously the nature and the workings of the brain and mind.

So far, we've discussed them in relatively discrete aspects of your life, and your love, and endeavors, but you've also bundled those three, pretty phenomenally, in your work with virtual worlds, where you've taken digital representations of the aesthetics, you've connected them to brain feedback to simulate. I mean, I forget who said this, but it's the whole great thing of, "Art is the lie that reveals the truth." So you've been creating these phenomenal, fascinatingly complex virtual lies that reveal some deeper truth. So talk to us about that. Talk to your experiences and your projects where you've been integrating all of these things.

Dr. Adam Gazzaley: Yeah. So the one thing that we haven't really talked about explicitly, but is core to everything I do, across both these two domains and others, is the complex interaction between the human brain and the world around us, the environment. So mind, and environment, and this type of interface, which to me is core to what it even means to think about us as humans, and where do we give that value, and purpose, and direction, is that our brains evolved to allow us to interact with this place, this environment around us, really for survival at the very beginning, right? To be able to detect threats, and to be able to detect nutrients, and to move towards or away from them appropriately, is the beginning of what became the brain. Even, you can find those elements in single cell creatures, right. That's sort of what we do to survive and integrate with our environment.

So that's something that I think about all the time, from both an evolutionary perspective, and then the very practical perspective of, what does it mean for us to thrive in this world around us, and how can an understanding of the brain and the mind, an understanding of the interface between us and the environment, help us do it better? So that's a high level way of thinking about it, that I don't often talk about, but it is my ground truth of where I start thinking about a more practical problem, like attention, which is something I focus a lot of my work on.

But it really starts with the interaction between the brain and the environment, and it is from that interaction that I feel the more hard to define concepts like mind and consciousness actually emerge. I view those as emergent properties that happen as the brain and the environment interact with one another. So, starting with that basis, then on a more practical perspective, I would look through my lens as a neurologist, because I'm a clinician, I was trained as a neurologist, and as a person that deeply cares about other people, and think about, what are the things that we suffer from that could be better, and that would make our lives more happy, and fulfilled, and valuable in all sorts of ways.

Then when I see, or as best as I can tell, that there is an area that we are not doing well on, maybe ever, or maybe right now, then I'll think about, how can an understanding of the brain, and of how we build interactions with the environment, allow us to improve those processes to lead to better lives?

Jamie Wheal: Is this all an elaborate and careful run-up to discussing your psychedelic virtual reality space pod?

I think on the highest level, I would say it is. Maybe one step before we get into the Sensory Immersion Vessel and its intersection with psychedelics, because that's probably the most fun thing to talk about, but it is ... I feel like we, look, we've given it a lot of context here, but maybe one other layer of context before we go deep, deep, deep, is, at the very core of what makes sense to me, from what I just described in terms of a practical, actionable thing to do, as opposed to something more philosophical, is that experience changes the brain. It's not anything that is mind-blowing to say, although it took us a long time, as a neuroscientific community, to really understand that was true, and to understand that it occurs throughout our lives, and understand the parameters and the molecular mechanisms that allow that to happen, but ...

Dr. Adam Gazzaley: Molecular mechanisms that allow that to happen. But if you just start with that premise that experience changes the brain, then to me, it seems that there is an entire largely unexplored domain of potential therapeutic approaches that can be designed and then validated that allow targeted experiences. So again, it's about the brain interaction with the environment, experience is sort of the child of that, to allow us to improve function.

So I didn't just arrive at this more heady, but exciting area of psychedelic research and sensory immersion vessels from nowhere, I started really basic over 10 years ago building digital experiences that were delivered on phones and tablets that were challenging the brain in various selective ways, and then through a decade of research, start plotting out how we can create experiences that are personalized through closed loop systems so that they're adaptive to the individual's performance and state and emotions in the moment to lead to these meaningful and hopefully sustainable benefits.

Once we establish that foundation, which took a decade, not that we're done, but we've done a lot of work on that, then to me, the next stage of my journey, looking to the next 10 years is how do we build upon that foundation to lead to much more impactful changes, and that's where deeper sensory immersive experiences and even molecules that have profound influences on our sense of self and our perception of the world started to make sense to me. 

Jamie Wheal: Yeah. This goes back to your life as a polymath and not being content in the lab looking at things through a microscope or even a camera lens. You started creating and exploring and even exploiting new technological developments. So let's talk about these other lenses you've been playing with, and even just paint the picture in kind of physical terms what is sensing, how did it come to be, and what do you hope it can become?

Dr. Adam Gazzaley: Yeah. So for the last decade, my research lab, which became a center at UCSF Neuroscape has really been focused in the software domain, and same with the company I created, Akili, to turn these into therapeutics, and we could talk about that more later if you want. What we've been doing there is figuring out how to design the experiential elements by manipulating the sensory input that you're getting as well as the reward structures. But it was not super sophisticated in terms of the immersive nature of it. So that's what we have been doing and we've had great successes with it. We've been publishing papers. We've got FDA clearance recently on one of those. So I feel like we hit a lot of really great milestones that were dreams just a decade ago.

But then I guess a couple of years ago, I started realizing that the ultimate vision was being limited not by what we're doing with software, but was the limited by our hardware that we had and also algorithms like machine learning, which we could come back to. So I put together a team. We created a company, founded a company called Sensync, which stands for sensory synchronization. 

Sensync: An Immersive Sensory Experience

Dr. Adam Gazzaley: The idea behind Sensync was to build the most immersive possible sensory experience that we could with any existing technology. So not necessarily to create all the elements, but to curate them, to bring them together, and most importantly, to figure out how to deliver sensory experiences that are synchronized in time.

