flashback as a term from what I, when I was looking into the history of the diagnosis of HPPD, it was like flashback was sort of like the sort of quick term to describe HPPD.

Flashback HPPD were the same thing.

And I know that in psychedelic culture right now, and in the research, there's a, there's a complex relationship to that terminology because of how it has been represented, hasn't really been accurate.

And, And like terms like bad trip, I think there's sort of a press back to be like, oh, flashback isn't a thing.

It's just like leftovers from the ignorance of the drug war propaganda against psychedelics and stuff like this.

And I'm wondering if you can comment there about flashbacks and in particular, if you as you're talking about psychedelic flashbacks, what they are, what they're not, how they relate to HPPD, is whether or not, you know, A, it needs to be a psychedelic, such as could it be cannabis, which, I mean, might be counted as a psychedelic, actually, especially depending on high doses, you know, and whether or not it needs to be drug-induced at all, because I know one thing that's going around now in the culture is like, yeah, HPPD is a thing, but it mostly happens.

There's a vast amount of people who get it not associated to drugs.

And so we shouldn't attribute psychedelics to HPPD.

We got to keep this perspective.

We got to keep the brand clean here or something like that.

There's a lot to speak to there, but that's sort of flashbacks and whether or not drugs need to be involved.

Right.

Yeah.

The flashback issue.

You know, the thing is, most people not in the community, so to speak, don't know what psychedelics really are about.

Right.

But I'd say I venture that everyone might mean my family and teachers at school included had heard of flashbacks before.

So it kind of speaks to just how much.

That term, and it's kind of associated, and it is basically a propaganda term, has penetrated how people perceive psychedelics.

But for what it's worth, I was reading about the history of the flashback literature, and before this podcast, it seems to begin with a particular paper by this guy Horowitz in 69.

So this is a couple of years after the summer of love.

LSD use was declining and you're starting to see.

And obviously there was a certain that obviously there was the existing turning tide that about how clinicians thought about psychedelics you know obviously they were initially perceived by many as being very promising captured by the counterculture more uncontrolled settings you start seeing people freaking out um and horowitz i believe based his writing on um people who had gone to the Haight-Ashbury Free Clinic.

So this was a community-run health clinic in the Haight-Ashbury District in San Francisco, which was the epicenter of the psychedelic revolution.

Totally, like epicentral.

Yeah.

And I believe that they had...

If I recall, by 1969, about 50,000 people come in through various different things.

A lot of people coming in having panic reaction to psychedelics, a lot of people with STDs, STIs, people with heroin addiction, methadone addiction, etc.

But some portion of the people who had experimented with psychedelics, when interviewed by Horowitz, reported that, They'd notice certain, let's say, I think that the phrase he uses is spontaneously occurring phenomena.

And so Horowitz and this other guy Schick the following year, they were the two main phenomena.

the two first scientists to document the phenomenon, but I'll start with Horowitz.

So Horowitz's paper, it describes a number of case studies through the Hayes-Ashbury flu clinic.

And it's, it's like clearly colored by a negative lens on psychedelics.

It's, it's, it's, it's very, I mean, it's just perfect for like journalistic copy at the time.

So one case study he describes is this 17 year old who, He seems to have been a pretty eccentric character because he was like, um, Horowitz describes him singing a song of LSD and speed are for me.

Like just singing this song.

Anyway, this guy, uh, taking a lot of trips and he has started noticing quite vivid, uh, pseudo hallucinations of scorpions overrunning his body.

Um, another guy, uh, I believe this is a woman, was having intense sort of prophetic visions of her getting into car crashes.

And Horowitz describes, so it's very wide ranging, the flashback phenomenon.

And then you see Schick come in the following year and he codified three different kinds of flashback.

You had the perceptual flashback, which was, you know, It could include very vivid things like the scorpion guy or the car crash woman, or it could have been spontaneously occurring geometric phenomena.

I didn't see much HPPD-style stuff like visual snow in these papers.

But anyway, so you have the perceptual flashback.

You have the mood flashback.

I heard...

So Schick writes about someone who would just have spontaneous onsets of depressive mood, which she attributed to a particular LSD trip, and he had somatic flashbacks.

From the outset, it was a very broad phenomenon, but the conceptual core of it was the idea of the spontaneous occurrence.

And then flashbacks, as you say, they were captured by...

So...

a certain wing of the drug warrior anti-psychedelic wing um and i was just reading before this about the narconon program which is run by the church of scientology and for what it's worth they've covered they've captured a lot of you know if you look up drug risk online narconon appears all the time i mean in the uk where the church of scientology isn't prominent at all You see their pamphlets being given out, I believe, to schools.

And they related flashbacks to L.

Ron Hubbard's New Life Detoxification Program, where you could clean all the drugs at your system.

You can clean it all out your spine because that was a kind of parallel.

Oh, yeah.

LSD was in your spinal cord and it was like releasing back into your brain.

Right.

You know, I was just at a drink the other day and talking to a friend of mine who was at school in the early 2000s.

And he was saying how in his like drug education classes, they would still parroting this bullshit that LSD accumulates in your spine.

Yeah.

And if you click it in the wrong way, you're going to have a flashback.

So like it's obviously bullshit, but that end of it.

But flashbacks.

So as I say, from the outset, a very broad, fuzzy phenomenon.

And it seems that the emphasis in the clinical literature is to move away from that term, because I mean, if only because it's so because it's so toxic, and it's been so weaponized.

But that said, I mean, I was describing at the start of the podcast that there are two types of HGPD.

You have the type one, which is like the flashback, the spontaneous occurrence.

