If you have ever told yourself to just stop worrying and watched it not work, here is why: willpower was never built for the job.

I sat down with Dr. Jud Brewer, a neuroscientist at Brown University who trained as an addiction psychiatrist at Yale. His TED talk on breaking habits has been watched close to forty million times, and his book Unwinding Anxiety spent weeks on the New York Times bestseller list. His thesis is that anxiety behaves like a habit, not a disease.

Jud found this first with smokers. Every habit, anxiety included, runs on the same loop: a trigger, a behavior, a reward. A restless feeling shows up. You worry, because worrying feels like doing something. The worry gives you a flicker of control, and that flicker is the reward that trains your mind to start the loop again, sooner, next time. Fighting the loop does not loosen it. Fighting it feeds it.

So instead of telling smokers to use willpower, Jud told them to keep smoking — and to pay close attention while they did. The taste. The smell. The feeling in the chest. They started coming back and telling him, “Doc, how did I not notice this before? These cigarettes taste like crap.”

Nothing about the cigarette had changed. Their attention had. That shift produced five times the quit rate of the standard treatment.

He turned the same move on anxiety. When the restless feeling shows up, the worried mind asks, “NO — is this going to last all day, is something terrible about to happen?”

Jud’s instruction is to flip the NO to WHAT.

“What is this feeling, exactly? Where do I feel it in my body?”

That turn, from running away to looking closely, loosens the loop.

I have been telling patients some version of this for most of my career: the mind is a tool you use, not a boss you obey. I did not expect to hear it back from a scientist with an fMRI scanner. But Jud said it almost word for word, unprompted:

“I would say it’s probably one of, if not the most important skills to learn. Because if we don’t have control of our minds, if we don’t train our minds so that we can control them, they’re going to control us, and things don’t end well when that’s the case.”

He has the data behind it, too. In a randomized controlled trial of his Unwinding Anxiety program, anxiety dropped sixty-seven percent in people with generalized anxiety disorder, against fourteen percent for usual care.

Curiosity Will Conquer Fear Even More Than Bravery Will

There is a practice below this letter for the next time the buzzing starts. But the idea underneath it is the one I want you to keep. Jud closed our conversation with a line from the Irish poet James Stevens:

“Curiosity will conquer fear even more than bravery will.”

If anxiety is fear of the future, that is the whole instruction. Get curious about the feeling instead of fighting it, and the feeling loses its grip.

Jud writes his own newsletter, Inside the Curious Mind, if you want more from him directly.

Food for thought.

Golden light,

Dr. Richard Louis Miller

In this episode — Dr. Jud Brewer, a Brown University neuroscientist and Yale-trained addiction psychiatrist, joins Richard to lay out a habit-loop model of anxiety. From his own residency panic attacks to the smoking-cessation work that produced five times the standard quit rate, to a randomized trial of his anxiety program, the throughline is one mechanism: pay attention to what a behavior actually does, and the brain stops finding it rewarding. We close on a thirty-second practice for the next time anxiety shows up.

Guest: Dr. Jud Brewer — Director of Research and Innovation, Brown University Mindfulness Center. Author of The Craving Mind (Yale University Press, 2017), Unwinding Anxiety (Avery, 2021, New York Times bestseller), and The Hunger Habit (Avery, 2024). His TED talk has roughly 40 million views combined. More at drjud.com.

Chapters

• 00:00 — Opening: the epidemic of anxiety and depression

• 01:56 — Jud’s own anxiety story

• 06:46 — Choosing mindfulness as a career in 2006

• 11:38 — Coke Enders and the academic-hazing pattern

• 15:10 — Reinforcement learning: pay attention as you smoke

• 20:28 — The anxiety habit loop

• 23:28 — The default mode network and the posterior cingulate cortex

• 25:49 — The mind is a tool, not the boss

• 29:46 — Richard’s Vipassana origin with Goldstein and Kornfield

• 31:07 — Conscious breathing and five-finger breathing

• 32:42 — Anxiety travels in clusters

• 34:40 — If these tools work, why are we prescribing

• 36:42 — Could this be taught in high schools

• 38:19 — Going Beyond Anxiety: the AI-paired digital therapeutic

• 41:52 — Mid-episode break

• 43:32 — Curiosity will conquer fear: flip the NO to WHAT

• 45:27 — Feelings are just feelings

• 47:15 — Off-air closing

Choice quotes

“I would say it’s probably one of, if not the most important skills to learn...”
— Dr. Jud Brewer, 30:47

“Here’s the most important thing I never learned in medical school. This goes back to the Borkovec paper, which is that anxiety could be driven like a habit through negative reinforcement.”
— Dr. Jud Brewer, 20:43

“We actually got a 67 percent reduction in anxiety in people with generalized anxiety disorder. This was relative to 14 percent in the usual-care group...”
— Dr. Jud Brewer, 38:29 (Caveat: this is the Unwinding Anxiety RCT, Roy et al. 2021/JMIR 2022, N=65 — distinct from the 5x smoking-cessation figure above; don’t conflate.)

“Curiosity will conquer fear even more than bravery will.”
— James Stevens, quoted by Dr. Jud Brewer, 45:14

“I detoxed 1,500 people in a 10-year period, and never had to hospitalize a single one, and never had an adverse effect.”
— Dr. Richard Louis Miller, 11:57 (The Coke Enders/Wilbur Hot Springs detox story — referenced on-air, not unpacked; full version is a standalone piece.)

Resources mentioned

• drjud.com — Jud’s hub

• Unwinding Anxiety (book) and app

• The Craving Mind (Yale UP, 2017)

• The Hunger Habit (Avery, 2024)

• TED talk: “A Simple Way to Break a Bad Habit”

• Inside the Curious Mind — Jud’s Substack

• @dr.jud on Instagram

Further reading

Richard’s recent conversation with journalist Robert Whitaker touches the same territory from the medication side (link the episode page once it’s live — Brewer referenced recognizing the same pattern in his own patients when Whitaker came up on-air).

My New Book

The Adverse Effects and Therapeutic Potential of Psychedelic Medicines was recently reviewed by Samuel Bendeck Sotillos in the Journal of Psychedelic Studies. I was honored by it. Read the review here.

Pre-Order

A few words from the front of the book:

Dr. Richard Louis Miller is a true elder and wisdom keeper of the psychedelic community, and his credentials come honestly, through hard-won experience. In this book, he continues his role as an educator by sharing his knowledge of both the perils and the promise of psychedelic substances. The reader will find valuable advice on how to avoid pitfalls while realizing the maximum benefits from the thoughtful and safe use of these remarkable medicines.

— Dr. Dennis McKenna, ethnopharmacologist and author of The Brotherhood of the Screaming Abyss

Putting forth the adverse effects of these substances in readable form contributes to their understanding and separates psychedelic scientists from those who would cover over, or even hide, negative effects of pharmaceuticals.

— Dr. Robin Carhart-Harris, neuroscientist at the University of California, San Francisco

It’s the fifth book in my series on psychedelic medicine. You can find it on Amazon.

My Other Books

• Master Your Mind: Practical Tools to Calm Anxiety, Silence Your Inner Critic and Stop Overthinking

• Psychedelic Medicine at the End of Life: Dying Without Fear

• Freeing Sexuality: Psychologists, Consent Teachers, Polyamory Experts, and Sex Workers Speak Out

• Psychedelic Wisdom: The Astonishing Rewards of Mind-Altering Substances

• Psychedelic Medicine: The Healing Powers of LSD, MDMA, Psilocybin, and Ayahuasca

• Integral Psychedelic Therapy (co-edited with Jason A. Butler & Genesee Herzberg)

This week I interviewed Carl Honoré, the journalist who started the International Slow Movement. What Carl told me about how people behave when you take their cell phones away matches what I saw in my years treating chemical dependence, a.k.a. addiction.

Take away someone’s phone, Carl said, and the body reacts the way it does coming off some drugs. Increased heart rate, sweaty palms, anxiety. He used the word addiction and meant it. During my sixty-five-year career (and counting), chemical dependence was one of my specialties, and I am quite familiar with the various forms of withdrawal. Carl’s description of what he calls addiction falls squarely within the parameters of chemical-dependence withdrawal.

Addiction means slavery, and we have made ourselves slaves to busyness and speed. Carl calls the rushing a kind of hiding.

A busy, fast life full of distraction and stimulation and over-caffeination is a form of denial. It’s a way of running away from ourselves.

We reach for the phone when the hard questions come close. Who am I? Am I living the right life, or moving too fast to ask? Socrates said the good life is the examined one. The feed is easier to face than that.

I have watched variations of the same story in my office for decades. The drink, the drug, and now the device. We hand the inside of our lives to something that takes the discomfort away for an hour, and then it demands more.

We tell ourselves the speed makes us productive. Carl says it does the opposite:

“Multitasking is not humanly possible. What you’re actually doing when you multitask is you’re toggling.”

Hand the same work to a fast multitasker and to someone who does one thing at a time, and the multitasker makes up to twice the mistakes and takes up to twice as long. The slow way is the accurate one.

The cost reaches past our work. Carl pointed to research that loneliness harms the body as much as smoking fifteen cigarettes a day. That landed hard, because connection has been the theme of my whole working life. We are tribal animals. We heal in each other’s company and sicken alone. The rush pulls us away from the people who keep us well.

Carl does not want us to throw our phones in the river. He loves speed when speed fits. He objects to living the whole day in fast forward:

“In a world addicted to speed, slowness is a superpower.”

The young are leading the way back. Carl spoke in Paris to a hundred people, all under thirty-five, who read real books together for five hours without once reaching for a phone. They have a game they call stacking: everyone piles their phones on the table, and whoever grabs theirs first buys the round for everyone. They invented it themselves, because they can feel what being always on costs them.

Golden light,

Dr. Richard Louis Miller

Show notes

In this episode — Carl Honoré, the journalist whose 2004 book In Praise of Slow named the global Slow Movement, returns with the thesis sharpened. He and Richard work through what “slow” actually means, why busyness has become a measurable chemical addiction, the myth of multitasking, loneliness as a mortality risk, the acceleration that precedes burnout, and the four prescriptions any of us can start today.

Guest: Carl Honoré — journalist and author of In Praise of Slow (2004), Under Pressure (2008), The Slow Fix (2013), and Bolder (2018). His TED talk has more than 3 million views. He writes Tempo on Substack. More at carlhonore.com.

Chapters

• [00:00] The case for connection

• [02:34] What slow is, and what it isn’t

• [04:28] The cost of a speed-driven culture

• [07:31] Where the drive to speed comes from

• [12:29] Busyness as addiction

• [15:59] The digital detox

• [19:12] What young people are getting right

• [27:21] The multitasking myth

• [30:09] Loneliness, longevity, and connection

• [34:22] Burnout and the last burst of speed

• [42:20] Carl’s four prescriptions

• [51:58] Two quotes to close

Moments worth the timestamp

[02:34] What slow really is.

I often say, in a world addicted to speed, slowness is a superpower. — Carl Honoré

Slow is doing one thing at the speed it deserves — what musicians call tempo giusto. Not as fast as possible, but as well as possible.

[12:29] Busyness as addiction.

When you take away people’s phones, they have the same reaction as heroin addicts do when you take away their fix. Elevated heart rate, sweaty palms, deep anxiety. — Carl Honoré

Note: “same as heroin” is rhetorical compression. The research shows symptomatically similar physiological activation, not clinical equivalence; the underlying finding (phone-separation anxiety) is real. Foundational paper: Clayton, Leshner & Almond, 2015, JCMC.

[27:21] The multitasking myth.

Multitasking is not humanly possible. What you’re actually doing when you multitask is you’re toggling. The fast multitasker will make up to twice as many mistakes and will take up to twice as long. — Carl Honoré

The “2×” is the upper bound of the task-switching literature (Rubinstein, Meyer & Evans, 2001), fair as a public claim.

[30:09] Loneliness as a mortality risk.

Social isolation, loneliness is as bad for your health as smoking 15 cigarettes a day. This isn’t just a nice to have, it’s a must have. — Carl Honoré

The benchmark traces to Holt-Lunstad, Smith & Layton, 2010, PLOS Medicine (148 studies, 308,849 participants).

[42:20] Carl’s four prescriptions.

1. Do less. Rank the week’s list, cut from the bottom, keep a “not-to-do” list in a drawer.

2. Use the off button. Notifications off; phone in another room while you eat, work, or sit with people who matter.

3. Build one slow ritual. Carl sketches; you might knit, read poetry, or walk without headphones.

4. Get into nature. “Even a tree in the back garden. Just take off your shoes and touch grass.”

[51:58] Two quotes to close.

Anything worth doing is worth doing slowly. — Mae West, quoted by Carl

If you want to go fast, go alone. If you want to go far, go together.

Resources mentioned

• Carl Honoré — carlhonore.com; In Praise of Slow, Bolder, TED talk, Tempo on Substack

• Clayton, Leshner & Almond, 2015, JCMC — phone separation and physiological activation

• Rubinstein, Meyer & Evans, 2001, J. Experimental Psychology — task-switching costs

• Holt-Lunstad, Smith & Layton, 2010, PLOS Medicine — social connection and mortality

• Richard Louis Miller — Master Your Mind and The Adverse Effects and Therapeutic Potential of Psychedelic Medicines

Further reading

• Johann Hari, Stolen Focus: Why You Can’t Pay Attention — the forces pulling our attention apart, and what helps.

• Cal Newport, Digital Minimalism — a practical philosophy for using technology on your own terms.

• The Offline Club — the in-person, phone-free gatherings spreading across Europe that Carl describes.

My New Book

The Adverse Effects and Therapeutic Potential of Psychedelic Medicines was recently reviewed by Samuel Bendeck Sotillos in the Journal of Psychedelic Studies. I was honored by it. Read the review here.

Pre-Order

A few words from the front of the book:

Dr. Richard Louis Miller is a true elder and wisdom keeper of the psychedelic community, and his credentials come honestly, through hard-won experience. In this book, he continues his role as an educator by sharing his knowledge of both the perils and the promise of psychedelic substances. The reader will find valuable advice on how to avoid pitfalls while realizing the maximum benefits from the thoughtful and safe use of these remarkable medicines.

— Dr. Dennis McKenna, ethnopharmacologist and author of The Brotherhood of the Screaming Abyss

Putting forth the adverse effects of these substances in readable form contributes to their understanding and separates psychedelic scientists from those who would cover over, or even hide, negative effects of pharmaceuticals.

— Dr. Robin Carhart-Harris, neuroscientist at the University of California, San Francisco

It’s the fifth book in my series on psychedelic medicine. You can find it on Amazon.