So when you experience the world around you, a key component physiologically is known as multisensory integration, and what that means is that the signal in your brain that's registering a sensory event is changed by the presence of another sensory event, so it could be auditory visual, that is transformed by them occurring temporally in time, closer in time and in space. So that event have multiple sensory signals happening simultaneously, sensory synchronization, leads to this unity effect. But basically defines our entire instruction of reality. If you jitter those, everything falls apart, things become unreal. They can also be manipulated in clever ways like illusions, ventriloquism is an example of cleverly manipulating sensory synchronization to trick the brain.

So I was motivated to think, can we create a sensory experience where you see, hear, smell and feel events simultaneously? I decided to focus it on nature, for obvious reasons of what we've been talking about, and then have that environment that you are immersed in be shaped and guided in real time by your own physiology. So this closed loop system, which we are developing. So can we capture all of these really difficult to quantify but meaningful aspects of what what it means to have an experience, with your stress, your arousal, your awareness, your mood, your attention as best we can, and then have the environment that you are now immersed in adapt to that in real time. That's the idea behind Sensync.

Jamie Wheal: When you say closed loop, who's zooming whom? So is it that I feel excited? My heart rate starts pulsing, my skin response shifts or changes, and then Sensync adapts and responds and gives me more of that? Or is it like a horror movie where I'm just walking along and there's a jump scare and Sensync actually does something to prompt a nudge or change my physiology?

Dr. Adam Gazzaley: Either of those things are possible. So it's more of a platform to create tools, and those tools could be designed to accomplish all sorts of goals. They could be things to just relax, to just chill you out like you've never been, or maybe to restore you by moving your thought processes away from areas that you're stuck in, or it could be to transform you. I mean, that's one of my most exciting thought processes is just thinking about how you could create a full shift in perspective, not just through something like a psychedelic, which we could talk about, but through an experience, a non-molecularly initiated experience alone. I believe that's possible as well.

So how an experience is delivered and for what goals are decisions that are made by whoever is helping build the interface between Sensync and the person. So it's really a platform, and it also could be a laboratory, like the ultimate single person sensory laboratory as well as a tool of creating change.

Jamie Wheal: Just to ground this, just because we're talking in sort of somewhat abstract concepts about a really quite embodied thing, right? Which is this really beautiful-

Dr. Adam Gazzaley: Oh yeah.

Jamie Wheal: Beautifully designed, futuristic almost sort of egg-shaped container that looks like the baddest ass spaceship meets recumbent bicycle you've ever seen. You have immersive VR goggles. You have olfactory cues, right? So you have scent, you're making use of that.

Dr. Adam Gazzaley: Mm-hmm (affirmative), scent.

Jamie Wheal: You have even wind and position and feelings like that, so you've got tactile positioning. You've got movement and motion of your body, so you're shifting vestibular sensation as well in relationship to gravity and the earth. What else is going? I know you've got so many markers and-

Dr. Adam Gazzaley: Yeah, obviously auditory stimuli, and we're experimenting with spatial, different types of spatial auditory. There is not in the current prototype, but temperature is another sense that we could control. So, yeah, I think you went through the list so that obviously most-

Jamie Wheal: Well, isn't your auditory... I mean, you spent quite a bit of time on really high quality audio though, haven't you?

Dr. Adam Gazzaley: Yeah. Oh yeah, yeah. Audio. I mean, the goal is that all of these channels that you just described, and there's dozens of them, will be elevated to whatever the state of the art technology brings to the table. So this is like a modular. We put it in a beautiful device, like a beautiful egg as you've described it. But we didn't build any of the components, right? The components are meant to be flexibly adapted as some new audio system comes out that has better spatial [inaudible 00:29:56] vary frequencies across the ears. When we have better scent delivery, that can be time locked to events. We're working with different companies on that. We'll just swap them in. So that's the really cool part is that it is modular and meant to constantly be updated as any of the components rise.

But what's most interesting as a neuroscientist, and I could tell you as someone that has experienced this, which is in Hawaii at the Four Seasons, which was actually delivering what I call a deep brain massage up until COVID shut us down. What's most interesting is not just the number of sensory stimuli that we bring into this, which I think is fairly unprecedented, but it's really how they mix together. It's the synchrony between them and the tricks and the perceptions that you could create.

So for quick example, if you're laying flat and the bed moves you into a position by lifting your head, dropping down your legs, even if it's very subtle, maybe just 10 to 15 degrees, and at the exact same time, we visually change your horizon and we put a wind, a forward facing wind on you, maybe a low frequency vibration so you feel that sense of motion, the perceptual conclusion that you reach is that you have now just stood up and moved forward in space, even completely stood up, but you haven't. So it gives this wonderful tool to really allow us to build environments that are just not possible to do in uncontrolled ways. Then of course, that's the fun and entertaining aspect of it. But the more interesting thing is what are the potential benefits that can come from having such a device.

The Research on Consciousness 

Jamie Wheal: Yeah. What do you see? I mean, obviously the ability to take people out of regular waking consciousness and to move them both neuro-physiologically, their bodies and brains, but also psychologically and emotionally into a different state or experience. What are some of the areas that that feels most intriguing, most impactful? Where do you kind of see the next few years going as far as you develop this?

Dr. Adam Gazzaley: Yeah. Well, I'd say the first thing is to take a lot of the lessons that we've gained just from the software side of development over the last 10 years and address the hypothesis, which is just a hypothesis right now, that if you create some of those same closed loop challenge and reward systems that we have been delivering on an iPad, right? So not the most immersive of tools. Good, but not that immersive. Just like the tap of a finger, now can have full body movement, vocalization as feedback tools.

