The lead essay
What we mean when we say a drug "works"
Psychedelic trials report dramatic numbers. Understanding what those numbers measure — and what they quietly leave out — is the first step to reading them honestly.
Latest essays
Thinking, not takes
Treatment-resistant
The clinical label describes what medicines have failed to do, not what a person is. That distinction changes how we read the research — and how we treat the people in it.
The body keeps the appointment
Trauma is not only a memory problem. Understanding why it lives in the body helps explain why some emerging therapies work on the body's terms, not the mind's alone.
Who gets to be a patient?
If psychedelic therapy becomes a real treatment, the next question is not whether it works but who will be able to reach it — and whether access will follow need or money.
A clinician's first session, in her words
A therapist describes what it was actually like to sit with a patient through a supervised dosing session — the boredom, the fear, and the part nobody had prepared her for.
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People imagine the dosing session as the climax of psychedelic therapy. In practice, clinicians often describe it as the prologue. What a person does with what they saw — over weeks, sometimes months — is where a temporary experience becomes a durable change, or fails to.
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Practical guides
Start here
How to talk to your doctor about psychedelic therapy
A calm, practical guide to raising the subject with a clinician — what to ask, what to expect, and how to tell credible care from a sales pitch.
How to think about set and setting
The two oldest words in this field, explained without mysticism — what they actually refer to, why clinicians take them so seriously, and how to apply the idea.
How to support someone after a difficult experience
A harm-reduction guide for friends and family — how to be useful to someone shaken by a psychedelic experience, and how to recognise when to seek help.
The newsletter
One careful letter, every other week
New essays and guides, plus a short, honest note on what the evidence does and doesn’t yet show.