My Other Books

• Master Your Mind: Practical Tools to Calm Anxiety, Silence Your Inner Critic and Stop Overthinking

• Psychedelic Medicine at the End of Life: Dying Without Fear

• Freeing Sexuality: Psychologists, Consent Teachers, Polyamory Experts, and Sex Workers Speak Out

• Psychedelic Wisdom: The Astonishing Rewards of Mind-Altering Substances

• Psychedelic Medicine: The Healing Powers of LSD, MDMA, Psilocybin, and Ayahuasca

• Integral Psychedelic Therapy (co-edited with Jason A. Butler & Genesee Herzberg)

At 82, five years ago, two different medical specialists diagnosed me with terminal illness within a two-week period.

The first specialist was my cardiologist. My echocardiogram showed a left ventricle that was pumping insufficiently, producing an ejection fraction (EF) of 34, which is 21 points below the lowest normal. The ejection fraction is the percentage of blood pumped with each beat, and the normal range begins at 55. I was also told I had a 60-to-70-percent blockage in the Left Anterior Descending (LAD) artery, aka the widow-maker.

I had been a marathon runner and was still an endurance athlete, and I was told to cut my exercise back and begin putting my affairs in order.

A few days later, a mole I had finally talked my doctor into biopsying, after a year of freezing it, came back as an aggressive nodular melanoma—the kind AI told me could kill within six weeks. I had been carrying the cancer, unknowingly, for a year.

I am still here to tell you how that all turned out. But first I will tell you about the scientist I interviewed on MBHP this week, because her life’s work helps explain what happened to me.

The Act of Noticing Things

Dr. Ellen Langer has been a professor of psychology at Harvard for half a century—the first woman ever tenured in that department—and she has spent those fifty years proving something most of medicine still treats as a slogan: that the mind and the body are not two separate things. They are one unit. Wherever you put the one, she says, you are necessarily putting the other.

She started somewhere that surprises people. When most of us hear “mindfulness,” we picture meditation—sitting still, eyes closed, repeating a mantra, leaving the world behind. Ellen’s mindfulness is almost the opposite. She defines it in five words: the act of noticing new things. And her uncomfortable conclusion, after all these decades of research, is that nearly all of us are mindless almost all the time. “When you’re not there,” she told me, “you’re not there to know that you’re not there.”

What puts us on autopilot is certainty. We are handed absolutes as children—facts to memorize, answers to know—and the instant you believe you know a thing, you stop paying attention to it.

She learned this, of all places, from a horse. A man at an event asked her to hold his horse while he fetched it a hot dog. Everyone knows horses don’t eat meat. To be polite, she said nothing—and the horse ate the hot dog.

“That’s when I realized,” she said, “that everything I thought I knew could be wrong.”

For Ellen, that was thrilling rather than frightening: if the things people swear can’t be done might actually be possible, then a great many doors we have been treating as walls are standing open.

Our Strongest Medicine

The most important of those doors is the one between the mind and the body, and her most famous demonstration of it is the counterclockwise study. She brought a group of elderly men to a retreat outfitted exactly as the world had been twenty years earlier—the magazines, the films, the news of the day—and had them live surrounded by the materials of their younger selves, in the present tense, rather than as men reminiscing about the past.

In five days their eyesight, their hearing, their strength, their memory, and even how old they appeared all measurably improved. The point, she was careful to say, was never that you should freeze your house in time. The point was possibility—that so much of what we accept about decline is something we mindlessly swallowed when we were young and never thought to question.

Dr. Langer also conducted a fascinating study in which she took various measurements on hotel workers before and after they were told that the Surgeon General considered their daily work to be exercise: vacuuming, making beds, cleaning bathrooms, pushing carts, climbing stairs, and scrubbing floors. They were also told how many calories each task burned, along with a good deal more about the health benefits of their movement. As you might now guess, the workers improved on many indices of health, and it was based on having been given the information, not on anything else changing in their lives.

Then Dr. Langer said the thing the pharmaceutical industry would prefer you not know. “Our strongest medication,” she told me, “is placebo.”

Dr. Langer walked me through sham-surgery studies in which patients with Parkinson’s had their skulls opened and closed with nothing done inside—and improved anyway, because they believed they had been treated. Her conclusion is as radical as it is simple:

“The pill is not making you well. You’re making yourself well.”

A drug that wants to reach the market has to beat that inner pill, which is exactly why the placebo is given a bad name it has never deserved.

There is a shadow side to mind-body unity, and it is the label. Ellen described what she calls the borderline effect: score a 69 on a certain test and you are called cognitively deficient; score a 70 and you are average. Nobody believes there is a real difference between 69 and 70—a guess, a sneeze, a misread question—yet those two people walk out into entirely different lives, and the label becomes a self-fulfilling prophecy.

The same machinery, she argues, runs disease, and it runs the epidemic of diagnoses we now hang on our children.

Dr. Langer is warning us about the dangers of limiting what we believe is possible, the dangers of labels, very much including the label of age. Especially later in life, acting one’s age can be dangerous to your well-being.

Add More Life to Your Years, Not Years to Your Life

Now I will tell you how my own story turned out, and you will see the connection with Dr. Langer’s research.

I did very nearly the opposite of some of what I was told by the cardiologists. Instead of cutting my exercise back, I went from three or four days a week of aerobic exercise to seven days a week, an hour at a time, building the pace slowly until I could go faster.

I began weight lifting three times a week with Mike Mihos, a professional trainer and bodybuilder. I further cleaned up my already clean fuel intake, and I created a ten-point rejuvenation program for myself.

I made a decision: I would live as a living man. I would live every single day as though I felt wonderful, because in fact I did. I refused to allow the words on a page to disrupt my lovely daily life, so long as I could direct that life.

I did not allow the diagnoses to harsh my mellow. To do so would indeed be adding insult to injury.

Three months later, my heart was pumping normally—the ejection fraction had climbed from 34 to 62—and it has stayed there ever since; my cardiologist eventually discharged me, told me I no longer needed him. I have a new cardiologist who monitors me yearly, and I continue to be tested, because prevention is my game whenever possible.

As for the aggressive melanoma, after the great surgeon Dr. Jonathan George performed a sentinel lymphadenectomy and biopsy, he called and reported that I was cancer free. I asked how it was that the cancer had not killed me. He said my immune system had built a capsule around the cancer and prevented it from spreading for an entire year. I was clear.

Dr. Ellen Langer’s counsel for all of us, and especially for those of us who are older, is to stop chasing the longevity industry’s serums and scores. “Rather than spend your time trying to add more years to your life,” she said, “add more life to your years”—and her data suggest that doing so actually adds the years.

I believe we create our own reality through our thoughts and feelings. Deep healing is something a person adds to consciously, from the inside. We are only beginning to learn how powerful the mind is in our healing process. One of the most powerful tools for that learning is psychedelic medicine.

Food for thought.

Golden light,

Dr. Richard Louis Miller

Show notes

In this episode—Dr. Ellen Langer, the Harvard psychologist who has studied mindfulness and mind-body unity for nearly fifty years, joins Richard to explain why mindfulness is not meditation, what the counterclockwise study revealed about aging, why the placebo is our strongest medicine, and how a diagnosis can become a self-fulfilling prophecy. Richard shares his own recovery from two terminal diagnoses at 82.

Guest: Dr. Ellen Langer—Professor of Psychology at Harvard (the first woman tenured in the department), author of Mindfulness, Counterclockwise, and The Mindful Body. More at ellenlanger.com.

[03:03] Mindfulness is not meditation

“Mindfulness, as I study it, you are very much in the world... it’s the act of noticing new things.” — Ellen Langer

• Her sobering finding: virtually all of us are mindless almost all the time. Certainty is the culprit—when you think you know, you stop paying attention.

[04:30] The horse and the hot dog

“And that’s when I realized everything I thought I knew could be wrong.” — Ellen Langer

[20:15] The counterclockwise study

• Elderly men lived as their 20-years-younger selves for five days; vision, hearing, strength, memory, and apparent age improved. The point was possibility, not a prescription to freeze your home in time.

[30:01] Imagined exercise

• Data from other labs: a group imagining lifting weights gained virtually the same muscle as the group actually lifting—both far above the do-nothing group.

[31:21] The borderline effect

• 69 vs. 70 on a test sorts people into “deficient” vs. “average” with no real difference—and the label becomes self-fulfilling. The same machinery runs disease labels.

Richard: “The psychological diagnoses we put on people... it becomes like a letter A on their foreheads.”

[40:05] Placebo and “you’re making yourself well”

“Our strongest medication is placebo... The pill is not making you well. You’re making yourself well.” — Ellen Langer

• Attention to symptom variability (Langer’s self-treatment for chronic illness): set your phone to check in through the day—“How is the pain now? Better or worse than before, and why?” The “why” engages a mindful search; symptoms often recede. No side effects, no cost.

[45:40] Richard’s two terminal diagnoses

“I did not change my way of life. I did not think of myself as a dying person.” — Dr. Richard Louis Miller
“If you went from feeling healthy to defining yourself as sick, you’re instructing your body how to no longer operate optimally.” — Ellen Langer

[52:30] Add life to your years

“Rather than spend your time trying to add more years to your life, add more life to your years. And... that will indeed add more years.” — Ellen Langer

Resources mentioned

• Dr. Ellen Langer—ellenlanger.com; The Mindful Body, Counterclockwise, Mindfulness (books)

Further reading

• Crum, A. J., & Langer, E. J. (2007). Mind-set matters: Exercise and the placebo effect. Psychological Science, 18(2), 165–171. https://pubmed.ncbi.nlm.nih.gov/17425538/

• Ranganathan, V. K., et al. (2004). From mental power to muscle power. Neuropsychologia, 42(7), 944–956. https://pubmed.ncbi.nlm.nih.gov/14998709/

• McRae, C., et al. (2004). Effects of perceived treatment on quality of life and medical outcomes in a double-blind placebo surgery trial. Archives of General Psychiatry, 61(4), 412–420. https://pubmed.ncbi.nlm.nih.gov/15066900/

• Rodin, J., & Langer, E. J. (1977). Long-term effects of a control-relevant intervention with the institutionalized aged. Journal of Personality and Social Psychology, 35(12), 897–902.

• Aungle, P., & Langer, E. (2023). Physical healing as a function of perceived time. Scientific Reports, 13, 22432. https://www.nature.com/articles/s41598-023-50009-3

• Langer, E. J. The Mindful Body: Thinking Our Way to Chronic Health (Ballantine, 2023). https://www.ellenlanger.com/books/

My Books

Pre-Order

I wrote Adverse Effects and Therapeutic Potential to contribute to how we, as a community, handle a moment of unprecedented attention and capital.

Will psychedelic medicines be another drug dispensed in 15-minute sessions with psychiatrists, or will they be used properly as facilitators of psychotherapy?

Early feedback:

Dr. Richard Louis Miller is a true elder and wisdom keeper of the psychedelic community, and his credentials come honestly, through hard-won experience. In this book, he continues his role as an educator by sharing his knowledge of both the perils and the promise of psychedelic substances. The reader will find valuable advice on how to avoid pitfalls while realizing the maximum benefits from the thoughtful and safe use of these remarkable medicines.

— Dr. Dennis McKenna, ethnopharmacologist and author of The Brotherhood of the Screaming Abyss

Putting forth the adverse effects of these substances in readable form contributes to their understanding and separates psychedelic scientists from those who would cover over, or even hide, negative effects of pharmaceuticals.

— Dr. Robin Carhart-Harris, neuroscientist at the University of California, San Francisco

If any of this speaks to you, you can order the book here.

My Other Books

• Master Your Mind: Practical Tools to Calm Anxiety, Silence Your Inner Critic and Stop Overthinking

• Psychedelic Medicine at the End of Life: Dying Without Fear

• Freeing Sexuality: Psychologists, Consent Teachers, Polyamory Experts, and Sex Workers Speak Out

• Psychedelic Wisdom: The Astonishing Rewards of Mind-Altering Substances

• Psychedelic Medicine: The Healing Powers of LSD, MDMA, Psilocybin, and Ayahuasca

• Integral Psychedelic Therapy (co-edited with Jason A. Butler & Genesee Herzberg)

I want to introduce you to someone I have known for years and admire a great deal. Jamie Joyce came on Mind Body Health & Politics this week. She is running for Congress in California’s 12th district, she founded the Society Library, and she is an artist (I keep one of her pieces that she made with a particle accelerator on my dresser). She is the real deal.

You know how I open this program most weeks: human beings are tribal animals, healthiest when we live in small groups where we know one another by face and by name. The standing threat to that is the small number among us who would rather dominate than collaborate. Jamie has built her whole campaign on exactly that distinction. She is running, she told me, because she is tired of watching power concentrate in a few hands while the rest of us are talked past.

It has already cost her something. Twenty minutes after she announced, the phone calls began — people telling her they would ruin her life if she did not drop out. In a later call, they read back the names of old boyfriends, to let her know they had been digging. A private citizen decides to run for office, and that is the welcome she receives. She did not drop out. When I asked her about it, she said something I have not stopped thinking about:

“There are people who have taken bullets to the head for me to even have the ability and the right to run for Congress. If I’m not willing to risk my reputation to stand up for the rights of others, then I don’t deserve the job.”

I felt protective when she said it, and I told her so on the air.

Here is the part that delighted me. Jamie founded her Society Library after reading, in her early twenties, about a club Benjamin Franklin started — a small group that met to reason together in a spirit of sincere inquiry into truth, with no taste for argument or domination. Franklin called it the Junto. I started a Junto in Fort Bragg twenty years ago, and it still meets every Thursday morning. I invited her to join us. Two people, two centuries apart, reaching for the same simple thing: people thinking together instead of shouting at each other.

We covered a great deal: the bill she wrote, the art she makes with a particle accelerator, the long odds she is running against anyway. I told her on the air what I will tell you now. I wish her all the luck, and all the help and support that the people who know her can muster.

Go to jamiejoyce.com and see for yourself.

Then listen to the whole conversation.

And then, just below, I have a small practice for you this week.

Golden light,

Dr. Richard Louis Miller

A note for Californians

This letter reaches you on a Monday. Tuesday, June 2, is the statewide primary.

If you live in California, you almost certainly already have a ballot sitting at home, because the state mails one to every registered voter. There is still time, but not much. Do not put it back in the mail now. Fill it out and drop it in any ballot drop box, or at any polling place, by 8:00 p.m. Tuesday. Or vote in person that day.