So starting with the very basic things that we've created and have shown in multiple papers and our FDA clearance as an ADHD treatment, we've shown that even this sort of low level experience, being fully honest about it, I think that what we've done is important, but nowhere near the depth of immersion that Sensync delivers, what is it like to deliver what we think of, I think of as experiential medicine, right? Digitally delivered experiential medicine. What is it like to deliver it with this level of immersion? The hypothesis would be that we could create bigger change, maybe more meaningful change, maybe more sustainable change, maybe help people that have a depth of disability and impairment like very, very intractable PTSD or depression to allow us to have healing that we were unable to accomplish with a phone or a tablet, and so that's one of my first goals.

Are we talking about like an entirely new medical device that can offer us solutions for things that we have just not gotten very far? Things like traumatic brain injury, autism, PTSD, Alzheimer's and other dementias. I'm really, really excited about bringing together what we've done in the software and what we've done on the hardware side. We have not done that yet. So that's to me the most obvious, and not that it's easy, but the first task is to start bringing those worlds together. That's-

Can We Trick Ourselves Into Neuroplasticity? 

Jamie Wheal: What comes to mind? I mean, one of our buddies is a former, I mean, he still is an extreme athlete, but he experienced a spinal cord injury. So he's been paraplegic for a decade and he pushed ski to the South Pole. He's done all sorts of things and he's been in a decade long journey of rehabilitation. As you were just describing in the Sensync that ability to come up 10, 15 degrees, feel like you're standing, be in a virtual world, engage in locomotion, engage in neuro-kinesthetic programming, basically. I can do things in this world and I've got the closed loop neurological inputs that actually are tricking me into thinking that I am doing them. Is there a pathway towards neurogen, and your fascination always with neuro-plasticity, is there a pathway towards neurodegenerative rehabilatory protocols, and can we trick ourselves into neuroplasticity even if our meat suits aren't always complying?

Dr. Adam Gazzaley: Undoubtedly. I mean, we've learned that through many, many really interesting studies in groups not just my own, the motor system is capable of rewiring under these virtual type of stimulation conditions. I think that, I don't even like to put any constraints on what's possible. I'd rather be convinced that it's not rather than just rule it out. So I'd put things like stroke recovery there, recovery after tumor resection, the really hard stuff to fix because it's not just neurochemical, but structural and neurochemical, and then some of the intractable degenerative diseases from MS and Parkinson's and Alzheimer's disease, and then of course the debilitating things we put sort of arbitrarily some ways in the mental health condition, things like schizophrenia and depression.

I would think that any of those are fair game for a good hypothesis and research studies and careful design of experiences to try to help repair from them and to harness our plasticity in a way that we have never accomplished before. So that's the first thing. The first thing is therapeutics, this is like an entirely new therapeutic modality that does not exist right now, and that's the first thing that I would like to do. 

The Cranial Nerve Tongue Stimulation PoNS Device

Jamie Wheal: Now, and I think we might've discussed this at some point briefly, but have you been following the PoNS device, that cranial nerve tongue stimulation?

Dr. Adam Gazzaley: Yeah.

Jamie Wheal: Because we know those guys are doing the phase three trials up in Vancouver, and just as you're talking about the neurodegenerative rehab and the ability to deeply stimulate the brainstem and to do it in a way that enhance, and they're using it for ALS, they're using it for TBI, they're using it for a number of this exact neck of the woods. It just feels to me like it would pair, you were talking about off the shelf tech and you're articulating the pattern language, but you're basically device agnostic. I'm just curious as to whether that might be complimentary and whether going through the virtual world and going through the sensory synchronization that you're doing, whether deep stimulation of the brainstem would then sort of amplify, or at a minimum support, some of the other neuro-generative experiences.

Dr. Adam Gazzaley: Yeah, it's a great... I'm really glad that you brought that up. I think that what we'll do with the closed loop system in an immersive vessel like I described will have an incredible degree of precision in activating brain networks. We've never activated brain networks selectively other than through experience. I'd love anyone to show me another way in something as complex as a [inaudible 00:38:24]. We've never done it with a drug. We have not done it with electrical stimulation. But both molecules-

Jamie Wheal: Meaning you've never been able to turn on or off a specific defined network and nothing else on purpose as is?

Dr. Adam Gazzaley: Yes, yes. We've done it for neurotransmitter systems. We've activated some maybe very simplistic circuits through motor stimulation, but not like a full network with things as complex as attention, perception, decision-making, emotion, never. That's a source of a lot of our challenges in medicine right now is that our therapeutics don't have that selectivity, and so we get the consequence of lack of selectivity, which has side effects. That's why we have side effects is because we always overshoot to get the effects, and then we just get the byproduct of lack of selectivity.

So that's why experience creation as medicine is so valuable because of that targeting, but it doesn't mean that that's the be all and end all because once you create the network targeting through experience in a very high level like we've been talking about, then the opportunity to integrate in a synergistic manner with molecules and electrical stimulation, then it becomes interesting to me. Because then you don't have to rely on those tools for the selectivity. You could rely on them for other things like the ability to drive a certain deep brainstem system or cortical system, or use a drug to just change in general a neurotransmitter system without the selectivity. So I'm really interested in how we bring these worlds together.

We've started doing a bit of that with electrical brain stimulation. So we have had several papers from Neuroscape over the last couple of years that you could download those PDFs on our website that have looked at both direct current and alternating current stimulation during gameplay showing that we can accelerate learning curves by stimulating your brain with a level of stimulation that you don't actually feel or not feel very much at all. So I think both cortical, deep brain stimulation, coupled with this could have really amazing effects in terms of enhancing the outcomes, and then of course, molecules as well, which is another fascinating conversation.

