“What type of Trip are you taking?”
The question appears on a phone screen, atop a soft-focus illustration of a dusky, Polynesian-seeming landscape. You could type in meditation or breathwork, or label it with a shorthand wink, like a mushroom emoji. The next question asks, “How far are you looking to go?” You choose “moderate”—you’re planning to ingest, say, 1.5 grams of magic mushrooms, which is still enough to make the bathroom floor tiles swirl like marbled paper. Select one of five prerecorded ambient soundtracks, and answer a few gentle questions about your state of mind. Soon you’ll be plumbing the depths of your consciousness, with an app as your guide.
It’s a capital-T Trip because the app belongs to Field Trip Health, a Toronto-based venture focusing on psychedelic-assisted psychotherapy. The Trip app, which begins a soft launch this week, is a digital companion to Field Trip’s clinics in New York, Los Angeles, and Toronto, where patients settle into rooms filled with Svago zero-gravity leather recliners and weighted blankets and take an ego-quieting psychedelic substance under the supervision of a Field Trip-trained therapist.
Field Trip belongs to a new and growing class of for-profit companies using psychedelic drugs (namely MDMA, ketamine, and psilocybin, the alkaloid that makes magic mushrooms magical) to treat depression, anxiety, and other obstinate mental illnesses. Unlike most players in that for-profit cohort, Field Trip is open for business. Field Trip isn’t dosing patients with MDMA or psilocybin; both are still listed by the government as Schedule 1 substances. But it’s also not waiting for legalization to find its customers. Instead, in New York and Toronto, Field Trip is treating select patients with ketamine, a dissociative drug that has FDA approval for off-label use right now. (The Los Angeles clinic opens later this month.)
And for those sheltering in place in the safety of the home, Field Trip's new app handily distills its consciousness-expanding protocols, making a guide—or at least a facsimile of one—accessible whether you can visit a clinic or not.
Psilocybin legalization is likely years away, but Field Trip cofounder Ronan Levy, a former executive at two Canadian cannabis companies, says the company plans to open 75 clinics in North America by 2024, if not sooner. “We’re building the infrastructure to support the coming wave, when psilocybin legalization efforts get across the line,” he says. “These experiences can be four, six, eight hours, and most doctor’s offices aren’t designed for that. You need a very different experience.”
For centuries, indigenous societies around the world have used psychedelic plants like psilocybin and ayahuasca in religious and societal ceremonies. The idea to study these substances and develop “best practices” for their use emerged in the United States in the late 1950s.
In 1957, a New York banker named R. Gordon Wasson wrote an article for Life magazine called "Seeking the Magic Mushroom," based on several trips from deep in Oaxaca, Mexico. The article introduced untold Americans to the therapeutic possibility of psilocybin mushrooms, and a new avenue for self-improvement materialized. Psychedelics piqued the interest of researchers.
One such research initiative was Timothy Leary’s infamous Harvard Psilocybin Project, which administered doses of the drug to Boston-area graduate students between 1960 and 1962. Leary’s most lasting legacy (aside from coining the phrase “turn on, tune in, drop out,” and freaking the bejesus out of parents and politicians) is the concept of “set and setting.” Set refers to the mental state a person brings to the trip; setting refers to physical surroundings. Both require careful consideration for a trip to feel safe and insightful.
In many ways, Field Trip is packaging and franchising a kind of “set and setting.” This version includes carefully designed protocols (a consultation plus six ketamine-infusion sessions, combined with nine therapy sessions, for $4,700), digital touch points (an online portal where patients can prepare for their trips and chart their progress afterward), and ambiance (mid-century modern furniture, jute rugs, many, many potted plants). Soon, a Field Trip session might be like a Sweetgreen salad or a Heyday facial—it doesn’t matter which location you go to, because you’ll find the same menu of services and the same airy, placid ambiance wherever you end up. “You’ll never be walking into a room with tie-dye T-shirts and patchouli floating in the background,” Levy says. “We’re developing an experience that’s 100 percent controlled by us.”
Until recently, practitioners of psychedelic therapy clung to a loose set of aesthetics—hand-me-down tropes from the counterculture that grew slightly less cartoonish over time. In Michael Pollan’s 2018 book How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence, the therapeutic spaces he visits—at New York University and Johns Hopkins University, or in the homes of underground guides—almost invariably feature a Buddha figure or a ceramic mushroom in an otherwise unremarkable room.
These nostalgic, unpretentious environments make sense, given the landscape within which psychedelics have existed so far. Neither a clinical trial nor an underground (i.e., illegal) trip is much of a capitalistic venture. The marketplace is inherently limited: If you want to trip in the controlled company of a person, you either have to seek enrollment in a clinical trial or travel to a retreat in Mexico, Jamaica, or another country with different substance laws.
A theoretically more accessible option is an underground guide, but they’re hard to come by. “Even as someone who had their foot in the community, I had a hard time finding someone,” says Michelle Janikian, author of Your Psilocybin Mushroom Companion: An Informative, Easy-to-Use Guide to Understanding Magic Mushrooms. This is largely because psychedelic substances are illegal, but also because the resurgent attention to psychedelic therapy has led to a new crop of guides, many of whom lack training but still charge upwards of $1,000 for a session. Janikian describes meeting one such self-styled professional guide at a psychedelics conference. “When I got to know him he was just a normal person”—a guy in his forties, an ex-engineer—“who was changed by mushrooms and wanted to share them with others.”