I say the same thing at the top of the program most weeks, and I mean it every time: get out and vote, and vote for the people who will actually represent you. And if you happen to live in the 12th district, around Berkeley and Oakland, Jamie Joyce is on your ballot.

Show notes

[00:00] The mission

Richard’s standing frame: human beings are tribal, healthiest in small groups where they know one another by face and name; roughly 95% of us want to collaborate, and a small minority would rather dominate. The civic conclusion he always reaches — get out and vote — sets up the guest.

[02:39] Why she’s running

• Jamie is running in CA-12 because she found her representatives unresponsive — she spent three months in DC last year and couldn’t get her own reps on the phone.

“We need to stop electing politicians and start electing legislators.” — Jamie Joyce

[06:17] “They said they’d ruin my life”

• Within twenty minutes of announcing, she got calls pressuring her to drop out; a later call referenced names from her past.

“There are people who have taken bullets to the head for me to even have the right to run for Congress. If I’m not willing to risk my reputation to stand up for the rights of others, then I don’t deserve the job.” — Jamie Joyce

[10:54] The MAD Act

Jamie’s omnibus bill bundles ten titles she’d otherwise have to pass separately. As she describes them: data-privacy/surveillance limits (requiring brokers to delete holdings), a “Demand a Plan for AI” framework of technical working groups, limits on the Insurrection Act, dark-money disclosure, electoral reform (funding ranked-choice / STAR voting), and mass digitization of government records.

[23:48] The jungle primary

• California’s top-two primary means Jamie and the incumbent — both Democrats — go straight to the general; no Republican is running. She’s a late entrant and out-fundraised, but the only challenger.

[36:05] The Society Library

• In her early twenties, Jamie read Benjamin Franklin’s autobiography and the description of his debating club — a group that reasoned together in “a sincere spirit of inquiry into truth.” She built the Society Library to do that at civilization scale, extracting arguments and evidence from across media into models city councils and universities now use.

“Our reasoning is fractured and broken across the web... We focus on creating models of formal civilization-scale debate.” — Jamie Joyce

[42:30] Her art

• Jamie funded college winning art competitions; a Burning Man honorarium led to her hand-cut wooden “wisdom” books and, later, Lichtenberg figures — three-dimensional lightning shapes made by irradiating acrylic in a particle accelerator.

“The real treasure is the friends you make along the way.” — Jamie Joyce

[48:22] Franklin’s Junto, and Richard’s own

• Franklin’s club was the Leather Apron Club, which became the Junto. Richard started a Junto in Fort Bragg twenty years ago that still meets every Thursday; he invites Jamie to visit.

[50:33] Closing

“Energy and persistence conquer all things.” — Benjamin Franklin, quoted by Jamie Joyce
“It matters less whether I win this particular seat... what really matters is that we never, ever give up.” — Jamie Joyce

Resources mentioned

• Jamie Joyce for Congress — jamiejoyce.com

• The Society Library

• Benjamin Franklin’s Junto (the Leather Apron Club)

My Books

Pre-Order

I wrote Adverse Effects and Therapeutic Potential to contribute to how we, as a community, handle a moment of unprecedented attention and capital.

Will psychedelic medicines be another drug dispensed in 15-minute sessions with psychiatrists, or will they be used properly as facilitators of psychotherapy?

Early feedback:

Dr. Richard Louis Miller is a true elder and wisdom keeper of the psychedelic community, and his credentials come honestly, through hard-won experience. In this book, he continues his role as an educator by sharing his knowledge of both the perils and the promise of psychedelic substances. The reader will find valuable advice on how to avoid pitfalls while realizing the maximum benefits from the thoughtful and safe use of these remarkable medicines.

— Dr. Dennis McKenna, ethnopharmacologist and author of The Brotherhood of the Screaming Abyss

Putting forth the adverse effects of these substances in readable form contributes to their understanding and separates psychedelic scientists from those who would cover over, or even hide, negative effects of pharmaceuticals.

— Dr. Robin Carhart-Harris, neuroscientist at the University of California, San Francisco

If any of this speaks to you, you can order the book here.

My Other Books

• Master Your Mind: Practical Tools to Calm Anxiety, Silence Your Inner Critic and Stop Overthinking

• Psychedelic Medicine at the End of Life: Dying Without Fear

• Freeing Sexuality: Psychologists, Consent Teachers, Polyamory Experts, and Sex Workers Speak Out

• Psychedelic Wisdom: The Astonishing Rewards of Mind-Altering Substances

• Psychedelic Medicine: The Healing Powers of LSD, MDMA, Psilocybin, and Ayahuasca

• Integral Psychedelic Therapy (co-edited with Jason A. Butler & Genesee Herzberg)

When I first read Anatomy of an Epidemic in 2010, I had already been a clinical psychologist for almost 5 decades, and I thought I understood the trouble inside American psychiatry.

Robert Whitaker’s book showed me I had been polite about it.

He returned to the program last week for the fourth time. I asked him to walk us through what the research literature actually says — about antidepressants, about the stimulants we give our children, and about the story the profession has told the public for forty-five years. He did it the way he always does: calmly, with the documents open on the table, and impossible to wave away.

The center of our conversation is a trial called STAR*D, the largest antidepressant study ever conducted in this country. It was reported to the world as a seventy-percent success. When a psychologist went back and scored it against the protocol its own designers had written, the success rate fell by half — and the number of patients still well a year later came to about three in a hundred. I’ll let Whitaker tell you that story himself. He has spent forty years earning the right to, and he tells it better than I could.

This conversation also has everything to do with my new book, The Adverse Effects and Therapeutic Potential of Psychedelic Medicines, which came out earlier this month. The pattern Whitaker documented in psychiatry — a theory reverse-engineered from a drug, sold to the public as settled science, then locked in place by money — is the very pattern I do not want repeated with the psychedelic medicines I have spent my life studying. Whitaker is the journalist who taught me what the early warning signs look like.

And then, near the end, he told me about the people he has interviewed who genuinely recovered, and what they said had made the difference. It was not a drug.

I want you to hear that part in his own voice.

Please listen, and write back to tell me what you think.

Golden light,

Dr. Richard Louis Miller

P.S. If you haven’t already taken my questionnaire, I’m collecting reader feedback to improve this publication and my other offerings. It’s three questions and only takes about 2 minutes to complete.

Take the Survey

A note on working together

For those who feel drawn to working together more directly, I offer a limited number of one-on-one sessions.

These are not traditional therapy sessions. They are quiet, practical conversations focused on calming the mind, easing anxiety, and working with simple tools that support steadiness in daily life.

We move at a thoughtful pace. We work with what’s present. We focus on what helps.

Book a Session

In this episode — Investigative journalist Robert Whitaker returns for his fourth conversation with Richard. They trace the antidepressant story from the 1980 DSM-III rebrand through the reanalysis of the largest antidepressant trial ever run, the long-term data on children and stimulants, and — at the end — what Whitaker learned from the people who actually recovered.

Guest: Robert Whitaker — investigative journalist, founder of Mad in America, author of Anatomy of an Epidemic (2010), Mad in America (2002), and Psychiatry Under the Influence. His 1998 Boston Globe series was a Pulitzer finalist.

Chapters

• [00:00] The epidemic of isolation

• [02:20] Introducing Robert Whitaker

• [03:30] The 1980 DSM-III pivot

• [05:50] Where the chemical-imbalance idea came from

• [12:40] What the public was told instead

• [18:30] How the drugs change the brain

• [23:10] Patients who’ve been on SSRIs for years

• [27:53] STAR*D: the trial reanalyzed

• [37:01] Why the press stayed quiet

• [39:53] Children on psychiatric drugs

• [42:56] The MTA stimulant study

• [51:00] “A menace to society”

• [55:34] Why informed consent drives him

• [57:32] The connection cure

Introductory notes - the epidemic of isolation [00:00]

The mission of the program: enhancing wellbeing by making connections with the people who live near you, by face and by name. Ninety-five percent of people want to collaborate, not fight. A small group of dominated predators benefits from divisiveness. The current American epidemic is isolation, alienation, and loneliness. The antidote is connection - a theme the conversation returns to in its final movement.

Introducing Robert Whitaker [02:20]

Whitaker is an investigative journalist and the founder of Mad in America. He is the author of Anatomy of an Epidemic (2010), Mad in America (2002), and Psychiatry Under the Influence. His 1998 Boston Globe series on psychiatric research was a Pulitzer finalist. Of all the people I have interviewed in over twenty years, his work has had the greatest impact on my professional life.

The corruption of psychiatry and the DSM-III pivot [03:30]

• The forty-five-year story begins in 1980, when the American Psychiatric Association published DSM-III and adopted a disease model. Schizophrenia, bipolar, anxiety, and a new diagnosis called attention deficit hyperactivity disorder were each declared distinct illnesses.

• The profession said it knew the causes. Depression was too little serotonin. Psychosis was too much dopamine. A second generation of drugs would correct those imbalances, “like insulin for diabetes.”

• Prozac arrived in 1988 as a breakthrough that could make you feel “better than well.”

• Before DSM-III, American psychiatry felt its legitimacy as a medical specialty was under attack. DSM-III was a rebrand to position psychiatrists as medical doctors treating medical illnesses.

“It was pitched to us as a story of science, but it wasn’t a science story. It was a marketing story. It was a rebranding story for American psychiatry, which in the 1970s was feeling that its legitimacy as a real medical specialty was under attack.” — Robert Whitaker

What the science actually showed [05:50]

• The chemical-imbalance hypothesis came out of the 1960s, working backwards from drug mechanism, not from measurement of patient biochemistry.

• Tricyclics and MAOIs both upped serotonergic activity. Researchers inferred that depression might be low serotonin. Antipsychotics block dopamine receptors, so they inferred schizophrenia might be high dopamine.

• Direct testing failed. By 1978 researchers weren’t finding it. A 1984 NIMH study concluded that a lesion in the serotonergic system is not a cause of depression.

• In 1998, the APA’s own textbook declared the monoamine theory of depression dead. The profession did not tell the public (Moncrieff et al., 2022, Molecular Psychiatry).

What the public was told instead [12:40]

• Pharmaceutical ads kept selling SSRIs that “fix chemical imbalances.” The APA website told the same story. In 2005 the APA put out a press release calling psychiatrists experts in fixing chemical imbalances in the brain.

• Drug companies funded APA education programs, media training, and “key opinion leaders” at Stanford, Harvard, Johns Hopkins, Penn. Thought leaders were paid hundreds of thousands, sometimes more than a million, over a few years.

• By 1998, when the New England Journal of Medicine wanted a review of antidepressants, it could not find an academic mood-disorders expert who wasn’t already on pharma payroll.

My Other Books:

• Master Your Mind: Practical Tools to Calm Anxiety, Silence Your Inner Critic and Stop Overthinking

• Psychedelic Medicine at the End of Life: Dying Without Fear

• Freeing Sexuality: Psychologists, Consent Teachers, Polyamory Experts, and Sex Workers Speak Out

• Psychedelic Wisdom: The Astonishing Rewards of Mind-Altering Substances

• Psychedelic Medicine: The Healing Powers of LSD, MDMA, Psilocybin, and Ayahuasca

• Integral Psychedelic Therapy (co-edited with Jason A. Butler & Genesee Herzberg)

How the drugs actually change the brain [18:30]

• Before treatment, a patient’s serotonergic system is not operating abnormally. The drug ups activity. The brain dials itself down to compensate (Hyman & Nestler, 1996, AJP).

• After long-term treatment, patients do in fact end up with a low-serotonin system, physiologically.

“The drug induces the very change that was hypothesized to cause the problem in the first place.” — Robert Whitaker

• On withdrawal, the dialed-down system can’t snap back. Patients feel terrible and conclude they are still sick.

• A University of Bristol cohort (n=222,121, 10-year follow-up, 2022) found elevated risk of coronary heart disease, cardiovascular events, and all-cause mortality among long-term antidepressant users.

What to tell patients already on SSRIs [23:10]

I described to Whitaker a patient of mine who has been on an SSRI for twenty years and no longer knows what she is without it. His answer:

• Before antidepressants became long-term care, 85% of hospitalized depressed patients recovered within a year.

• As long-term medication became standard, the one-year recovery rate dropped. By 1998, the reported stay-well figure on antidepressants was about 15%.

• A 2025 systematic review found the median antidepressant trial lasts 8 weeks. The median real-world prescription is 5 years. The science backing five-year prescribing was never built.

STAR*D - a $35 million study that became a hoax [27:53]

• STAR*D enrolled 4,041 outpatients, the largest and longest antidepressant trial ever conducted. Four chances to remit across four steps.

• Reported a 70% cumulative remission rate. Medical school curricula, the New Yorker, and the New York Times cited it.

• The protocol specified HAM-D as the outcome scale. The paper used QIDS, which the protocol explicitly said not to use.

• 931 of the 4,041 patients weren’t depressed enough at baseline to be eligible. Some scored in remission at baseline. They were counted as remitters anyway.

• The protocol said dropouts without remission were treatment failures. The researchers imputed dropouts as remitters at the same rate as those who stayed - roughly 600 imagined remissions.

• Psychologist H. Edmund Pigott obtained the protocol via FOIA, then patient-level data under the RIAT Act. Applying the registered protocol, the true cumulative remission rate was 35% (Pigott et al., 2023, BMJ Open).

• Of the original 4,041 patients, 108 were in sustained remission and still in the trial at one year. That is roughly 3%. The figure did not appear in the abstract of the 2006 AJP summary paper.

“The stay-well rate at the end of one year in the largest and longest trial of antidepressants ever conducted was 3%. We were being told of a stay-well rate of being cured of 70%.” — Robert Whitaker

• Two follow-on RIAT reanalyses extended Pigott’s work to the rest of the trial: Step 2 drug-switch arms (medRxiv, Feb 2025) and Step 2/3 augmentation arms (medRxiv, Oct 2025). Both reach the same conclusion: when you score the trial the way the protocol said, the headline numbers collapse.

The press silence on STAR*D [37:01]

• Mad in America ran a retraction campaign. Pigott sent letters to the AJP. The AJP declined.

• The AJP invited a rebuttal. The original authors called Pigott’s work “ad hoc post-analysis.” In fact Pigott had applied the registered protocol.

• In October 2024 Pigott’s team formally called on the AJP to retract five articles tied to the original analyses. None have been retracted.

• The New York Times was still citing the 70% figure in 2023.

“From a newspaper standpoint, this is being handed to them on a plate. They don’t have to dig anything up. They just have to read what the protocol says.” — Robert Whitaker

Children on psychiatric drugs [39:53]

• Before 1980, major mental disorders were understood as disorders of the mature personality. ADHD as a diagnosis was born in 1980.