Jamie Wheal: Yeah. I mean, that's very much kind of up the alley that I'm researching right now, and I'm really curious about, because that sense of basically trauma relief, how do we do that, how do we do it better and more effectively for more people? The idea that in a lot of respect, it's the E. O. Wilson famous quote, the Harvard biologists who said we have paleolithic brains, medieval institutions and godlike technologies, and the idea that we are still, in fact, our brains are 50,000 years behind the curve of what our opposable thumbs have been able to create as far as our technologies and we're all experiencing micro-PTSD.

So we're just kind of in a state of perpetual fibrillation and that was actually one of the findings on that PoNS device with the cranial nerve stimulation. So rather than wearing headsets and trying to get through thick skulls and that kind of stuff, it's going straight in, straight to the cranial nerves and they experience a global cascade effect. So that even though they were specifically targeting one or two nerves, they were actually getting an overall what they like into rebooting a computer where it gets all glitchy and junky when it's been with too many windows open too long, it's kind of how we are these days and the ability to do that reset and reboot...

... we did do that reset and reboot of our nervous systems feels profoundly healing and also gives us a chance to return to homeostatic balance. And you just mentioned three different forms. It feels like pulsing of energy through that nervous system, right? From neocortex to spinal column to vagal nerve, you name it, all of our deep core systems. It seems like it all works. I mean, you mentioned AC, DC, there's transcranial magnetic, there's magnetic stimulation, there's a lot of profound work with sound waves. And then on a DIY level, there's the sexual arousal network and orgasm which has been cultivated in different religious traditions. But is there something there that's essentially creating a charge and then discharging energy and information and impulse through the nervous system, has some stimulating, invigorating, buffering balancing effect? Is that the path to accelerating neuroplasticity?

Is Stimulating the Nervous System the Path to Accelerating Neuroplasticity?

Dr. Adam Gazzaley: I mean, there is evidence to suggest it is. I think we still have a lot of work to do before we totally be a thousand percent in, but I'm really excited about it. I always just try to think going back to early in our conversation that no tool and no diagnostic approach is going to be the answer. I'm more interested in integration of multiple tools together, which is rare than it sounds. It sounds like, who doesn't do that? But you don't see it.

Look at a scientific paper, it likely has one window or one intervention, but first, my bias is always that something that could be as profoundly effective as electrical stimulation, regardless of the form of where it's coming in is going to benefit by being presented while an experience is occurring. That's my bias and that's what guides a lot of our research and even technology development, is that, yeah, you can do those things, just like you can also take a drug without a particular experience in mind. But you're not really taking capitalizing on this amazing detailed network capacity of the human brain to help target those other tools. That's how I look at it. Is that, yeah-

Jamie Wheal: Context matters, right? It's like active release stretching. You could statically stretch or you could engage a muscle and move that limb through a range of motion and it gets more out of it.

Dr. Adam Gazzaley: Undoubtedly. I mean, context, in some ways it's everything, right? You can have totally opposite effects with the same compound. Not to veer into this conversation right now if we don't want to, but with psychedelics, for example, I would say that sure, they're molecularly initiated, but those are experiential treatments in many of the same ways that we've been discussing with technology. And so you can take the same molecule and cause PTSD with a certain context or curate with a different context. That is what the data seems to be suggesting after 40 years of up and down in this field. And I would say it's a similar thing with electrical stimulation, that the context establishes the network and on other physiology baseline of where you are now. And then these other, in many ways, blunter tools, but strong tools then layer on top of that. And it's the interface of the two that I find really fascinating, and there's not much research in that area.

Jamie Wheal: Well, in specifically in which area?

Dr. Adam Gazzaley: Either in the area of electrical stimulation being coupled with experience or molecules, including and not including psychedelics being coupled with experiences as well.

Jamie Wheal: Yeah. Although I'll tell you what, Roger Walsh, similar background to yours, MD, PhD [crosstalk 00:46:27] Davis, he gave me a copy of his book, Higher Wisdom. And it is basically the late '50s, early '60s psychedelic research in the UCLA, Manitoba, Hungary, all the places that it was really going off back when and it was straight up [Sandoz 00:46:42] research chemicals so there was none of the stigma. So they were balls out, and UCLA was using it for three-year-olds to 12-year-olds, in schizophrenia children. They were using it for oncology pain relief. In Manitoba, they were doing all kinds of stuff. And Stan Grof, beginning of his career, I mean, they were hooked up in Hungary doing strobe lights, galvanic skin response, EEG, crazy amounts of music. I mean, I think we still haven't got anywhere near just picking up the thread that they kicked off with. I was blown away with the just [crosstalk 00:47:15] ballsy inventiveness and the harnessing of technology that feels archaic now. But they went for it.

Dr. Adam Gazzaley: Yeah. I mean, I met Roger. I haven't caught up with him in a long time, but I did read his book, maybe even on your recommendation. And then I recently had a nice Zoom call with Stan Grof and talked about some of his early work. And yeah, I've been inspired by some of that early research, but a lot of it really did not get embedded in the scientific literature at the time. Not to diminish it. It was some really clever experimentation, but it wasn't really with a lot of the methodology that now we've come to expect, nor was it always with the intentions of publishing protocols. A lot of it was learning that was advancing through apprenticeship and other exchanges [crosstalk 00:48:14] of course completely-

Jamie Wheal: Apprenticeship [crosstalk 00:06:15].

Dr. Adam Gazzaley: An anecdote, which is great. It's just not fully scalable to the level that we need these solutions right now on a global scale. And so I feel like when I talk to even those pioneers, and I'll get to say even more so when I talk to people that have engaged in treatments from indigenous cultures or underground therapists, people that have really not used a lot of technology but have long experienced a deep wisdom in this, they love this concept, even if they haven't seen the vessel or done this type of high level, both state recording and experience creation, they describe to me that this is the essence of what they mean by shamanic practices and practices in the first place.

