Promoters are giving us the hard sell for clinics dispensing psychedelic drugs mental health treatment but also for expensive spas where customers can go without a diagnosis of mental disorder and have a guided psychedelic experience.
Newspapers are a key venue for the promoters to make their case to convert laypersons into consumers in what is projected to be a multibillion-dollar industry.
Should newspapers take on this function to signal that their brand is more avante garde than their stodgy competitors? Or is it newspapers’ job to filter the information they are given and take a critical stance in order to protect their readers?
Arecent article is one of a number in the New York Times covering what is claimed to a breakthrough in the acceptance and use of previously illegal drugs.
Click on this link to the article, preferably on a desktop computer to get the full effect.
A Psychedelic Drug Passes a Big Test for PTSD Treatment. A new study shows that MDMA, known as Ecstasy or Molly, can bring relief when paired with talk therapy to those with…www.nytimes.com
You will see the opening of the article displayed as a bold split-screen ribbon that takes over your entire screen display. One blackened side with white font announces the psychedelic drug MDMA has passed a “big test” as a treatment for PTSD.
The other side is a slick photo that has been shot at an upward angle that might be used for the trailer of a Netflix movie being released next week. A caption indicates that the buff traditional male was a patient in the PTSD clinical trial, not a paid actor.
He is quoted as describing the effects of the drug: “Literally I’m a different person.”
Many readers will relax and be entertained by the article. The article is from the Health section of the NY Times. It might fit better in the Leisure or Entertainment sections.
Some readers might be seeking something other than entertainment and might feel cheated.
Once upon a time, I recommended the NY Times as a trustworthy, authoritative go-to place for intelligent laypersons without the skills, time, or resources to evaluate scientific and medical claims for themselves that might impinge on their well-being or wallet. I stopped when I repeatedly saw prominent journalists publishing fawning reports of the products being offered by positive psychology TED talkers and other wellness wannabe advice gurus.
The NY Times journalists were acting like publicists and were not appropriately critical interpreters of what the gurus were trying to sell us.
Let’s analyze this article and see if we should similarly be skeptical about the promotion of psychedelic drugs in the NY Times, but let’s keep the task simple.
We will give a lot of attention to four large, high-quality staged photos.
These photos represent four of the seven named sources who are quoted. I will comment on how the seven are quoted. I will briefly bring in my other reactions.
I am encouraging readers to be skeptical about what is conveyed in the article if they are making any decisions about their health and wellbeing or for what readers should tell others, as on social media.
Scroll below the banner introducing the and you find it the article is about a peer-reviewed report in one of the most prestigious scientific journals, Nature. However, no link is provided to the paper because it is not yet published. We will have to rely on what the journalist tells us about what is in the paper, assisted by the sources she brings into the article.
Some readers might cry foul at this point. They believe that newspaper articles should provide a link to important papers being discussed so that motivated, sophisticated readers can check what is being said in the newspaper.
Savvy readers might even note that scientific journals often protect their own reputation and the lay public from misleading statements in newspapers by placing an embargo on newspaper accounts until the scientific article is published.
Let’s proceed anyway, and decide whether it is a good idea to rely on the NYT article by itself.
The NYT article introduces its Source #1, a neuroscientist at Johns Hopkins University. He gushes that he is “excited as he gets” about a clinical trial and that this trial is like no other.
The journalist assures the readers that Source #1 is credible because he was not an author of the forthcoming Nature report of the trial.
It does not take much of a Google search to find that Johns Hopkins University is the recipient of millions of dollars from foundations like the one that funded the study. You can also search and find an article where I marveled at the capability of Johns Hopkins University to mount a publicity campaign for papers reporting research on psychedelics.
After some more praise of the research, the NYT journalist brings in the first author of the study as Source #2. Describes as a neuroscientist, she informs us of her delight that now is the first time in 50 years that people are willing to consider psychedelics as medical treatments.
This statement is followed by a large photo of Source #2 that is attributed to the NYT, again dominating an entire desktop display of the article. She is dressed in black and wears a floral kerchief that matches a jungle-like backdrop of lots of probably artificial flowers. The photo is striking, but ambiguous in its message. Certainly, the NYT and the author are opting out of portraying the author as a whitecoat investigator of medications.
Next, readers are introduced to Source #3 who is described as an emeritus professor and the former chair of psychiatry at a prestigious medical school. He complains that:
“All new treatments in medicine have always had a temporary halo effect by being new and by promising more than they can deliver.”
That is the signature statement that this particular expert offers all the time in social media. He is known to be critical of overdiagnosis and overmedication of mental health problems. We cannot be sure how this quote came about. There is no indication that the journalist provided him with a copy of the embargoed article by or invited him to make further comment, as would be customary.
The NYT article has at least provided its obligatory dissenting voice before returning to comments of Source #1the first author of the study. She explains that the study was not an evaluation of a drug but a treatment package in which the drug is combined with psychotherapy. She theorizes that the combination allows “the brain to process painful memories and heal itself.”
This explanation is elaborated and amplified by Source #4, the senior (last) author of the paper. He hints the therapy is intensive and demanding and indicates that the patient must be motivated to work on their traumatic experiences to benefit.