Ketamine is only slightly more attainable. Patients with a doctor’s referral can visit one of many ketamine clinics across the United States, some more reputable than others. The Polaris Insight Center in San Francisco, for instance, was founded by clinicians from the Multidisciplinary Association for Psychedelic Studies (MAPS) and takes care to customize ketamine treatments for patients with varying dosages and talk therapy after a trip. On the flip side, a 2018 investigation by the science publication STAT found that many freestanding ketamine clinics fail to thoroughly screen patients, skip the integration step, and tend to oversell and overpromise, touting treatments like custom ketamine infusion “blends” based on a patient’s DNA.
Field Trip and its competition—companies like Compass Pathways, Mindbloom, and MindMed—present a new model for this kind of therapy, although actual access to these services varies. Compass has raised $116 million to run clinical trials for psilocybin treatment; MindMed is in the lab, developing medications based on psychedelic substances. Mindbloom, like Field Trip, offers in-clinic ketamine sessions as well as an at-home option; in that case, Mindbloom mails ketamine lozenges to its patients. (Field Trip will only administer ketamine in its clinics. If you use the Trip app to explore with drugs, you’ll have to procure your own substances.)
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Ketamine has weathered a difficult reputation, first as a horse tranquilizer and then as a raver party drug, but it’s also widely used as an anesthetic and as an anti-inflammatory medication. It won’t occasion a colorful, hallucinogenic experience (like mushrooms do), but the right dose can put a person in a trance-like, dissociative state. “This facilitates the loosening of the habits in the mind,” says Joseph De Leo, Field Trip’s lead psychologist. “When an individual has a mystical experience, it provides them with a lot of material to process.”
Research on ketamine dates back decades. The Ketamine Papers, edited by Phil Wolfson (who has godfather status with the drug) and published by MAPS, documents those findings, many of which describe ketamine as an agent for spiritual processing. More recent studies from Yale and the National Institute of Mental Health home in on ketamine as a fast-acting treatment for depression. “For that, the science is good,” says Adam Kaplin, director of the Johns Hopkins Psychiatric Esketamine Clinic, before pointing out the problems: “We don’t yet know the best way to sustain the long-term benefits. It’s virgin territory. If patients don’t want to keep coming in and sitting in the clinic, what do we replace it with? We don’t know.”
Screen as Looking Glass
Psychedelics can easily acquire an enticing sheen of before-and-after; even the very people developing long-range therapy programs will cite “an experience” that ended a depression or rewired a sense of self. The trick is what you do with the trip once it’s ended. In psychedelic-assisted therapy this is called integration, and it involves talk therapy, journaling, and goal-setting. “There’s actual work involved,” Levy says. “It’s not just, take this antidepressant and you’ll feel better.”
With Field Trip, much of that work takes place online, via a dashboard that tracks scheduled sessions, daily moods, goals, tasks, and perceived results. “It’s kind of like how One Medical has their own app,” says Kori Harrison, Field Trip’s head of product. A self-described “Silicon Valley type A person who saw the lights” after a few formative psychedelic experiences at Burning Man, she’s the bridge between Field Trip’s psychologists and its slate of tech products, including the Trip app.
Trip takes cues from journaling apps like Jour and Reflectly, and prompts users to take notes on their “narrative identity.” Harrison worked with Lucid—a company that uses machine-learning programming to compose music for “mental wellness”—on five custom, preprogrammed soundtracks. Each 45-minute track plays on a loop, mixing ambient music with nature sounds. Each selection is meant to facilitate a slightly different kind of emotional experience, from processing to healing to growth. (This is a theme among these new companies; Mindbloom also offers custom music.)
A red Record button sits front and center on the app's screen to let users take audio notes. Harrison heard from guides that patients find voice memos less overwhelming than journals. (“I wanted the app to feel like a beautiful oasis,” she says.) Trip technically doesn’t tout itself as a how-to guide for ingesting illegal substances—that would be against the rules of the App Store—but it mimics the work of a human guide, presenting calming visuals and encouraging introspection with multiple-choice questions like “How are you feeling right now?” Answers get saved in a journey log that can be accessed later.
Screens are a relatively new prop for psychedelic-assisted therapy. Experienced trippers caution against keeping a device around, for obvious reasons—just imagine picking up your phone to use Spotify, and instead winding up in a Twitter doomscroll while your drugs take hold—but digital interfaces could influence a trip in other, subliminal ways. In How to Change Your Mind, Pollan recounts a curious incident of looking at a computer during a guided mushroom trip. In an effort to try out some heady psycho-visual experiment, Pollan watches a video on his laptop mid-trip. Afterwards, eyeshades back on, he mentally finds himself in an “urban landscape that appeared to have been generated by a computer.” During his processing session the next day, Pollan’s guide suggests that the laptop screen inspired the computer-rendered hallucinations. “Could there be a better demonstration of the power of set and setting,” he asks.
If you follow that logic, then the media that’s consumed during a trip has a profound impact in shaping the visual tenor of what is typically an ineffable and unpredictable journey of the mind. Follow that logic further, and a more existential question emerges: With a specific animation and soundtrack in place, can you engineer a certain kind of trip? Would you want to?
For now, the Trip app makes a rarified toolkit much more accessible than before. While the app is useful for any kind of mood-tracking, Levy says it would be naive and insincere to pretend that people don’t self-medicate or explore at home—especially while many of us are stuck indoors, grappling with the ripple effects of a global pandemic. “This way, at least, we can make sure you have well-considered instructions,” Levy says. “I like to say we’re like Home Depot for self-exploration. You can do it, we can help.”