It is the sculpting of the context from the '60s term of set and setting and building, it's what everyone, as far as I can tell in the field, and I'm not in this field, I'm entering this field with psychedelics as a research tool, sort of believes. And what I meant in that there's a lot of work to be done is that if you try to find papers in the scientific literature that describe, let's take an example, the role of olfactory stimulation during a psilocybin treatment for any outcome. I mean, if anyone finds that, send me that paper, because I can't find any of that. And so I feel like we're almost like in a meadow right now, which happens very few times in a scientific career that you feel like you've stepped into a meadow that no one's really walked in yet, at least from this prospectively designed empirical study point of view.

And so I would love to get knowledge from people that have done this, approached this as practitioners and turn it into research studies so that we can start really understanding the ingredients of the recipe and the recipe itself that goes into creating the type of contextual envelope during a psychedelic treatment that leads to more personalized experiences and better outcomes. That's where we're as Neuroscape entering that domain.

Where Does Information Come From During Non-Ordinary States Of Consciousness?

Jamie Wheal: Beautiful. Beautiful. And so I'd love to just actually ask you a question because I'm noodling on a thought experiment that leaps off from exactly here, which is if you create these immersive multisensory experiences and if you have the ability create effectively that deep nervous system reboot. And if you take a look at, there's fascinating overlaps with ketamine and its impact on the brainstem, nitrous oxide and its impact on the brainstem. Again, orgasm and its impact on the brainstem. Electrical therapy, even carbogen, which is one of the things that they were using in that early what it was called [Meduna 00:51:20]. He was one of Grof's colleagues who was using it to... It was high concentration CO2 and oxygen, he was using it to trigger epileptic seizures. And basically it was kind of a respiratory equivalent to ECT therapy, electroconvulsive therapy.

And it didn't play out there. But just that idea that there are these multiple ways to do it completely congruent with your modeling that all do that cold reboot, and that often that is a neurophysiological thing. It's a benefit. You, again like electroshock, you're calm, grounded, integrated. But there is this other element, which is the interiority of it. And that consistently people report very high bandwidth information, very high salience, very high sense making in those spaces. And for me at least, one of the top questions is where is the information coming from in those non-ordinary states of consciousness? And the best I can come up with is four choices. I'd love to run them past you and then you can tell me where you lay, where not to lunch. But from most reductionist, materialist or straight forward to the most conjectural is basically how we do it.

So option one is you have heightened perceptions and an expanded [inaudible 00:00:52:46]. So literally, your five senses are simply picking up more of reality that's normally streaming by us, and we've whittled our aperture down to next to nothing and you've broadened it a little bit. That's the reducing valve of consciousness. Henri Bergson, Aldous Huxley, right? So that's level one. That one seems very straightforward. Increased norepinephrine, increased brain synchrony, hemispheric synchrony, decreased default [inaudible 00:00:53:11], blah, blah, blah. Level two would be that in non-ordinary states, we have some heightened basically pattern recognition or data access of epigenetic material. That there is the ability and it feels like a squishy field. So I'd love your thoughts on it, but whether that's POWs in the Confederacy or Holocaust survivors or that famous Scandinavian village studies and all those kinds of things.

There's been mixed and contested results, but whether it's methylation RNA, your various other mechanisms by which there's a sense that both the biological and psychological experiences of our ancestors does feel to get passed on in something other than words, memory, and culture. And is it possible that in the non-ordinary States, do we find some clearer access to them? And then there was also the... I'm sure you've seen the fear extinction studies with the mice and the cherry blossoms; sense. So back to smell, right? So the idea of that cascading through, I think, four to six generations. So you're like, "Oh, wow." And then the analog is obviously ancestor worship, whether that's Japanese or Native American or a hundred other traditions that say, "We look back to who came before us. They have some ongoing presence beyond their physical form and we access their wisdom or knowledge." So you're like, "Oh, there's even a cultural analog.

The third would be some here true for unknown mode of accessing information encoded on DNA, and even just at the material level where you've got George Church at Harvard literally storing songs and movies on DNA, expansion of DNA. You're like, "Oh, okay, interesting." We are, as Carl Sagan said, we are made of star stuff. The building blocks in our bodies are the same as they were if we're landed here on this [inaudible 00:55:14] from the Big Bang. And we know that DNA can be encoded and decoded. So purely hypothetically because now we're fully off where the sidewalk ends. Is it somehow possible that we might have access to be able to read and write? And I mean, I don't even know about the write, but for sure, read DNA as it's being done in labs all day.

And then the final one would just be John Wheeler's it from bits, that the universe itself is information and that we have some capacity to, again... In fact, I think even David Eagleman. And I haven't been able to follow up with David to specifically ask him this, but he has floated, in fact, incognito. He floated the notion the brain as receiver, brain as radio receiver, which that's been a metaphor forever. But that idea of, in a heightened state, are we perhaps picking up non-local, non-corporeal information from the substrate of the universe? So out of that four, shoot holes in them, tell me which ones seem most concurrent with your own thinking. What do you think? Where does the information that feels so meaningful, so profound often plays such a key role in healing and creativity and integration, where do you think it's coming from?

Dr. Adam Gazzaley: It was really awesome to hear you describe all those things. I've heard them in pieces but never listed like that and a hierarchy as well, so I appreciate that. So this is where my conservative neuroscientist part of my personality comes in, which I have. I mean, sometimes my other colleagues might feel like I'm totally in outer space with the building immersive vessels and integrating it with psychedelics. But at the very core of our empirical contribution to the scientific literature, there are experiments that look really like their experiments and they're very basic stepwise, somewhat iterative, unfortunately ways of advancing our knowledge. And so level one is the only one that I feel really comfortable with right now, from what you described.