• 25 to 30% of incoming college freshmen now carry a psychiatric diagnosis and a prescription.

• The Social Security Administration’s 2024 disability report: adult mental-illness disability has more than doubled since Prozac entered the market, and disability among children for mental-illness causes has risen more than thirty-fold.

“We are taking away from our kids their God-given right to try to make something of themselves, to grow up and try to settle with their mind, to come to grips with their minds.” — Robert Whitaker

The MTA stimulant study and informed consent [42:56]

• The MTA (Multimodal Treatment of ADHD) study was designed by NIMH to answer a direct question: do stimulants help kids long term?

• At 14 months, expert-medicated kids did slightly better on reading and ADHD symptoms (MTA Cooperative Group, 1999). The abstract became the story.

• By 3 years, medication status was a marker of deterioration rather than benefit. The abstract said benefits “seemed to disappear.” The data tables said worse.

• By 6 to 8 years, medicated children had greater functional impairments, worse cognitive tests, worse ADHD symptoms, and higher delinquency rates (Molina et al., 2009, JAACAP).

• The NIMH website described the 14-month benefit. It did not describe the three-year, six-year, or eight-year results.

“A menace to society” [51:00]

• Past APA president Jeffrey Lieberman called Whitaker “a menace to society, causing great harm.” Whitaker plans to put it on his gravestone.

• Whitaker’s position: he isn’t doing the research. He reads NIMH’s own work and the data tables past the smoothed abstracts.

“I’m a menace to a profession that has decided not to be an honest narrator of its own science.” — Robert Whitaker

Informed consent is the belief that motivates me [55:34]

• Whitaker’s frame is not anti-medication. It is pro-informed-consent. People have a right to know the risks and benefits, including long-term, and then to decide.

• “Drugs worsen long-term outcomes” is an aggregate claim. Individual patients can still feel better than baseline. The comparison that matters is the natural recovery rate.

The connection cure - nobody said the drug did it [57:32]

“When I spoke to people who were better, who had gotten their lives back, nobody said the drug did it. What everybody said is they made a connection with somebody.” — Robert Whitaker

• After Anatomy of an Epidemic came out, Whitaker began interviewing the people who had recovered from depression, schizophrenia, and other diagnoses once considered chronic.

• Across every interview, the same answer: connection. Somebody believed in them. They developed a relationship. Through that relationship they joined groups, worked, volunteered, brought food to the elderly.

• Julia Hotz’s The Connection Cure (Simon & Schuster, 2024) documents clinicians around the world who prescribe movement, nature, art, service, and belonging instead of, or alongside, a drug.

• What we need, in order: someone to love, someone who loves us, meaning, then exercise, shelter, and food.

Why this conversation, now

This episode follows the release of my new book, The Adverse Effects and Therapeutic Potential of Psychedelic Medicines (Park Street Press, May 5, 2026). The pattern American psychiatry ran with antidepressants for thirty years - reverse-engineer a theory from a drug, hand it to the public as settled science, lock the story in with guild incentives - is the pattern I do not want repeated with psilocybin, MDMA, or ibogaine. Whitaker is the journalist who taught me what the early signs look like. The book is an attempt to keep us honest about the next round before it ships.

Resources mentioned

• Robert Whitaker, Anatomy of an Epidemic (Crown, 2010) and Mad in America

• Pigott et al., 2023 STAR*D Step 1 reanalysis, BMJ Open

• Pigott et al., 2025a STAR*D Step 2 drug-switch reanalysis, medRxiv

• Pigott et al., 2025b STAR*D Step 2/3 augmentation reanalysis, medRxiv

• October 2024 retraction call covering five AJP articles

• Moncrieff et al., 2022 serotonin theory umbrella review, Molecular Psychiatry

• Bristol primary-care cohort, 2022

• Antidepressant trial duration vs real-world use, 2025, Journal of Affective Disorders

• Hyman & Nestler, 1996, AJP

• MTA Cooperative Group, 1999; Molina et al., 2009, JAACAP

• SSA 2024 Annual Statistical Report

• Julia Hotz, The Connection Cure (Simon & Schuster, 2024)

• Inner Compass Initiative (Laura Delano), rxisk.org (David Healy), International Institute for Psychiatric Drug Withdrawal

• Richard Louis Miller, Master Your Mind and The Adverse Effects and Therapeutic Potential of Psychedelic Medicines (Park Street Press, May 5, 2026)

Today is the official launch of my new book, The Adverse Effects and Therapeutic Potential of Psychedelic Medicines. It is the fourth book in my psychedelics series after Psychedelic Medicine in 2017, Psychedelic Wisdom in 2022, and Psychedelic Medicine at the End of Life in 2024.

I have been thinking about how to introduce a book to people who already read this newsletter.

You may have already read my commentary on Trump’s recent executive order, and the warning Rick Doblin sent the field a week and a half ago.

You may have been following my internet radio broadcast, where I have been recording the interviews that become the source material for my books.

But you have not seen is the book itself.

So I am going to do something a little different. Instead of telling you what the book is about, I am going to share most of the prologue. The two passages I have left out are personal—one on the criminalization of LSD after 1965 and one on a head-on collision I had with a Winnebago—and they deserve more space than a letter like this one gives them. The full version is in the book.

Before we get to it, I have three requests:

1. If you have a minute, a 3-question reader survey helps me understand who is reading these letters and what would be most useful to create next.

2. Subscribe to my podcast to hear my upcoming interview with award-winning journalist Robert Whitaker – launching this Thursday. The pattern he traced with antidepressants is the pattern this book is meant to keep us from repeating.

3. Lastly, order a copy of Adverse Effects, and if you enjoy it, consider leaving an honest review. I am available for interviews. Email my producer to arrange.

Order the book

And now, enjoy this excerpt.

Prologue to The Adverse Effects and Therapeutic Potential of Psychedelic Medicines

Many of us in psychedelic science are advocating for certain psychedelic substances to be reclassified as legitimate medicines that both heal and raise consciousness. Therefore, it is essential that we in the psychedelic community—scientists and practitioners—model elevated consciousness through practicing the highest standards of transparency about what is known, what is not known, and what remains uncertain about these substances.

This book focuses on the potential unwanted complications, often called adverse effects, of psychedelic medicines. I use the nomenclature unwanted complications to be precise because adverse effects are typically ascribed to the medicines themselves, whereas unwanted complications take into account the contributions made by factors in addition to the medicine itself, such as the administrator (a.k.a. therapist or guide), the patient’s history, the patient’s mental set at the time of administration, the setting of the administration, the sounds in the environment, and more. An unwanted complication, then, is any harmful, unintended, or undesired reaction to a substance, its administrator, and/or the environment.

Many activities in life bring with them unwanted complications or the potential for such effects. When deciding whether to take any action, we can either make a considered decision weighing the promises and the perils, or we can throw caution to the wind. How much consideration we give each decision typically relates to the potential of serious harm. While we don’t always act sensibly, it makes sense that greater risks call for deeper reflection before taking action.

One of the most severe unwanted complications is death. While most unwanted complications are less severe, they vary in severity from negligible to excruciating. For example, I once took the cardiovascular medicine spironolactone but stopped when it dramatically blistered my lips—the adverse effects outweighed any potential benefit.

My lovely wife, Jolee, is presently undergoing radiation for lobular breast cancer. She is also taking the immunosuppressant letrozole, which suppresses her body’s production of estrogen and progesterone. Both treatments bring unwanted complications including fatigue, loss of appetite, and pain. While some women bypass the treatment because of the severity of the unwanted complications, Jolee has decided that the benefit of the treatment—reduced risk of recurrence—outweighs the unwanted complications.

Anecdotal stories of unwanted complications and adverse effects are common in all cultures—they’re one of the ways that humans learn. Against today’s backdrop of sobering statistics, the data on unwanted complications and adverse effects of all substances require our close attention to make informed decisions.

In 2022, approximately 480,000 people died from the effects of smoking cigarettes and 140,000 died from the adverse effects of alcohol. The toll from pharmaceutical drugs is equally stark: 70,000 deaths from fentanyl, 17,000 from OxyContin, 27,000 from cocaine, and 14,000 from heroin. Contrary to the beliefs of many, deaths from classic psychedelics like LSD, psilocybin, MDMA, and ayahuasca remain vanishingly rare.

This data informs our participation in what has become a worldwide experiment with psychedelic medicines. As research accelerates and personal experimentation grows, we must ask, What are the unwanted complications and adverse effects, the rewards, and the risks?

Order the book

A significant percentage of the American public has been misled about the relative dangers of psychedelic substances, which has allowed those substances to be kept federally illegal. At the same time, the dangerous mood- and physiology-altering substances—alcohol and cigarettes—are advertised nationally. While we should remain prudently cautious and informed about all new psychoactive compounds, the data suggests our societal fears about them are simply misplaced.

Until we collaborate as a people in placing the value of life above the value of money, we will all suffer from what I call Honest Information Deficit DisEase, or HIDDE (pronounced hiddy). We cannot trust the information we get from cigarette, alcohol, and pharmaceutical companies and even some academic institutions, as profit motives too often, reprehensibly, override public health concerns. In an effort to offer light in these murky waters, I advocate that psychedelic science set the model for radical transparency. This book represents a step toward that goal.

For nearly sixty years, when reflecting on my traditional scientific self-experimentation with psychedelic medicines, I observed growth, expansion, and creativity. These medicines helped me create a life of meaning, love, and little fear. They facilitated my living in a state of chronic gratitude, fostering an endeavor to treat every person I encounter with dignity, respect, kindness, and love. These substantial benefits I have received have led me to lobby for radical transparency and opine that secrets quite often create distance, isolation, anxiety, and depression.

…

I imagine you agree that the decision to take a medicine known to be dramatically powerful deserves our careful attention. As informed citizens, we want to understand the benefits and liabilities of such a medicine before we ingest it. We seek information from the internet, pharmaceutical companies, pharmacies, health professionals, media, family, and friends. We ask around to find out who might have taken this. Yet in a world where profit often trumps public health, which sources can we trust? How can we be certain of what is contained in black market substances?

This book strives to illuminate both the promises and perils of powerful psychedelic substances. To bring you up-to-date evidence-based information on psychedelic medicines and both psycholytic- and psychedelic-assisted therapy, I have interviewed prominent psychedelic scientists in the United States and England. Much of what you’ll read in this book comes from these one-on-one conversations with the researchers themselves.

Through careful examination of known risks, emerging research, and personal accounts, we can work toward more informed decisions about the use of these medicines. Only through radical transparency about the benefits, unwanted complications, and adverse effects can we hope to realize the full life-enhancing potential of psychedelic medicines while minimizing harm.

To start, how do we balance the promise of psychedelic therapy with its potential risks? How can we ensure that science, rather than hype, guides our path forward? Who are the real experts in a world where credentials don’t always align with ethical practice? And perhaps most pressingly, why is there still reluctance in some circles to openly discuss adverse effects?

Human nature hasn’t fundamentally changed with the resurgence of psychedelic interest. People are still looking for the latest panacea or the fountain of life, and thus the allure of quick fixes may still cloud our judgment. This is where our journey begins—in the space between hope and caution, promise and peril.

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The twelve chapters that follow cover the acute mental and somatic effects, the prolonged perceptual and existential effects, the abuses of patient trust by individual practitioners, and the harm-reduction practices that have taken sixty years to build.

Before I let you go, I would be grateful for your answers to a short reader survey. It’s just 3 questions. I read every response, and they tell me what to write next.

Take the survey

On Thursday I am publishing my conversation with Robert Whitaker on Mind, Body, Health and Politics. Bob has spent twenty years documenting how Honest Information Deficit DisEase actually played out inside American psychiatry—the chemical-imbalance story the public was sold for thirty years and quietly retired in 1998, the largest antidepressant trial we ever ran and what its real one-year numbers were (3 percent, not the 70 percent you have read), and the disability rates that have followed every wave of expanded prescribing.

The pattern he traced with antidepressants is the pattern this book is meant to keep us from repeating with psychedelics. If you have ever taken an SSRI, or you have someone in your life who has, the conversation will be worth your time.

Watch for it Thursday morning.

Golden Light,

Dr. Richard Louis Miller

A note on working together

For those who feel drawn to working together more directly, I offer a limited number of one-on-one sessions.

Book a Session

These are not traditional therapy sessions. They are quiet, practical conversations focused on calming the mind, easing anxiety, and working with simple tools that support steadiness in daily life.

We move at a thoughtful pace. We work with what’s present. We focus on what helps.

My Other Books:

• Master Your Mind: Practical Tools to Calm Anxiety, Silence Your Inner Critic and Stop Overthinking

• Psychedelic Medicine at the End of Life: Dying Without Fear

• Freeing Sexuality: Psychologists, Consent Teachers, Polyamory Experts, and Sex Workers Speak Out

• Psychedelic Wisdom: The Astonishing Rewards of Mind-Altering Substances

• Psychedelic Medicine: The Healing Powers of LSD, MDMA, Psilocybin, and Ayahuasca

• Integral Psychedelic Therapy (co-edited with Jason A. Butler & Genesee Herzberg)

On April 18, the President signed an executive order fast-tracking federal review of psychedelic medicines for serious mental illness. By Monday morning, shares of one publicly traded psychedelic drug company had jumped more than 50% in a single trading day.

The Executive order is narrower than the headlines suggest. It directs the Food and Drug Administration to fast-track review for psychedelic compounds with breakthrough therapy designation, opens a Right-to-Try pathway for the terminally ill, and routes $50 million through ARPA-H to match state research programs. It is a meaningful step. It deserves a measure of celebration. And it also deserves a closer look, for it is difficult to trust a government that has normalized lying to such an extent that the public has lost trust and does not know what to believe.

For the past three years, I have been writing a book about what could go wrong at exactly this moment. It is called The Adverse Effects and Therapeutic Potential of Psychedelic Medicines (Park Street Press), and it comes out on May 5.

Pre-Order

The title has two halves for a reason. The therapeutic potential and the adverse effects belong together. We cannot lose sight of one when we focus on the other.

What I want to share with you today is what I am watching as the book nears publication.

What I am hearing this week

The cheers in the field are loud. Veterans groups, who have been the most effective advocates for ibogaine research, are calling this a turning point. Biotech executives are calling it validation. Researchers I respect are calling it a threshold moment.

In addition to the cheers there are other voices, and these are the ones I want to draw your attention to.