But, you know, interestingly, in the literature, there's a tendency to describe the type one flashback phenomenon as being positive, which is.

It seems to be a lot of the time, but then other people find their spontaneous flashbacks actually quite distressing.

So maybe that's another room for kind of for evolution and the literature.

But and whether HGPD really...

Whether it really is the same thing, these two types, I'm not sure because there seems to be quite a strong difference between it being an invested feature of your whole way of experiencing the world versus just spontaneity happening.

But I think that's just why we need more research because, I mean, speaking as someone who has read the literature but is still not a scientist, I have no idea.

idea what is going on when you have a spontaneous re-experiencing.

But that said, another question you put in there was, what's the link to psychedelics?

You're absolutely right that HGPD is an unfortunately name disorder because there is no the sole link between these changes and psychedelics.

I mean, people, I mean, psychedelics in and of themselves are such a broad set of drugs.

I mean, you have LSD, you have Ibogaine, you have DMT, you have psilocybin.

I mean, LSD is serotonergic, and dopaminergic psilocybin i believe is just serotonergic but both can create these changes uh salvia can create these changes just cannabis i mean the cannabis hits is not it's it's hitting cannabinoid receptors uh maybe others are not an expert i think it has impact on uh dopamine receptors too but i'm not i'm not up on the right pharmacology of cannabis right Interesting.

OK.

But yeah, so all sorts of drugs can trigger these changes.

I mean, even SSRI antidepressants have been linked to these perceptual changes.

So what does all this suggest?

It suggests on the one hand that...

This is clearly a very complicated phenomenon at the level of neurophysiology that I'm not really an expert to address, but I can maybe outline.

So the original hypothesis by Dr.

Henry Abraham, who was the...

who is the psychiatrist who first codified the condition of HGPD, is that psychedelics caused a surge of electrical current in the brain that damaged certain neurons that kind of control how the brain filters out vision information.

And he links it to the serotonergic system.

But as I just said, like non-serotonergic drugs, non-serotonergic recreational drugs can create these changes.

And the fact that SSRIs can as well.

But even people have had experiences where taking antipsychotics can trigger them.

one but so a potential treatment for hdpd can create the changes themselves independently i've read reports of people taking a certain classes of antibiotics and then having these changes so there's no definitive link to just psychedelics sure and from what i understand there are also people who just have extreme experiences that have nothing to do with any kind of drug and end up having these changes too is that correct Right.

Yeah.

So this is something that's been emphasized by Dr.

Terry Krebs, who is a really valuable voice on this issue, which is that people experience exactly the same kind of visual phenomena.

So, The visual snow, the halos, the auras, the traces were just anxiety.

And from the very limited reading I've done, this might make sense.

even on a neurophysiological level, because anxiety is associated with lower levels of GABA.

And GABA is what is being released to kind of inhibit...

So if you have less...

So I might be getting a little confused in neurophysiology, but less GABA is it ties into the theory that Abraham had outlined about kind of neuronal damage.

And then at the same time, more anxiety is associated with more fixation on symptoms.

So maybe this isn't a matter of neurophysiology at all.

Maybe it's an issue of people in more anxious states fixating on certain symptoms that may be a fairly normal, but then within the anxious, elevated state, they're all intensified.

We just don't really know.

But psychedelics specifically, I mean, it's undeniable that despite the fact that there's a wide ranging pharmacology or indeed non-pharmacological influences that create these symptoms psychedelics do play a role i mean like sometimes very quickly i mean my i first started noticing changes the next day some people uh within a week some people within a few days but then at the same time there's so much vagueness in the literature some some people are diagnosed with having had hdpd 20 years later which doesn't make too much sense to me Um, but that said psychedelics just maybe not psychedelics are associated in some kind of special way.

It seems there's something about the way they work, uh, that creates them more.

I mean, LSD by far is associated with HPD more than any other drug.

So whilst cannabis can cause it, whilst MDMA can cause them, LSD seems to be, um, above all the others, the one most likely to trigger them.

I mean, from my personal perspective, I think that this is a very complicated condition, which just speaks to how little we know about how the brain works.

And I think that drugs are likely some kind of just catalyst.

They're a kind of psychoaccelerance that can create changes that...

that can create changes that the brain and the visual cortex are already capable of producing.

And there might be a kind of looping feedback.

There might be a feedback loop with anxiety, but we just don't know.

What you just heard was a clip from episode 152 of Adventures Through the Mind.

The title of that is Hallucinogen Perception Persisting Disorder, HPPD, with Ed Perdeaux.

It's one of my older episodes, and whenever I go back to make these clips, it always amazes me how...

I guess how much progress, progress, progress, progression I have had in my audio and video quality.

If you've ever gone back and watched anything from, especially before episode 100, compared to some of the things that are coming out over the last year or so, It's really night and day.

Now that said, the whole episode does explore a topic that was at least at the time very under-discussed and discussed in a distorted way.

It's still under-discussed, but at least it is coming more into the forefront thanks to people like Ed.

That entire episode is going to be listed in the show notes of this one wherever you're checking it out.

And that's it for this little micro.

As you may or may not know, micros are clips from older episodes that come out in between full length episodes.

And so the next episode coming out will be a full length one.

And the one before you guessed it was also a full length one.

The one before this episode was actually episode 200, a very long episode that featured for the first time a lecture that I recorded explicitly for the podcast, Slides and All.

If you're watching it where you can, well, watch it, such as at least for now, Spotify and YouTube.

And that's it.

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Thanks for listening to this short little micro.

I've been your host, James Jesso, and I'll see you on the next one.

And until then, take care and stay curious.