I could tell you that it is not for lack of finding those others fascinating and interesting and exciting as potentials. I'm very open-minded, especially about things that haven't been disproven or that I don't know a lot about. And that some of those things are literally pretty far out of my expertise. I wouldn't feel comfortable making strong statements about them. I do think that from what I read in terms of mechanisms of action from the type of literature that I've been consuming to understand where I can play a role in psychedelic research at Neuroscape, to me, it seems that you can explain a lot of the benefits that we talked about. And not just for people that are suffering, but even the enhancement and growth for people that are healthy that are looking to expand.

I think that with a shift in perception and maybe an expansion of it coupled with a change, not just perceptual change, but a change in your own conceptualization of who you are, your identity, and sense of time, with these elements changing and distorting as profoundly as they do, I believe that there's the building blocks there to explain an incredible amount of the phenomena that we see with prolonged ingestion and treatments, I believe. I don't think that we've explained it enough, which is what I want you to do as a scientist, is help understand how those things could come together to lead to change so that we can do better. That's the translational neuroscience part. I don't just want to geek out about it, although that's pretty fun. I want to say, "Oh, now we know how to do it better and help people that have previously been unable to have relief from suffering or people that have been unable to grow."

But so for me, I just find that those other levels are pretty empirically inaccessible, at least by the methodology that know. And so I like [crosstalk 00:17:51]-

Jamie Wheal: Well, yes [crosstalk 00:59:53]. So the thing is, is that for me, at least, those were, the first three in particular, they're all bodily based. Now, whether there's a provable or there's a plausible mechanism of action, whether there's a demonstrable one TBD, in the information theory notion, you're like, I mean, again, weirdly neuroscientists are coming back around to it, which is almost like the ether or the noosphere or the platonic realm of forms. You're like, "Holy shit, we are really potentially coming full circle." If you go to the psychological or the metaphysical interpretations, those feel even squishier to me. And I've never felt... And it's one thing if you're trying to build from first principles. But you know, in particular, if you are putting people under the influence of psychedelics in the [inaudible 01:00:42] device, they are likely going to come out with some hair-on-fire-holy-shit moments that are not in the script, that are not in the code.

They are going to have some epiphanic experiences, and they will often... The typical thing, and Oliver Sacks did a beautiful job translating a lot of this. They often feel as real or more real than waking life. And the question of is that... The Freudians will say, "Oh, that's just simply the repressed workings of your own unconscious and you're actually... You didn't think up anything new and you've just been playing tiddlywinks. You've been hiding your own Easter eggs. There's no magic here." And that always feels profoundly unsatisfying, and not in the sense of just demystifying what might have been a profoundly held mystical experience. But it's just it feels inadequate to explain the combinations of profound insights, integrations, often wicked humor, you name it, of that information feed.

Now, in the past, pre-Freud, you've got the Greeks saying when somebody has an experience like that, it's not you, it's the muses. Or in other traditions, they would always be some deus ex machina to explain it. We crumpled that, crushed that and called it our subconscious. So the tracks that we went down, if we were just spitballing, I wouldn't give them much credence either. But we are actually, I feel at this point, we are obligated to be reverse engineering what we already know as epiphany. We're not wondering if epiphany is possible. We're now creating experiences and delivering it pretty consistently. And now, to me, it feels like there's both an academic obligation because they're there, but there's also an ethical obligation, which is that if we're putting people in these states to have these experiences and we're somehow realizing or understanding that they have something to do with the healing, something to do with creative positive outfits, it feels, we feel obliged to know where we're sending folks.

Dr. Adam Gazzaley: Yeah. I love what you said. And I mean, I think that that connects with me. I've become incredibly practical in-

Took me ... I've become incredibly practical in my science and my thinking over the years. I don't know how that happened, but it has. I think just because I'm like, "I'm not going to live forever. I want to really help people in this time I have. If I'm not really practical, I'm not going to succeed."

And so I am always like, "What is reducible to an experiment?" This is the tools that I know that I would train to how to increase our understanding and our ability to create therapeutic approaches. When I hear the things you say, I'm like, "Okay. It's a hypothesis of mine." Let's just say that with just the raw mental machinery, without even going to RNA, DNA, other external information. I'm hypothesizing that you can change your environment and your brain in such a way that they come together, to go back to our early conversation.

That's where I believe the mind and consciousness emerge from. You could change both sides of those. That's what we're talking about here. Both sides of them changing. You're changing the chemistry in the brain with these compounds. You're changing the environment.

You can have an incompletely new set of conscious experiences that can, under the right circumstances, lead to epiphanies and breakthroughs and all of these benefits. I'm going to hypothesize that that is possible and that we just don't understand how that occurs.

The main reason why I am, because I actually think it's empirically accessible. It's accessible through experimentation, and that's what I want to do. I want to do these experiments that no one has done yet. I would say ... So I try to think about that like, "Okay. What is the study that we can either succeed or fail and say, 'wow, this is just not possible.'"

There has to be some other source of information that we're either not gathering, or we're not aware of that's leading to this. That might be our conclusion, but that's how I would approach it.

What I want to do is what I call the full metal jacket, full multimodal biosensing with everything we have during a psychedelic treatment, so that we can as clearly as possible start delineating the physiology, the neural, the behavioral, the performance signatures that are associated with the state that someone is in the moment.