Rick Doblin, who founded MAPS and has spent forty years advocating for psychedelic medicine legitimacy, immediately reminded the field that the results we have been celebrating came from drug access combined with psychotherapy access.

Drug access alone is a different model. Lineage holders are warning that a rush to FDA-approved pharmaceuticals could strip these medicines of the contexts that made them medicines in the first place. Researchers are cautioning against politicized science driven by influencer advocacy and veteran testimony, against the slow, careful work of safety and efficacy data being skipped. The field’s critics are pointing at industry connections in the funded research and asking who benefits.

The community is unanimous on very little. We should be honest about that.

When the money arrives

I have lived through every phase of this story since 1965. What I am watching now is the money arriving. The medicines have been here for thousands of years. The money is what is new.

Some of the companies whose stocks jumped 20 to 50 percent on Monday morning are doing real science. What concerns me, as someone who has watched a great many medical revolutions arrive and depart, is the pattern that surrounds the money. Several of the companies at the front of the line have already begun stripping psychotherapy out of their psychedelic protocols. Therapy is expensive. Therapy is hard to scale. Therapy is impossible to patent. A pill is cheaper to make, easier to deliver, simpler to sell.

The outcomes that brought us to this moment came from a trained guide, an integration practice, and a setting that supported the work. A pill alone has never produced them.

I am old enough to remember when Merck was the most admired company in America. Fortune gave them that title for seven straight years. Their founder said in 1950 that medicine was for the people, not for the profits, and for most of a century the company lived by that line. Then came Vioxx. Doctors wrote 107 million prescriptions for the drug between 1999 and 2004. When the internal data showed it raised the risk of heart attack, the company did not tell doctors. When academic researchers raised concerns, their universities were pressured to quiet them.

A century of trust was destroyed in five years.

The pattern is the risk.

A reckoning for the field

For sixty years, the people who advocated for these medicines did so with little, if any, institutional support, with minimal funding, often at risk to their careers and sometimes their very freedom. I include myself among them. We were a small community holding a small flame. I wrote about many of these courageous scientists in my book Psychedelic Medicine.

A lot has changed since the 2010s when I wrote that book and conducted those interviews. At the time, it was actually possible to speak to every single researcher in the United States who had been allowed to do clinical trials with psychedelics.

That community has grown. And it is about to be very large, very well-funded, and very visible. The work of the next five years will look very different from the work of the last fifty. The people who arrive in this field over the next decade will outnumber the people who built it.

Here is what I think the psychedelic community has to do, now that the tide is turning.

Let us be honest about the unwanted complications of these medicines, including the prolonged perceptual disturbances, the existential crises, the somatic challenges, and the abuses of patient trust by individual practitioners. The information will surface anyway. If we are not the ones telling the truth about it, someone less careful will be.

Let us set the standard for transparency that we have spent decades accusing other industries of failing to set. Let’s hold ourselves to the standard we have asked Big Pharma to meet.

And let us refuse to look away when bad actors in our own field exploit vulnerable people. There are practitioners operating right now who attach prestigious academic credentials to mass emails, charge a fee through PayPal, and promise to heal cancer, depression, addiction, and trauma in a weekend retreat. People have died at those retreats. I write about one of them, by name, in chapter 12 of my book. Every field has people like this. Ours is no exception. The next five years will sort the field into people who confront that and people who do not.

Why I wrote this book

I wrote Adverse Effects and Therapeutic Potential to contribute to how we, as a community, handle a moment of unprecedented attention and capital.

Will psychedelic medicines be another drug dispensed in 15-minute sessions with psychiatrists, or will they be used properly as facilitators of psychotherapy?

A few early readers of my book have written kind words. From Dr. Dennis McKenna, ethnopharmacologist and author of The Brotherhood of the Screaming Abyss:

Dr. Richard Louis Miller is a true elder and wisdom keeper of the psychedelic community, and his credentials come honestly, through hard-won experience. In this book, he continues his role as an educator by sharing his knowledge of both the perils and the promise of psychedelic substances. The reader will find valuable advice on how to avoid pitfalls while realizing the maximum benefits from the thoughtful and safe use of these remarkable medicines.

And from Dr. Robin Carhart-Harris, neuroscientist at the University of California, San Francisco:

Putting forth the adverse effects of these substances in readable form contributes to their understanding and separates psychedelic scientists from those who would cover over, or even hide, negative effects of pharmaceuticals.

If any of this speaks to you, you can pre-order the book here.

In the meantime, if you want to, celebrate the executive order. Celebrating is always fun. And keep your eyes, heads and hearts open as big money changes the psychedelic medicine landscape.

Golden Light,

Dr. Richard Louis Miller

A note on working together

For those who feel drawn to working together more directly, I offer a limited number of one-on-one sessions.

Book a Session

These are not traditional therapy sessions. They are quiet, practical conversations focused on calming the mind, easing anxiety, and working with simple tools that support steadiness in daily life.

We move at a thoughtful pace. We work with what’s present. We focus on what helps.

My Other Books:

• Master Your Mind: Practical Tools to Calm Anxiety, Silence Your Inner Critic and Stop Overthinking

• Psychedelic Medicine at the End of Life: Dying Without Fear

• Freeing Sexuality: Psychologists, Consent Teachers, Polyamory Experts, and Sex Workers Speak Out

• Psychedelic Wisdom: The Astonishing Rewards of Mind-Altering Substances

• Psychedelic Medicine: The Healing Powers of LSD, MDMA, Psilocybin, and Ayahuasca

• Integral Psychedelic Therapy (co-edited with Jason A. Butler & Genesee Herzberg)

I then asked him about the people in between: the ones who do not work there and are not currently on the retreat. He said there weren’t really any.

I don’t remember thinking it was a particularly important moment. That was the whole exchange.

But when Sam came onto my podcast, Mind, Body, Health and Politics, this week, the first thing he wanted to tell me was that he had spent the ten days since our last conversation drafting a permanent community for the people who already pass through LaWayra. It has ten founding members and a financial structure. Three people had signed up before the plan was complete.

I have been broadcasting for twenty-one years to find out whether the work travels. Sometimes it does. Sometimes it travels ten days and shows up as three founding members of something that was not there before.

I hope you’ll enjoy our conversation.

We talked about:

• the 3,000 ayahuasca ceremonies Sam has hosted without a single hospital transfer

• the pattern he calls “bastardization,” and

• what 65 years in clinical practice tells me about the executive order signed two weeks ago.

You’ll find the detailed summary below.

But first, I want to tell you about my latest book on the adverse effects and therapeutic potential of psychedelic medicines comes out May 5. You can pre-order it here.

A few of my distinguished colleagues wrote kind endorsements:

Dr. Richard Louis Miller is a true elder and wisdom keeper of the psychedelic community, and his credentials come honestly, through hard-won experience. In this book, he continues his role as an educator by sharing his knowledge of both the perils and the promise of psychedelic substances. The reader will find valuable advice on how to avoid pitfalls while realizing the maximum benefits from the thoughtful and safe use of these remarkable medicines.
– Dr. Dennis McKenna, ethnopharmacologist and author of The Brotherhood of the Screaming Abyss:

Putting forth the adverse effects of these substances in readable form contributes to their understanding and separates psychedelic scientists from those who would cover over, or even hide, negative effects of pharmaceuticals.
– Dr. Robin Carhart-Harris, neuroscientist at the University of California, San Francisco

Pre-Order the Book

Show notes / Summary

Welcome and the Epidemic of Isolation [00:00]

• Richard opens with a thesis he has carried for two decades: humans are tribal animals, and we are healthiest in small groups where you know everyone by face if not by name.

• The current American condition is an epidemic of alienation, isolation, and loneliness. The antidote is connection, and connection is easier inside tribe-scale community.

• He introduces Sam, coming in from roughly an hour south of Medellín, Colombia.

Tribal scale is a health variable, not a lifestyle preference

Richard’s 21-year body of work puts community density in the same category as sleep, nutrition, and movement. The retreat context about to unfold is, in his framing, a case study in rebuilt tribal scale.

Sam’s Origin Story: From Latvia to Colombia [01:40]

• Sam grew up in Latvia under Soviet rule. His birth certificate carries a hammer and sickle. He worked as a marine mechanical engineer in offshore oil and gas, made around $500 a day tax-free when the Latvian minimum wage was $350 a month, and was clinically depressed.

• He quit his job and his relationship, took a year off, and traveled South America to learn Spanish. He cycled Colombia, Ecuador, Peru, went home to refill his savings, and kept returning to Medellín until he stopped leaving.

• Ayahuasca found him in an “echo chamber” of friends and podcasts. He tried it once and thought he was finished with it. He was not.

• During the COVID era he moved to the countryside. A stranger found him online and asked to rent his space to run a ceremony. The partnership did not last, but the retreat did.

• In his seventh ceremony, Sam says ayahuasca told him his purpose was to work with ayahuasca. He has followed that directive since.

“I quickly bought myself everything that society tells you you need to buy when happiness comes, and happiness never came.” — Sam Believ

Building LaWayra and the Community Spark [06:02]

• Richard asks what occupies Sam’s mind when it is quiet. The honest answer: how to fill the next retreat. The business side of a healing container is, like any business, stressful.

• Sam credits Richard’s last appearance on Sam’s own Ayahuasca Podcast with seeding a plan he had somehow never considered: a permanent community of the people who already pass through LaWayra.

• In the ten days between that conversation and this one, Sam drafted a plan for 10 founding members and a financial structure. Three signed up before the plan was complete.

• Running the retreat is running four businesses at once: hotel, restaurant, media company, and what Sam calls a “crazy house” where guests temporarily lose their minds by design. Team of 37 staff.

• Sam first came to ayahuasca for his own depression, then abandoned his own work to facilitate others’ healing, then returned to the medicine six months ago. A maloka sits 100 meters from his office.

Richard’s community prompt traveled ten days and hit ground

The episode captures an unusual proof point: the ideas this show transmits are not only consumed but acted on inside a recognizable timeline.

“Since we last spoke, about 10 days ago, I have created a full plan of how I’m going to start my own community.” — Sam Believ

Frequency: Indigenous Lineage vs. Western Protocol [14:08]

• Richard frames the frequency debate. His daughter did roughly 20 to 30 ceremonies in three months at a Peruvian retreat. American clinicians often recommend three, six, or even nine months between sessions. What does Sam see on the ground?

• Sam’s position is a middle ground. 20 in three months is a shamanic deep dive, useful for a narrow profile. LaWayra’s standard program is one week, four ceremonies.

• On the other extreme, single-session protocols drew the episode’s most quotable line.

• Sam’s reasoning rests on lineage. His Taita comes from seven generations of shamans inside a thousand-year-old tradition. If forced to pick between that lineage and “some doctor from a United States hospital,” he trusts the lineage.

• LaWayra has served close to 3,000 people. Sam considers one to two weeks, with up to 10 or 12 ceremonies a month, safe for the average guest. He does not recommend three months of continuous ceremony for anyone without a shamanic training path.

Reverse tolerance is the pharmacological anomaly behind his frequency stance

Sam’s dosing math only works because ayahuasca behaves differently from classical serotonergic psychedelics.

• Psilocybin and LSD build tolerance fast. Take five grams of mushrooms today, you need 10 tomorrow.

• Ayahuasca inverts that curve. Take one cup today, tomorrow you may need half a cup. Sam calls this reverse tolerance, attributed in the pharmacology literature to the harmala alkaloids in the Banisteriopsis caapi vine.

• The same property enables titration. One cup, wait, add half a cup, and the effect combines.

“One ceremony every nine months is, unfortunately, total bullshit.” — Sam Believ

Dosing: Why You Trust the Shaman, Not a Scale [21:53]

• Richard asks how strength is measured. With LSD it is micrograms. With psilocybin it is grams. With ayahuasca there is no standard recipe.

• Ayahuasca varies by vine, by admixture plant, by cook time, by tradition. Each shaman has his own recipe, his own extraction window, his own dose ladder.

• The dose is not a number. It is the shaman’s read of the person in front of him. Sam says guests are sometimes disappointed by a half cup, then grateful at hour three that the shaman gave them exactly that.

• Sam is explicit: this is not a home medicine. Set, setting, and facilitation are structural requirements.

The Bastardization Triad: Tobacco, Cacao, Coca [24:10]

This is the sharpest rhetorical passage in the episode. Sam lays out a pattern the West repeats.

• Tobacco. Indigenous people used it for peace treaties, social bonding, and healing. Industrial processing made it a “death stick that gives you lung cancer.”

• Cacao. A heart-opening ceremonial medicine. Add milk and sugar and it drives diabetes.

• Coca. A traditional superfood leaf, “much better than coffee.” Process it and you get cocaine.

• Sam’s concern: the same extraction logic is circling ayahuasca. Pull the medicine from the tradition, and the tradition dies or zombifies.

The framework is the argument against overly clinical psychedelic medicine

Sam is not anti-regulation. He is anti-extraction. The clip carries without needing Richard in frame, which is exactly why it travels.

“The beautiful medicine became a death stick that gives you lung cancer.” — Sam Believ

Adverse Effects: 3,000 Ceremonies, Zero Hospitalizations [26:17]

• Richard introduces the book directly. He has been studying adverse effects of psychedelics and has a new title coming out the following month. He wants to know what Sam has seen across 3,000 people.

• Sam’s framing: ayahuasca is a very strong plant medicine, not a joke. Adverse effects arise in specific conditions, not at random.

• Risk drivers Sam names: pre-existing medical conditions, drug-drug contraindications, excessive dose, and unsafe settings.

• Short-term: purging, vomiting, diarrhea. Sam classifies these as integral to the healing rather than side effects, and dos Santos et al.’s pharmacology review of ayahuasca supports the somatic-release framing.

• Post-retreat: if the dose is wrong, emotional destabilization. Dose discipline is the control variable.

Zero hospital transfers, zero psychiatric transfers across 3,000 guests

Sam is precise about what the worst cases looked like.

• No one has required hospitalization.

• No one has required a psychiatric transfer.

• The hardest cases involved childhood sexual abuse memories surfacing mid-ceremony and overwhelming the guest. Those required extended follow-up with the integration team, and the guests reported improvement over time.

• Sam is honest that malpractice exists in the broader field. Stories of guests being overdosed, running, falling, or entering psychotic states come from settings with thin screening and weak facilitation.

• At LaWayra, the container is designed to suppress those failure modes. A pre-arrival questionnaire, training workshops, and 26 hours of on-site onboarding before the first cup.