The therapy starts before the patient is given the medication or the placebo to prepare the patient for the experience if they are provided the medication, rather than the placebo, Patients are told to expect from the medication, they will quickly know which condition they have been assigned.
Source #4 acknowledges that participants and clinicians should be blinded to the condition the patient is assigned throughout the trial and the final assessment of outcome. This is so the results can be considered unbiased and valid in the Food and Drug Administration approval process. Source #4 dismisses objections that patients quickly becoming unblinded in this study, by simply saying that this is not a problem.
Newspaper accounts routinely quote senior authors about the purpose and results of the clinical trial that they have overseen. Experienced journalists expect senior authors to be boastful and self-congratulatory and may protect readers by challenging the senior author directly or introducing a dissenting expert. However, Source #4 is also the founder of the funding source for the trial and he has raised over $100 million in two years to promote acceptance of the use of psychedelics as medical treatments and in spa treatments.
Normally, representatives of funding sources are not included as authors on papers reporting clinical trials. Instead, the articles acknowledge who funded the trial, but declare that the funding source had no say in the analysis and interpretation of data.
This is not a typical clinical trial and the NYT including commentary from a funding source is not normal.
It is not reassuring that the funding source is a nonprofit corporation, any more than it is reassuring that other sources who are cited are described as not involved in the conduct of the study when their institutions also receive substantial money from similar foundations.
Source #5 is identified as the patient in the study who was introduced in the first banner display that opened the NYT article. He describes the vivid nightmares that dominated his life before the study and how nothing he tried could free him from them. His life was in ruins.
Then, Source #5 described the treatment sessions he received in the trial:
During his first of three sessions in early 2019, lying on a couch with eyeshades, and in a lucid dreamlike state, Mr. Ostrom encountered a spinning, oily black ball. Like an onion, the ball had many layers, each one a memory. At the center, Mr. Ostrom relived the moment in Iraq, he said, that “I became the person I needed to be to survive that combat deployment.” Over the next two sessions, Mr. Ostrom engaged with “the bully,” as he calls his PTSD alter ego, and asked permission for Scott to return.
Source #5 describes how he is now gainfully employed and owns a house, that he shares with a girlfriend and a service dog named Tim.
Readers do not have a basis for disputing Source #5’s personal account of his lived experience of suffering and miraculous cure. Many readers will find it an inspiring story, maybe even suitable for re-telling in a Netflix film.
But skeptics can point out that such vivid, retrospective subjective experiences are not retrieved from their storage as accurate accounts of what happened. Memories are shaped by retelling and suggestions from the later environment. Source #5’s subjective experiences are not generalizable facts, in the sense that we can expect to hear from other persons who suffer from PTSD. Unless we cast aside all skepticism, we cannot accept his accounts as validating the theoretical accounts that proponents of psychedelic treatment want us to believe. After all, the therapists in the study prepared patients to expect certain experiences and coached their interpretations of their experience while under the influence of the drug.
This account is immediately followed by a full-screen photo of the earlier Source #4, the enterprising senior author and creator of the foundation that raised millions for this ambitious initiative.
Let’s put that aside and focus on what the photo conveys.
I see what could be a rented attic apartment. It must be a cheap place, because the wall is stained, perhaps by a serious leak in the roof. There is an air conditioner that is crammed into the window and an inexpensive ventilation fan. The room is quite messy and could use a good cleaning. The man is sitting cross-legged on the floor and vaguely smiling. He is either entertained by what is watching on a vintage TV or oblivious because of his altered state of consciousness.
I do not know what to make of this, except that is a sharp contrast to the portrayal of the first author in her junglelike background and this man as the head of a flourishing nonprofit foundation.
Some seemingly factual information about the history of MDMA follows, interrupted by a cockamamie theoretical orientation of how MDMA-assisted therapy works that cites a mouse study as evidence:
Its primary therapeutic effect may come from its seeming ability to reopen what neuroscientists refer to as a “critical period,” the window during childhood when the brain has the superior ability to make new memories and store them.
Maybe, but who can know? My skepticism is getting the best of me. Anyway, we may be reaching a saturation point in not being able to learn anything new from further exploration of the photos and sources selected for the article.
I should leave readers on their own to form judgments on their own about Source #6, except that I will point out that he is a junior qualitative researcher at Hopkins, of course not an author of the study. I don’t know how he has the expertise to declare that
The findings ‘make a clear case for medical approval,” something that “represents a sea change that could revolutionize health care.’”
I can’t help commenting on Source #7, a patient who says the MDMA-assisted therapy allowed him:
To revisit his traumatic memory through the eyes of his 4-year-old self, unclouded by stigmas, adult interpretations, or heavy emotion.
“This allowed me to accept myself and recognize who I am,” he said.
The final of the four photos depicts Source #7 in a magical forest of tall trees and no underbrush, looking skyward. Perhaps he has found his Own Private Idaho.
“My Own Private Idaho” is an imaginary place where one is locked in the arms of love — that is, both protected and free. It is the promise of America, chronically out of joint with reality, especially for its most vulnerable inhabitants.
The NY Times invested a lot in producing this article so slickly. I am sure the promoters of psychedelics were pleased with what their collaboration and granting of access to patients accomplished. Maybe readers were entertained, but what did they learn?