We've done an incredibly poor job. We, the world, the human enterprise, of understanding the state of an individual in a moment in any really granular way. But I believe that technology and the machine learning tools and the neuroscience insights are there to allow us to do that now.

And then once we understand someone in the moment, then we can start even manipulating their environment through sense and tactile information, maybe binaural beats or visual, auditory. All the ways that we could put them in a new world with a brain that's been influenced as profoundly as it would with the psychedelic treatment and start seeing if we can dissect out what are the elements that allow these peak experiences.

These transformative events, these epiphanies, that lead to these remarkable therapeutic changes to occur. That is what I believe is experimentally accessible that has not been done.

Jamie Wheal: Well, yeah. I've been tracking in my research for my next book. What is that roadmap? What are those GPS coordinates? Let me run these past you and then see what you think, see how that tracks with what you're saying.

Dr. Adam Gazzaley: Sure.

How Can We Engineer These Therapeutic Conscious Experiences?

Jamie Wheal: And then also how close or far away from being able to engineer that experience. It for sure feels like a saturated and activated endocannabinoid system as one of the core systemic markers, the same high vagal nerve tone.

Probably a baseline of alpha theta neuro electrical activity with [inaudible 01:07:12] into gamma and deep drops into delta, high nitric oxide in the bloodstream and across the blood brain barrier. Let's think what else is going on. And then throw in the multisensory, multimedia. So light, sound, music. And potentially again, lyrics, if you choose to go in that space or purely atmospherics. And then some form of energy pulsing, AC, DC, mag STEM, or sexual arousal.

And pretty much to me, you're hard pressed not to have your mind blown and your heart opened in that neck of the woods. How does that track for you? And then throw in ... If we wanted to get fancier, we could throw in something to do with the serotonergic system and something to do with ...

And this is a whole other rabbit hole, but I've just been getting updated on the research of Dimethyltryptamine in the pineal gland actually finally being validated and showing up somewhere. You have to go so cautiously into that space because there's been so much hype and misinformation for so long, but let's just say tryptamines in the serotonin system. That feels like the crossroads of a bunch of things.

Dr. Adam Gazzaley: Yeah. My initial reaction is that there's a lot about what I'm hearing that sounds really intriguing and a lot that we don't know yet, especially on how they come together. It to me sounds like a great experiment. I'm an empiricist. There could be experiments constructed like that.

I think you're unlikely to be able to load them all the first time and that very first experiment, which was even some of the challenges we're facing with less known things, like just even multisensory stimulation, coupled with multimodal biosensing has really not even been done yet very much at all.

We're still really pretty naive in being able to create experiences way less complicated than the ones you just described, but I find it super fascinating. Yeah, I would say it falls into the greater, bigger goals that I have over the next 20 years, are to start understanding those pieces.

The many that you described, some others that you haven't, and how they might be ... Like I said, the ingredients in this recipe that we don't quite understand yet. But if we're going to use technology, and that technology could be molecules or digital devices to really advance us as humans, whether we're suffering or not, this is the work that has to be done.

Not just in terms of the explorers in the world, the Psychonauts and the brave frontiersmen, but in terms of academics like myself that are willing to push on their systems. I push on my university all the time to say these are real addressable questions.

And the fact that we've been doing so poorly at helping so many people around the world for so long creates an imperative for us to explore more robustly, rigorously. And with safety always in the front, but we could be doing a ton better. I like all that.

What Does Life And Your Contribution To The World Look Like 10 Years From Now?

Jamie Wheal: Beautiful. Well, I got to share a night at the museum with you. You were giving an awesome talk at the Museum of Natural History in New York. And afterwards you mentioned something that I found fascinating, just that you've always kind of seen time and treated time and the unfolding of things very differently than maybe most folks.

You haven't been sort of going from one goal to the next goal. You've been seeing in sort of tenure chunks, and just kind of always being able to kind of reel in the future from where you stand. From where we stand today, where do you see the next decade?

If you get to continue pursuing and fulfilling all of your goals and the research of the Neuroscape lab on all of your projects, what does it, what does it look like? What does life in the world and your contribution to it look like in 10 years from now?

Dr. Adam Gazzaley: Yeah, that's a great question. It is sort of my process of how I go about creation, whether it's on the entrepreneurial side or on the academic side. As you described, I try to project myself 10 years in the future, think about the world that I want to live in, and then essentially reverse engineer to today and say, "How the hell do I get there?"

That's my process. It works to some degree so far, because we recently got FDA clearance on a video game. The first video game ever approved as a medical device ever, which was an idea that I had 10 years ago. And so now that I've sort of validated my science fiction oriented process of creation and research, it's more comfortable for me to do it again.

I spend a lot of time now trying to live in the future, that 10 year future as much as I can, and then think about how would can get there. I would say without the exhaustive details of what that is, which is what most of my thinking is.

The idea of integration, which I feel like our species does particularly poorly at. Even to go back to your earlier description that we tend to think of the brain as like this cell does this, this area does that. That's a lack of imagination of integration. The brain doesn't really work like that.

brain is an integrated dynamic network. Our brain struggles with multi-variate processes like that. We also struggle with it in the tech world and all sorts of places. In the pharma world, look at the pharma world!

We've built silos around every single drug we've ever created, almost never really studying how they could work synergistically. And then the intersection of what we're talking about that seems so obvious in this conversation of, how could you not look at how a drug and an experience might come together? There's hardly any examples of that in the scientific literature.

As a clinician, I saw patients with Alzheimer's disease when I saw patients at UCSF. How we treat them is with a Cholinesterace inhibitor, which increases the acetylcholine and the synapses and has effects that are broad. Like we said, these are blunt instruments. There are attentional and memory effects and some negative side effects, of course, and that's what we do when someone has Alzheimer's like almost all the time. That's like our main treatment right now is that approach.