“We’ve given ayahuasca now to close to 3,000 people... We’ve never really had anyone with such an adverse effect that we needed to take them to the hospital or where they needed to be taken to a psychiatrist.” — Sam Believ

This is self-reported field data. It is not peer-reviewed outcome data. It is the largest single retreat-operator dataset Richard has on tape, and the book’s chapter on ayahuasca needs exactly this kind of input.

Age range: 18 to 84

Sam’s oldest guest to date was 84. He has served roughly 30 guests aged 70 and older. Average age is 35 to 40. When Richard, 87, mentions the book, Sam extends an open invitation: come to LaWayra and be the oldest guest on record.

The Facility and Why Colombia Is Safer Than the Headlines [30:58]

• 12 cabins, 20 beds, a pool, a sauna, a gym, massage, and a QEEG brain lab that scans guests before and after the retreat. Kitchen team of four. Ayahuasca-friendly menu.

• Hospital is 10 minutes away in a town of roughly 20,000 people.

• Richard asks whether Colombia is safe for American visitors, the Pablo Escobar question. Sam’s reframe: Medellín was the most dangerous city in the world 50 years ago. Today at least seven U.S. cities rank higher on global homicide lists and Medellín is not in the top hundred.

• Ayahuasca was historically popularized in Colombia. The Yajé Letters by Burroughs and Ginsberg, and Richard Evans Schultes‘s ethnobotanical expeditions, put it on the map. Dennis and Terence McKenna came through as well. The narco era pushed psychedelic tourism to Peru and Costa Rica, and Sam argues most Costa Rican ayahuasca is sourced from Colombia anyway.

• Colombian regulation is tight. Only indigenous people with an official council permit can serve ayahuasca. Sam’s shaman operates under that permit.

• Sam is producing a documentary with Sam Lipman-Stern (of VICE’s Telemarketers) pitched as a “cocaine to ayahuasca” rebrand of Colombia.

From Oil and Gas to Purpose [39:43]

• The wealth arrived early and hollow. $500 a day tax-free bought everything society advertises and delivered no happiness.

• Sam’s baseline was a traumatic childhood that taught him emotions were painful. He had, in his words, tuned his emotional dial to zero.

• Travel did not fix it. Ayahuasca did.

• The depression lifted. Purpose emerged. Sam dedicated his life to the medicine that rescued him.

• He does not universalize. Some guests leave LaWayra with a new vocation. Others leave with a new relationship to the one they already had.

Marxism, AI Unemployment, and Finland’s Housing Answer [43:56]

• Richard asks Sam what he thinks of “from each according to his ability, to each according to their need.”

• Sam grew up inside the Soviet aftermath. He knows the slogan’s failure mode: resentment at unequal contribution destroys motivation.

• He floats that AI, blockchain, and a post-scarcity planning layer might change the calculus, and asks Richard how motivation works without extrinsic reward.

• Richard’s answer is the teaching moment of the episode. People are already motivated. The engine is purpose. The purpose does not have to be large. Winston Churchill built a brick wall in his backyard. JFK put a man on the moon. The structure is the same.

• Richard then pivots to the political implication. Autonomous driving alone will eliminate every truck and cab driver. Millions of jobs collapse in one wave. If working society does not plan for the displaced, the unrest will dwarf any unemployment check.

• The pragmatic template exists. Finland has largely ended homelessness by housing people without charging rent, on the basis that ER and fire-department costs for the unhoused exceed the cost of housing. Washington state’s 1811 Eastlake program showed the same math in the U.S.

Purpose is the floor of any functioning political economy

Richard’s through-line from psychedelic healing to housing-first policy is the same argument in two registers.

“What matters is having purpose. I think people are motivated towards purpose.” — Dr. Richard Louis Miller

Psychedelics, Hydration, and the Closing Invitation [52:44]

• Hydration during ceremony is non-trivial. Purging drains fluids. LaWayra keeps electrolyte drinks on hand.

• Richard thanks Sam and gives him space to say anything he wished he had said. Sam uses it to thank Richard for continuing to broadcast at 87 and to reinforce that older voices matter in a world without elders.

• Sam’s two closing asks to listeners: consider visiting Colombia, and if ayahuasca interests you, come to LaWayra. If you are not ready to drink, listen to his podcast.

• He extends the invitation to Richard himself: come be the oldest guest on record.

“I appreciate that in your very old age you’re still creating content and educating people... We have modern-day elders, or grandfluencers as you said, and I appreciate that you continue doing that work.” — Sam Believ

Resources mentioned

• LaWayra Ayahuasca Retreat — Sam’s retreat, also reachable at lawayra.com

• Ayahuasca Podcast with Sam Believ — long-form conversations on plant medicine, available on Apple, Spotify, iHeart, and Amazon Music

• The Adverse Effects and Therapeutic Potential of Psychedelic Medicines by Dr. Richard Louis Miller (Park Street Press / Inner Traditions, May 5, 2026) — [pre-order link]

• Psychedelic Medicine (2017) and Psychedelic Wisdom (2022), Richard’s prior two psychedelics titles

• Master Your Mind, Richard’s most recent book

• Rick Doblin — founder of MAPS, upcoming guest on Sam’s podcast

• Dennis McKenna — ethnopharmacologist, past guest on Sam’s podcast

• Gabor Maté — physician and author, past guest on Sam’s podcast

• Richard Evans Schultes — Harvard ethnobotanist whose Colombian expeditions helped introduce ayahuasca to the West

• The Yajé Letters — Burroughs and Ginsberg, 1963

• Mind, Body, Health and Politics archive at mindbodyhealthpolitics.org — 21 years, open source

• Housing First Finland via the Y-Foundation and Washington state’s 1811 Eastlake project

I grew up in Manhattan. I lived in an eleven story building and rode the elevator every day to school.

In all those years, the people in that elevator never talked to each other. Everybody faced forward. Maybe a small hello. I didn’t know the people living on my own floor.

This is how many of us live now. Close together and completely alone.

This week, I spoke with Dr. Ellen Vora, a psychiatrist in Greenwich Village, about anxiety, grief, and something that stopped me in my tracks.

She and her family live what she calls an urban commune.

Two families, a short walk apart, sharing life together. They take the children to school together. They cook and eat together four nights a week. They shop together. They clean up together.

I asked her what those dinners feel like.

She said, “It’s the best.”

Ellen also shared a practice I’ve been thinking about since our conversation.

She takes thirty seconds, many times a day, to pause and set an intention to be of service. Not asking for something. Just a quiet moment of direction.

Ten times a day.

That’s thousands of moments over time.

A little something over time is a lot of something.

That is the same principle I teach with conscious breathing.

We also talked about anxiety.

She makes a distinction I find very useful. There is false anxiety and there is true anxiety.

False anxiety comes from the body being out of balance. Poor sleep. Blood sugar swings. Inflammation. Too much stimulation.

True anxiety is a signal. It is your system telling you that something in your life needs attention.

Most people treat all anxiety the same. She does not.

She said something simple that stayed with me.

“You’re never stuck. It is not hopeless. Sometimes you need to find a different path.”

In our conversation we explore:

• why anxiety is not a fixed condition
• how the body plays a larger role than most people realize
• the urban commune and what it offers for connection
• small daily practices that change how we feel
• and the importance of staying open to different ways of healing

If there is one thing I would leave you with this week, it is this.

Try one small act of connection.

Call someone. Say hello. Sit quietly for a moment and set an intention.

Connection is medicine.

Golden light,
Dr. Richard L. Miller

About the guest

Dr. Ellen Vora is a board-certified psychiatrist, acupuncturist, and yoga teacher based in Greenwich Village, New York City. She is the author of The Anatomy of Anxiety and her second book, Season of the Witch: A Psychiatrist's Case for Magic, comes out in October 2026.

Links & Resources:

Website: ellenvora.com
Instagram: instagram.com/ellenvora

1-minute mind control

Traditional mindfulness and meditation techniques often require a huge investment of your most precious resource (time) without guarantees of results.

My own version of mindfulness—what I sometimes refer to as “mind control”—can be mastered in much less time if you commit to regular 60-90 second practice throughout the day.

Buy the book

Breathing. Witnessing. Changing the channel on negative thoughts.

I’ve honed these techniques over a lifetime of personal and professional practice, and now I’m sharing them with the world.

Get my new book Master Your Mind, and as a thank you for your support, I’ll give you a free 30-day subscription to our premium newsletter and exclusive content. Just reply to this email after you buy it to confirm your purchase.

Work with Me

After six decades as a practicing psychotherapist, I'm offering limited opportunities to work directly with me. I bring extensive experience addressing anxiety, depression, trauma, relationship challenges, addiction, and psychedelic integration.

Book a Session Here

1. One-to-one sessions - Individual therapy tailored to your specific needs and goals. To request an appointment, book a session here.

2. Group Therapy (waitlist) - Join a small, curated group dedicated to personal growth. You’ll tap into community support, learn from others’ experiences, and develop practical tools for lasting transformation. Reserve your spot.

3. Support my work with a founding subscription ($295) and get a complimentary 30-minute consultation, in addition to a hardback copy of Master Your Mind and full access to my premium content. Sign-up here:

My Other Books:

• Psychedelic Medicine at the End of Life: Dying Without Fear

• Freeing Sexuality: Psychologists, Consent Teachers, Polyamory Experts, and Sex Workers Speak Out

• Psychedelic Wisdom: The Astonishing Rewards of Mind-Altering Substances

• Psychedelic Medicine: The Healing Powers of LSD, MDMA, Psilocybin, and Ayahuasca

• Integral Psychedelic Therapy (co-edited with Jason A. Butler & Genesee Herzberg)

The mind is a powerful tool.

And if we’re not careful, it can work against us.

It can criticize.
It can replay the past.
It can create stories that make us feel worse than we need to.

But we can learn to work with it.

What follows is a short do-list.
5 ways I keep my mind working for me.

1. I take responsibility for what goes on inside me.
   Thoughts and moods don’t come from the room around me. They arise within. Once I understood that, I stopped waiting for the world to change and began working with what was happening inside.

2. I change the channel when my mind turns negative.
   If the mind starts criticizing, I don’t stay there. I shift it. I think of something supportive. A memory I enjoy. A moment that brings ease. The mind will talk — I decide what it talks about.

3. I let failure move me forward.
   Failure is part of succeeding. We try, we miss, we learn, and we try again. Staying in motion matters more than getting it right the first time.

   

4. I give myself something to feel grateful for.
   Gratitude changes the tone of a day. I take a moment to recognize something I have, something I experienced, or someone in my life. Feeling it, even briefly, makes life feel more complete.

5. I make small choices that support my life.
   Sometimes it’s as simple as parking further away and taking the walk. Small decisions, repeated over time, support the body and the mind in quiet ways.

There is something important to remember:

You are the boss of your mind.

It is your tool — not your master.

I don’t claim mastery of this.
I practice.
I forget.
I begin again.

Today, notice what your mind is doing —
and gently guide it in a better direction.

If you wish, you’re welcome to write back and share what you’re working on.

Golden Light,

Dr. Richard Louis Miller

A note on working together

For those who feel drawn to working together more directly, I offer a limited number of one-on-one conversations.

These are not traditional therapy sessions. They are quiet, practical conversations focused on calming the mind, easing anxiety, and working with simple tools that support steadiness in daily life.

We move at a thoughtful pace. We work with what’s present. We focus on what helps.

If you’d like to learn more about working together one-on-one, you’re welcome to reply to this email and my team will share additional details.

Learn more

1-minute mind control

Traditional mindfulness and meditation techniques often require a huge investment of your most precious resource (time) without guarantees of results.

My own version of mindfulness—what I sometimes refer to as “mind control”—can be mastered in much less time if you commit to regular 60-90 second practice throughout the day.

Learn more

Breathing. Witnessing. Changing the channel on negative thoughts.

I’ve honed these techniques over a lifetime of personal and professional practice, and now I’m sharing them with the world.

Get my book Master Your Mind, and as a thank you for your support, I’ll give you a free 30-day subscription to our premium newsletter and exclusive content. Just reply to this email after you buy it to confirm your purchase.

My Other Books:

• Psychedelic Medicine at the End of Life: Dying Without Fear

• Freeing Sexuality: Psychologists, Consent Teachers, Polyamory Experts, and Sex Workers Speak Out

• Psychedelic Wisdom: The Astonishing Rewards of Mind-Altering Substances

• Psychedelic Medicine: The Healing Powers of LSD, MDMA, Psilocybin, and Ayahuasca

• Integral Psychedelic Therapy (co-edited with Jason A. Butler & Genesee Herzberg)

At eighty-seven, I’ve come to trust something simple:

Change does not come from intensity.

It comes from repetition.

What looks like a breakthrough is usually something much quieter — a small action, returned to again and again, until it becomes part of you.

What follows is a short do-list.
5 ways I change my life without overwhelming myself

1. I make the first step small enough to begin.
   When something feels difficult, I reduce the size of the task. A short walk. A few minutes. One small action. Beginning matters more than the size of the effort, because starting is what creates movement.

2. I return to the same action again and again.
   The value is not in doing something once. It is in coming back to it. Repetition builds familiarity, and familiarity turns effort into something natural

   

   A photo of me at the Empress by Boon in SF, celebrating my birthday the night before surgery at UCSF Medical.

3. I practice on myself first.
   Before sharing anything with others, I live it. What works in real life is what I trust. This keeps things grounded and practical.

4. I give change time to accumulate.
   Results are often quiet at first. Days layer into weeks, and weeks into something noticeable. Change builds gradually, even when it feels like nothing is happening.

5. I keep things simple enough to continue.
   When something is simple, I can return to it. When it is complicated, I avoid it. Simplicity supports consistency, and consistency carries change forward.

There is something important to remember:

A little over time is a lot.

I don’t claim mastery of this.
I practice.
I forget.
I begin again.

Choose one small action today —
and return to it again tomorrow.

If you wish, you’re welcome to write back and share what you’re working on.

Golden Light,

Dr. Richard Louis Miller

A note on working together

For those who feel drawn to working together more directly, I offer a limited number of one-on-one conversations.

These are not traditional therapy sessions. They are quiet, practical conversations focused on calming the mind, easing anxiety, and working with simple tools that support steadiness in daily life.

We move at a thoughtful pace. We work with what’s present. We focus on what helps.

If you’d like to learn more about working together one-on-one, you’re welcome to reply to this email and my team will share additional details.

Learn more

1-minute mind control (my latest book)

Traditional mindfulness and meditation techniques often require a huge investment of your most precious resource (time) without guarantees of results.

My own version of mindfulness—what I sometimes refer to as “mind control”—can be mastered in much less time if you commit to regular 60-90 second practice throughout the day.