But to me now, in retrospect, not when I was actually prescribing it as a doctor. Now in retrospect, it seems insane to me that we give a compound that changes a neuro transmitter system in the way that does, and do not couple that with some type of experience, some type of behavior or stimulation.

We don't do that for Alzheimer's disease right now. We just don't. To me, it seems like a bodybuilder taking steroids but then just sitting on the couch all day. It's like, well, you put the fuel in there, but you didn't direct the rest of the system for growth.

Integration across all the things we're talking about is like the world that I want to live in 10 years, right? Where this really interesting journey that we've been on that is advancing now of using molecules, like psychedelics I think in particular, but not only psychedelics.

We know very little, as I said, about Cholinesterace inhibitors, about how any molecule interacts with experience. How those tools that you just described, that long list, really fascinating. Not an area where a lot of people are doing research, but quite open for that.

The sensory, synchronized, immersive experiences that we're creating, the role of stimulation through electrical systems. All of those things for us not to be so timid, to bring things together and really understand how we can use our tools to elevate us. Always returning to the science meets humanity, right? Sometimes it's just so much fun to geek out and build stuff and do experiments.

They're sort of satisfying in their own regard. But to get distracted, the ultimate mission is to really ... To me, the ultimate mission for me ... Because everyone can have different missions, is really to just better our lives and what it means to be human takes a constant, as I said, reorientation.

Are we building these silos because our patent system and our research system and our granting system and our regulatory system and our reimbursement system are all set up to really support everything in silos, which I believe is true.

Rather, that's a lot of systems that have to change to start thinking about how your technology that you have patent on in yours, that you're getting reimbursed at this level. How they come together, and until we start really changing the systems fundamentally, I don't think we'll be successful at dealing with some of the most immense problems we face as humans.

That goes beyond the pathologies that we face. It goes to what I described as this cognition crisis, that we're just not evolving our minds. And because we're not, we're not capable of bringing the attentional focus and the decision making, and the empathy and compassion that are necessary to deal with things like climate change and COVID.

We just don't have the abilities to do that. I think that the 10 year vision that I see is that the tools that we create don't just entertain us and allow us to communicate, but allow us to really elevate ourselves and to deal with those challenges.

Jamie Wheal: Beautiful, man. Hell yeah. Hell yeah.

Dr. Adam Gazzaley: Well, you're [inaudible 01:17:33] so that's why ...

Jamie Wheal: Tear down this wall, Mr. [inaudible 00:01:17:36]! Tear down this wall!

Dr. Adam Gazzaley: No, I feel like I'm waxing more poetic and being more sort of aggressive in my vision now expressing it. Not that what goes on in my head than I normally am, because I treasure you as a person. We've created our own brotherhood and really have a lot of conversations.

I know the audience of people that you assemble have sort of done their homework and are willing to stretch into some of these topics, but I don't often talk about these even in all the podcasts I do.

Jamie Wheal: Really?

Dr. Adam Gazzaley: And the talks I do on stage. Not very frequently. There's a lot of just real detailed stuff on how do you get FDA approval, how do you build a company that integrates Quest medicine and digital technologies. That could easily consume an hour of our time.

Jamie Wheal: Oh, yeah.

Dr. Adam Gazzaley: It's fun for me to really reach into the vision of what's possible and what do we want for our species, because that's the place I like to spend a good amount of time in. Thank you for helping to stimulate that.

Jamie Wheal: Absolutely, man. Thank you for hanging. We'd love to have you come and be on our advisory board and contribute to the stuff we're up to.

Dr. Adam Gazzaley: I would love to.

Jamie Wheal: Yeah.

Dr. Adam Gazzaley: My pleasure.

Jamie Wheal: Yeah. All right, mister. What is it? It's a Friday! Are you doing a-

Dr. Adam Gazzaley: Yeah.

Jamie Wheal: It's not a first Friday. It's soon. First Friday is next week.

Dr. Adam Gazzaley: It's not a First Friday. Yeah.

Jamie Wheal: Okay.

Dr. Adam Gazzaley: My First Friday is next Friday. Yeah. I like to think about Fridays and weekends as different than Mondays to Wednesdays. Even though during COVID, sometimes it doesn't feel very different since I'm still in my same home.

But I like the idea of feeling a week's end and really allowing myself to do different things than a million Zoom calls that I spend most of my week doing. Yeah. I'm looking forward to-

Jamie Wheal: How has the High Fidelity of your beautiful loft worked out? How's that experiment?

Dr. Adam Gazzaley: Yeah. It's been really fun. Jamie and I are referring to a project that I'm an advisor on, a company called High Fidelity that my dear friend Philip Rosedale, the creator of Second Life, has built. And that allows you to have interactions without video, which is different. With audio, but with spatial audio.

So you essentially see yourself as a bot on a two dimensional map if you've ever had ... You know, flat world. It's sort of like this really interesting way of interacting with people by approaching them in two dimensions, and then hearing if they're on the left or the right. It leads to some really fun dynamics. Yeah, it's been going great. We continue to do it and explore what it means to interact in different virtual spaces. I love that.

Jamie Wheal: Beautiful. Beautiful, beautiful. By the way, I had assumed that we had stopped so I was just chatting with you. But if that discussion fits, I didn't want to out you on First Fridays or anything like that.

Dr. Adam Gazzaley: It's up to you. I don't mind talking about stuff like that.

Jamie Wheal: Awesome. All righty, buddy. Well, thank you so much.

Dr. Adam Gazzaley: Yes. All right.

Jamie Wheal: Thank you.

Dr. Adam Gazzaley: Thank you.

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