Learn more

Breathing. Witnessing. Changing the channel on negative thoughts.

I’ve honed these techniques over a lifetime of personal and professional practice, and now I’m sharing them with the world.

Get my new book Master Your Mind, and as a thank you for your support, I’ll give you a free 30-day subscription to our premium newsletter and exclusive content. Just reply to this email after you buy it to confirm your purchase.

My Other Books:

• Psychedelic Medicine at the End of Life: Dying Without Fear (release date: November 5)

• Freeing Sexuality: Psychologists, Consent Teachers, Polyamory Experts, and Sex Workers Speak Out

• Psychedelic Wisdom: The Astonishing Rewards of Mind-Altering Substances

• Psychedelic Medicine: The Healing Powers of LSD, MDMA, Psilocybin, and Ayahuasca

• Integral Psychedelic Therapy (co-edited with Jason A. Butler & Genesee Herzberg)

This week’s conversation brought together two issues that concern me deeply.

The first is the growing epidemic of loneliness, isolation, and mental suffering.
The second is the urgent need for better treatments.

I spoke with Tania De Jong, who joined me from Australia, where she and her colleagues have helped bring psychedelic assisted therapies into legal clinical practice for treatment resistant depression and post traumatic stress disorder.

What moved me most was not just the science.

It was the sense of real hope.

Tania spoke about people who have suffered for years, sometimes decades, trying antidepressants, psychotherapy, and every other available treatment, only to find little or no relief. And now, at last, some of those same people are beginning to experience genuine healing.

As she put it,

It’s our birthright to have the experience of being on this planet and experience the magical beauty that is here rather than the immense suffering that so many people experience every single day of their lives.

In our conversation we discuss:

• Why Australia has become a leader in psychedelic assisted therapies
• the striking difference between current remission rates and what these new treatments are making possible
• why the medicine and the therapy must work together
• the dangers created when healing is forced underground
• the importance of trained guides, clean medicine, and proper integration
• what indigenous wisdom still has to teach us about healing and consciousness
• why singing together, like healing together, can reconnect us to tribe
• and why isolation may be one of the deepest illnesses of our time

What stayed with me after the interview was something larger.

Healing is not only about chemistry.
It is also about connection.

Connection to self.
Connection to others.
Connection to meaning.
Connection to life itself.

If this episode interests you, I think you’ll find it both encouraging and thought-provoking.

Golden light,
Dr. Richard L. Miller

About the guest

Tania De Jong AM is one of Australia’s leading social entrepreneurs and innovators. She is a co-founder of Mind Medicine Australia, an international speaker on wellbeing, creativity, leadership, and psychedelic assisted therapies, and a multi award winning singer whose work centers on healing, connection, and human flourishing.

Links & Resources:

Website: taniadejong.com
Facebook: facebook.com/taniadejongam
Instagram: instagram.com/taniadejongam
LinkedIn: au.linkedin.com/in/taniadejong
X: twitter.com/TaniadeJong
YouTube: youtube.com/@taniadejong.creativeuniverse

1-minute mind control (my latest book)

Traditional mindfulness and meditation techniques often require a huge investment of your most precious resource (time) without guarantees of results.

My own version of mindfulness—what I sometimes refer to as “mind control”—can be mastered in much less time if you commit to regular 60-90 second practice throughout the day.

Buy the book

Breathing. Witnessing. Changing the channel on negative thoughts.

I’ve honed these techniques over a lifetime of personal and professional practice, and now I’m sharing them with the world.

Get my new book Master Your Mind, and as a thank you for your support, I’ll give you a free 30-day subscription to our premium newsletter and exclusive content. Just reply to this email after you buy it to confirm your purchase.

Work with Me

After six decades as a practicing psychotherapist, I'm offering limited opportunities to work directly with me. I bring extensive experience addressing anxiety, depression, trauma, relationship challenges, addiction, and psychedelic integration.

Book a Session Here

1. One-to-one sessions - Individual therapy tailored to your specific needs and goals. To request an appointment, book a session here.

2. Group Therapy (waitlist) - Join a small, curated group dedicated to personal growth. You’ll tap into community support, learn from others’ experiences, and develop practical tools for lasting transformation. Reserve your spot.

3. Support my work with a founding subscription ($295) and get a complimentary 30-minute consultation, in addition to a hardback copy of Master Your Mind and full access to my premium content. Sign-up here:

My Other Books:

• Psychedelic Medicine at the End of Life: Dying Without Fear (release date: November 5)

• Freeing Sexuality: Psychologists, Consent Teachers, Polyamory Experts, and Sex Workers Speak Out

• Psychedelic Wisdom: The Astonishing Rewards of Mind-Altering Substances

• Psychedelic Medicine: The Healing Powers of LSD, MDMA, Psilocybin, and Ayahuasca

• Integral Psychedelic Therapy (co-edited with Jason A. Butler & Genesee Herzberg)

At eighty-seven, one realization has changed my life more than almost anything else:

Mood is not something that happens to me.

It is something I practice creating.

For much of my life I believed my mood came from the world around me —
from circumstances, from people, from events.

But over time I learned something different.

Much of a day’s emotional tone comes from within.

What follows is a short do-list.
Five ways I work with my mood when the day begins to go sideways.

1. I decide on my mood before the day begins.
   When I wake up, I pause for a moment and ask myself: What mood would I like to live in today?
   Then I begin the day with that tone in mind.

2. I reset my mood during the day.
   Moods drift. That’s natural. When I notice myself slipping into a state I don’t enjoy, I close my eyes for a moment, breathe, and choose again.

3. I watch what I say to myself.
   The mind records everything it hears.
   If I criticize myself repeatedly, those words accumulate.
   If I speak with encouragement and kindness, those words accumulate as well.

   

4. I pause before responding.
   Reacting happens quickly. Responding happens thoughtfully.
   A short pause often allows a calmer and wiser response to emerge.

5. I stabilize my body before I change my mood.
   When emotions rise, I start with the body.
   A few slow breaths from the abdomen calm the nervous system and steady the mind. Once the body settles, choosing a different mood becomes much easier.

There is something remarkable about being human:

We have influence over the tone of our inner life.

Not perfect control. But real influence.

I don’t claim mastery of this.
I practice.
I forget.
I begin again.

Today, take one moment to notice your mood.

If you wish, choose the one you would like to live in — and step into it.

If you feel inclined, you’re welcome to write back and share how it goes.

Golden Light,

Dr. Richard Louis Miller

A note on working together

For those who feel drawn to working together more directly, I offer a limited number of one-on-one conversations.

These are not traditional therapy sessions. They are quiet, practical conversations focused on calming the mind, easing anxiety, and working with simple tools that support steadiness in daily life.

We move at a thoughtful pace. We work with what’s present. We focus on what helps.

If you’d like to learn more about working together one-on-one, you’re welcome to reply to this email and my team will share additional details.

Learn more

1-minute mind control (my latest book)

Traditional mindfulness and meditation techniques often require a huge investment of your most precious resource (time) without guarantees of results.

My own version of mindfulness—what I sometimes refer to as “mind control”—can be mastered in much less time if you commit to regular 60-90 second practice throughout the day.

Learn more

Breathing. Witnessing. Changing the channel on negative thoughts.

I’ve honed these techniques over a lifetime of personal and professional practice, and now I’m sharing them with the world.

Get my new book Master Your Mind, and as a thank you for your support, I’ll give you a free 30-day subscription to our premium newsletter and exclusive content. Just reply to this email after you buy it to confirm your purchase.

My Other Books:

• Psychedelic Medicine at the End of Life: Dying Without Fear (release date: November 5)

• Freeing Sexuality: Psychologists, Consent Teachers, Polyamory Experts, and Sex Workers Speak Out

• Psychedelic Wisdom: The Astonishing Rewards of Mind-Altering Substances

• Psychedelic Medicine: The Healing Powers of LSD, MDMA, Psilocybin, and Ayahuasca

• Integral Psychedelic Therapy (co-edited with Jason A. Butler & Genesee Herzberg)

Dear friends,

This week, I had the pleasure of joining Jock Putney on The Pathway to Peak Performance podcast for a conversation about health, resilience, and the simple ideas that have guided my work for decades.

In the episode I talk about:

• The motorcycle accident in which I was run over by a 6,000-pound Winnebago and how conscious breathing helped save my life and my legs

• Why our culture’s approach to health is failing and the simple “gasoline” analogy I use to explain metabolism and nutrition

• How tiny increments can take someone from a sedentary lifestyle to walking, jogging, and even running marathons

• The importance of learning to treat the brain as a tool rather than letting every thought run your life

• The emerging role of psychedelic medicines like MDMA and psilocybin in modern therapy

• My thoughts on where human intelligence may be heading as technology and consciousness continue to evolve together

One of the central themes of our conversation was conscious breathing.

It is one of the simplest tools we have, and one of the most powerful. It helped save my life during a traumatic accident, and it remains a practice I teach to anyone seeking greater calm, resilience, and clarity.

If there is one lesson that runs through this entire conversation, it is this:

A little something, practiced consistently, even something as simple as conscious breathing, can change the course of a life.

Golden light,
Richard

A note on working together

For those who feel drawn to working together more directly, I offer a limited number of one-on-one conversations.

These are not traditional therapy sessions. They are quiet, practical conversations focused on calming the mind, easing anxiety, and working with simple tools that support steadiness in daily life.

We move at a thoughtful pace. We work with what’s present. We focus on what helps.

If you’d like to learn more about working together one-on-one, you’re welcome to reply to this email and my team will share additional details.

Learn more

1-minute mind control (my latest book)

Traditional mindfulness and meditation techniques often require a huge investment of your most precious resource (time) without guarantees of results.

My own version of mindfulness—what I sometimes refer to as “mind control”—can be mastered in much less time if you commit to regular 60-90 second practice throughout the day.

Learn more

Breathing. Witnessing. Changing the channel on negative thoughts.

I’ve honed these techniques over a lifetime of personal and professional practice, and now I’m sharing them with the world.

Get my new book Master Your Mind, and as a thank you for your support, I’ll give you a free 30-day subscription to our premium newsletter and exclusive content. Just reply to this email after you buy it to confirm your purchase.

My Other Books:

• Psychedelic Medicine at the End of Life: Dying Without Fear (release date: November 5)

• Freeing Sexuality: Psychologists, Consent Teachers, Polyamory Experts, and Sex Workers Speak Out

• Psychedelic Wisdom: The Astonishing Rewards of Mind-Altering Substances

• Psychedelic Medicine: The Healing Powers of LSD, MDMA, Psilocybin, and Ayahuasca

• Integral Psychedelic Therapy (co-edited with Jason A. Butler & Genesee Herzberg)

I recently read something that saddened me.

A professor posted that exercise may increase lifespan. But many of the comments underneath said:

“Why would I want to live longer?”
“The world is terrible.”
“What’s the point?”

I’m 87 years old, and I see it differently.

The gift of being here is the gift.

None of us are guaranteed a perfect hand. Some inherit comfort, others difficulty. But what we do with the hand we’re dealt still matters.

For over fifty years I’ve been advocating some simple practices that make life feel better:

• exercise that lifts mood through endorphins
• clean food, clean water, and clean air
• good sleep and conscious breathing
• friendship, family, and community

Exercise alone can change the entire tone of a day. Thirty minutes can create hours of endorphin release — a natural lift that makes the world look more manageable.

Life isn’t perfect.

But it can still be deeply worthwhile.

And as Cicero reminded us two thousand years ago:

“If you see a stranger on the road, be kind to him — he is going through what you are going through.”

We’re all in this together.

Golden light,
Dr. Richard L. Miller

A note on working together

For those who feel drawn to working together more directly, I offer a limited number of one-on-one conversations.

These are not traditional therapy sessions. They are quiet, practical conversations focused on calming the mind, easing anxiety, and working with simple tools that support steadiness in daily life.

We move at a thoughtful pace. We work with what’s present. We focus on what helps.

If you’d like to learn more about working together one-on-one, you’re welcome to reply to this email and my team will share additional details.

Learn More

1-minute mind control (my latest book)

Traditional mindfulness and meditation techniques often require a huge investment of your most precious resource (time) without guarantees of results.

My own version of mindfulness—what I sometimes refer to as “mind control”—can be mastered in much less time if you commit to regular 60-90 second practice throughout the day.

Learn More

Breathing. Witnessing. Changing the channel on negative thoughts.

I’ve honed these techniques over a lifetime of personal and professional practice, and now I’m sharing them with the world.

Get my new book Master Your Mind, and as a thank you for your support, I’ll give you a free 30-day subscription to our premium newsletter and exclusive content. Just reply to this email after you buy it to confirm your purchase.

Work with Me

After six decades as a practicing psychotherapist, I'm offering limited opportunities to work directly with me. I bring extensive experience addressing anxiety, depression, trauma, relationship challenges, addiction, and psychedelic integration.

Book a Session Here

1. One-to-one sessions - Individual therapy tailored to your specific needs and goals. To request an appointment, book a session here.

2. Group Therapy (waitlist) - Join a small, curated group dedicated to personal growth. You’ll tap into community support, learn from others’ experiences, and develop practical tools for lasting transformation. Reserve your spot.

3. Support my work with a founding subscription ($295) and get a complimentary 30-minute consultation, in addition to a hardback copy of Master Your Mind and full access to my premium content. Sign-up here:

My Other Books:

• Psychedelic Medicine at the End of Life: Dying Without Fear (release date: November 5)

• Freeing Sexuality: Psychologists, Consent Teachers, Polyamory Experts, and Sex Workers Speak Out

• Psychedelic Wisdom: The Astonishing Rewards of Mind-Altering Substances

• Psychedelic Medicine: The Healing Powers of LSD, MDMA, Psilocybin, and Ayahuasca

• Integral Psychedelic Therapy (co-edited with Jason A. Butler & Genesee Herzberg)

At eighty-seven, one of my deepest concerns is this:

Loneliness has become a quiet epidemic.

We live closer together than ever.
We communicate faster than ever.
And yet many people feel alone.

Isolation. Alienation. Disconnection.

These affect the body and the spirit.

What follows is a short do-list.
5 ways I work with loneliness to stay connected and alive.

1. I make one phone call each week.
   No agenda. No request. Just, “I wanted to say hello.”
   One call can dissolve a surprising amount of distance.

2. I introduce myself wherever I go.
   The person at the market. The pharmacist. A neighbor. “Hi, my name is Richard.”
   Names matter. A name exchanged brings two human beings slightly closer.

3. I treat daily life as tribal life.
   For many of us, work is where we spend most of our waking hours. Those people are our social circle. When we engage there — when we show warmth there — loneliness shrinks.

   

4. I schedule what makes me happy.
   I ask myself: What three things truly make me happy?
   A cuddle time with my dog. A long conversation with a friend. Listening to music I love.
   Then I make sure I do them. Happiness grows when it is acted upon.

5. I remember that connection is medicine.
   We are designed for proximity, conversation, shared meals, and shared laughter. Human contact strengthens the nervous system and steadies the mind.

There is something simple underneath all of this:

The difference between doing nothing and taking one small action
is the difference between night and day.

I don’t claim mastery of this.
I practice.
I forget.
I begin again.

This week, make one call.
Introduce yourself once.
Do one thing that brings you genuine happiness.

If you wish, you’re welcome to write back and tell me what you chose.

Golden Light,

Dr. Richard Louis Miller

A note on working together

For those who feel drawn to working together more directly, I offer a limited number of one-on-one conversations.

These are not traditional therapy sessions. They are quiet, practical conversations focused on calming the mind, easing anxiety, and working with simple tools that support steadiness in daily life.

We move at a thoughtful pace. We work with what’s present. We focus on what helps.

If you’d like to learn more about working together one-on-one, you’re welcome to reply to this email and my team will share additional details.

Learn more

1-minute mind control (my latest book)

Traditional mindfulness and meditation techniques often require a huge investment of your most precious resource (time) without guarantees of results.

My own version of mindfulness—what I sometimes refer to as “mind control”—can be mastered in much less time if you commit to regular 60-90 second practice throughout the day.

Learn more

Breathing. Witnessing. Changing the channel on negative thoughts.

I’ve honed these techniques over a lifetime of personal and professional practice, and now I’m sharing them with the world.

Get my new book Master Your Mind, and as a thank you for your support, I’ll give you a free 30-day subscription to our premium newsletter and exclusive content. Just reply to this email after you buy it to confirm your purchase.

My Other Books:

• Psychedelic Medicine at the End of Life: Dying Without Fear (release date: November 5)

• Freeing Sexuality: Psychologists, Consent Teachers, Polyamory Experts, and Sex Workers Speak Out

• Psychedelic Wisdom: The Astonishing Rewards of Mind-Altering Substances

• Psychedelic Medicine: The Healing Powers of LSD, MDMA, Psilocybin, and Ayahuasca

• Integral Psychedelic Therapy (co-edited with Jason A. Butler & Genesee Herzberg)

Most people are chasing a future moment when they’ll finally feel okay.

A different job.
More money.
Less stress.
A quieter mind.

But as Light Watkins reminds us in this week’s episode, the internal state rarely changes just because the external circumstances do.

It changes when we learn to regulate the nervous system and cultivate presence.

As Light put it,

“The only Zen you’ll find at the top of the mountain is the Zen you bring up there with you.”

In this conversation, we explore what presence actually looks like in real life and why inner work is less mystical and more practical than most people imagine.

We talk about:

• why stress chemistry pulls us out of the moment
• how rest regulates the nervous system
• why some people sleep eight hours and still wake up exhausted
• how stress thinking differs from creative thinking
• why stress can sabotage intimacy and connection
• why meditation is not about forcing focus
• how to begin with one minute and build consistency
• how simple walking habits compound over time
• why happiness has best practices, just like physical fitness

If you’ve been feeling scattered, fatigued, or trapped in your own thoughts, this episode may help you understand why.

You don’t need a different life.

You may simply need a different internal state.

Golden light,
Dr. Richard L. Miller

Links & Resources:

• About Light Watkins

• Light Watkins Latest Book

1-minute mind control (my latest book)

Traditional mindfulness and meditation techniques often require a huge investment of your most precious resource (time) without guarantees of results.

My own version of mindfulness—what I sometimes refer to as “mind control”—can be mastered in much less time if you commit to regular 60-90 second practice throughout the day.

Buy the book

Breathing. Witnessing. Changing the channel on negative thoughts.

I’ve honed these techniques over a lifetime of personal and professional practice, and now I’m sharing them with the world.

Get my new book Master Your Mind, and as a thank you for your support, I’ll give you a free 30-day subscription to our premium newsletter and exclusive content. Just reply to this email after you buy it to confirm your purchase.

Work with Me

After six decades as a practicing psychotherapist, I'm offering limited opportunities to work directly with me. I bring extensive experience addressing anxiety, depression, trauma, relationship challenges, addiction, and psychedelic integration.

Book a Session Here

1. One-to-one sessions - Individual therapy tailored to your specific needs and goals. To request an appointment, book a session here.

2. Group Therapy (waitlist) - Join a small, curated group dedicated to personal growth. You’ll tap into community support, learn from others’ experiences, and develop practical tools for lasting transformation. Reserve your spot.

3. Support my work with a founding subscription ($295) and get a complimentary 30-minute consultation, in addition to a hardback copy of Master Your Mind and full access to my premium content. Sign-up here:

My Other Books:

• Psychedelic Medicine at the End of Life: Dying Without Fear (release date: November 5)

• Freeing Sexuality: Psychologists, Consent Teachers, Polyamory Experts, and Sex Workers Speak Out

• Psychedelic Wisdom: The Astonishing Rewards of Mind-Altering Substances

• Psychedelic Medicine: The Healing Powers of LSD, MDMA, Psilocybin, and Ayahuasca

• Integral Psychedelic Therapy (co-edited with Jason A. Butler & Genesee Herzberg)

At eighty-seven, I’ve lived long enough to know this:

The world does not calm down.
We calm ourselves down.

There is always a new reason to worry.
A new headline.
A new prediction.

And yet, there is also always a choice.

What follows is a short do-list.
5 things I do when the world feels overwhelming

1. I remember that external events do not control my inner life.
   Marcus Aurelius taught this two thousand years ago. Circumstances may shift, but feelings arise inside. Thoughts arise inside. I work on the inner computer. That is where my power lives.

2. I lower fear in order to protect my health.
   Fear spreads quickly. It turns people against one another. It clouds judgment. I ask myself a simple question: What good does walking around afraid do for me today? Then I return to what I can do right now with clarity.

3. I strengthen the connection to make the day good.
   Old friendships are gold in the bank. Family ties matter. A phone call can restore warmth. When we gather, eat together, laugh together, the day improves regardless of what is happening in the larger world.

A photo of me and my daughter, Evacheska.

4. I invest in the fundamentals in order to support longevity.
   Movement. Mostly plants. Enough sleep. A sense of purpose. Upbeat company. These are not glamorous ideas. They are powerful ones. The basics build resilience.

5. I take 60-second resets in order to stabilize the mind.
   Several times a day, I pause. I close my eyes. I breathe consciously. Sixty or ninety seconds. The investment is small. The return is immediate. Every time I do it, I feel steadier.

There is one more thing.

We are given a remarkable birthright as human beings:

The ability to influence our thoughts.

I don’t claim mastery of this.
I practice.
I forget.
I begin again.

Today, choose one of these and put it into action.

If you wish, you’re welcome to write back and share which one you’re working with.

Golden Light,

Dr. Richard Louis Miller

A note on working together

For those who feel drawn to working together more directly, I offer a limited number of one-on-one conversations.

These are not traditional therapy sessions. They are quiet, practical conversations focused on calming the mind, easing anxiety, and working with simple tools that support steadiness in daily life.

We move at a thoughtful pace. We work with what’s present. We focus on what helps.

If you’d like to learn more about working together one-on-one, you’re welcome to reply to this email and my team will share additional details.

Learn more

1-minute mind control (my latest book)

Traditional mindfulness and meditation techniques often require a huge investment of your most precious resource (time) without guarantees of results.

My own version of mindfulness—what I sometimes refer to as “mind control”—can be mastered in much less time if you commit to regular 60-90 second practice throughout the day.

Learn more

Breathing. Witnessing. Changing the channel on negative thoughts.

I’ve honed these techniques over a lifetime of personal and professional practice, and now I’m sharing them with the world.

Get my new book Master Your Mind, and as a thank you for your support, I’ll give you a free 30-day subscription to our premium newsletter and exclusive content. Just reply to this email after you buy it to confirm your purchase.

My Other Books:

• Psychedelic Medicine at the End of Life: Dying Without Fear (release date: November 5)

• Freeing Sexuality: Psychologists, Consent Teachers, Polyamory Experts, and Sex Workers Speak Out

• Psychedelic Wisdom: The Astonishing Rewards of Mind-Altering Substances

• Psychedelic Medicine: The Healing Powers of LSD, MDMA, Psilocybin, and Ayahuasca

• Integral Psychedelic Therapy (co-edited with Jason A. Butler & Genesee Herzberg)

Psychedelics are not going away.

Millions of people are using them, whether the medical establishment approves or not. So the real question is no longer if people will experiment. The real question is simple:

As Dr. Daniel Kruger puts it,

“Abstinence doesn’t work for everyone. If people are going to do this, we have an obligation to help keep them as safe as possible.”

In this week’s episode, I’m joined by Dr. Kruger from the University of Michigan to discuss new research on adverse psychedelic experiences and what practical safety actually looks like.

We talked about:

• how common adverse experiences really are

• why fear, sadness, or anxiety may arise during a journey

• the difference between temporary discomfort and serious distress

• why set and setting are safeguards, not slogans

• the difference between self-experimentation and psychedelic-assisted psychotherapy

• how a challenging experience can become therapeutic with proper guidance

• why testing powders and pills matters

• why ketamine without therapy often misses the point

My position is straightforward.

If people are going to explore these substances, and many are, they deserve honest information. Not scare tactics. Not hype.

Safety. Preparation. Responsibility.

That is how we get this right.

Golden light,
Dr. Richard L. Miller

Links & Resources:

• Dr. Daniel Kruger’s Website

1-minute mind control (my latest book)

Traditional mindfulness and meditation techniques often require a huge investment of your most precious resource (time) without guarantees of results.

My own version of mindfulness—what I sometimes refer to as “mind control”—can be mastered in much less time if you commit to regular 60-90 second practice throughout the day.

Buy the book

Breathing. Witnessing. Changing the channel on negative thoughts.

I’ve honed these techniques over a lifetime of personal and professional practice, and now I’m sharing them with the world.

Get my new book Master Your Mind, and as a thank you for your support, I’ll give you a free 30-day subscription to our premium newsletter and exclusive content. Just reply to this email after you buy it to confirm your purchase.

Work with Me

After six decades as a practicing psychotherapist, I'm offering limited opportunities to work directly with me. I bring extensive experience addressing anxiety, depression, trauma, relationship challenges, addiction, and psychedelic integration.

Book a Session Here

1. One-to-one sessions - Individual therapy tailored to your specific needs and goals. To request an appointment, book a session here.

2. Group Therapy (waitlist) - Join a small, curated group dedicated to personal growth. You’ll tap into community support, learn from others’ experiences, and develop practical tools for lasting transformation. Reserve your spot.

3. Support my work with a founding subscription ($295) and get a complimentary 30-minute consultation, in addition to a hardback copy of Master Your Mind and full access to my premium content. Sign-up here:

My Other Books:

• Psychedelic Medicine at the End of Life: Dying Without Fear (release date: November 5)

• Freeing Sexuality: Psychologists, Consent Teachers, Polyamory Experts, and Sex Workers Speak Out

• Psychedelic Wisdom: The Astonishing Rewards of Mind-Altering Substances

• Psychedelic Medicine: The Healing Powers of LSD, MDMA, Psilocybin, and Ayahuasca

• Integral Psychedelic Therapy (co-edited with Jason A. Butler & Genesee Herzberg)

Happy Valentine’s Day.

At eighty-seven, I’ve come to understand a profound truth about love:

It grows through action.

Not through grand gestures or a single holiday, but through small, steady expressions.

What follows is a short do-list.
3 ways I practice love in order to feel more connected and alive.

1. I perform one small loving act each day in order to strengthen the heart.
   One gesture. One kind word. One thoughtful action.
   A smile in the supermarket. A brief phone call. A moment of patience.
   The difference between doing nothing and doing something is immense. One act shifts the tone of a day.

2. I include myself in the circle of love in order to stay balanced.
   Love is not only outward. It also turns inward.
   A gentle touch on the arm. A few kind words spoken privately. A pause to breathe.
   Taking a moment to comfort yourself isn’t selfish. It’s the same care you would offer a dear friend.

   

   3. I reach out in order to build connection.
   A simple call. A short message. A note that says, “I was thinking of you.”
   Connection does not require romance. It requires sincerity.
   A small effort restores warmth in places that may have grown quiet.

There is one more truth that has become clearer to me with age:

Love given helps the giver as much as the one who receives it.

When we act with love, we feel it too.
A small loving act can gently change the way we feel inside.

I don’t claim mastery of this.
I practice.
I forget.
I begin again.

Today, choose one small act of love and carry it out before the day ends.

I’d love to hear from you—reply and share the small act of love you chose today.

Golden Light,

Dr. Richard Louis Miller

A note on working together

For those who feel drawn to working together more directly, I offer a limited number of one-on-one conversations.

These are not traditional therapy sessions. They are quiet, practical conversations focused on calming the mind, easing anxiety, and working with simple tools that support steadiness in daily life.

We move at a thoughtful pace. We work with what’s present. We focus on what helps.

If you’d like to learn more about working together one-on-one, you’re welcome to reply to this email and my team will share additional details.

Learn more

1-minute mind control (my latest book)

Traditional mindfulness and meditation techniques often require a huge investment of your most precious resource (time) without guarantees of results.

My own version of mindfulness—what I sometimes refer to as “mind control”—can be mastered in much less time if you commit to regular 60-90 second practice throughout the day.

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Breathing. Witnessing. Changing the channel on negative thoughts.

I’ve honed these techniques over a lifetime of personal and professional practice, and now I’m sharing them with the world.

Get my new book Master Your Mind, and as a thank you for your support, I’ll give you a free 30-day subscription to our premium newsletter and exclusive content. Just reply to this email after you buy it to confirm your purchase.

My Other Books:

• Psychedelic Medicine at the End of Life: Dying Without Fear (release date: November 5)

• Freeing Sexuality: Psychologists, Consent Teachers, Polyamory Experts, and Sex Workers Speak Out

• Psychedelic Wisdom: The Astonishing Rewards of Mind-Altering Substances

• Psychedelic Medicine: The Healing Powers of LSD, MDMA, Psilocybin, and Ayahuasca

• Integral Psychedelic Therapy (co-edited with Jason A. Butler & Genesee Herzberg)