“The research around psychedelics is just unreal; the potential of these medicines to completely transform the way that we provide mental health care and help people who really need big changes in their life is really exciting.” – Jack Swain

Jack Swain is Head of Clinical Operations at Mindbloom, a mental health and wellbeing company focused on psychedelic therapy. Before joining Mindbloom, Jack Swain was a healthcare consultant at The Chartis Group, where he worked with the Cleveland Clinic and Michigan Medicine.

To listen to Jack’s bonus interview and learn more about his own habits and routines, click here.

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Chapters

Jack’s background and intro to Mindbloom
How healthcare today is broken, and why Jack is hopeful that it will improve
What is psychedelic therapy?
Why Mindbloom is focused on treating depression and anxiety
Progress in the world of psychedelic medicine
Examples of successful treatment with Mindbloom
Mindblooms treatment model and clinicians
Scaling a telemedicine company
The history of psychedelic medicine
The importance of journaling in mental health therapy
The data and research coming from Mindbloom

Terminology

Books Recommended by Jack Swain

How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence by Michael Pollan
The Psychedelic Explorer's Guide: Safe, Therapeutic, and Sacred Journeys by James Fadiman‍
Stealing Fire: How Silicon Valley, the Navy SEALs, and Maverick Scientists Are Revolutionizing the Way We Live and Work by Steven Kotler and Jamie Wheal

Learn More About This Topic

Mindbloom’s Blog

Full of articles on the basics of psychedelic therapy, breathwork, journaling, and more, this blog is a great place to start.

The future of psychedelic-assisted psychotherapy

This 16-minute TED talk with Rick Doblin is a quick and entertaining intro to how psychedelics are being used with psychotherapy.

Why Psychedelics, Big in the 1960s, Are Drawing New Interest Now – Bloomberg

This quick summary from Bloomberg gives a basic overview of what psychedelics are and how they’re being used today.

Psychedelic Therapy with Roland Griffiths, PhD

This podcast episode with a professor of psychiatry and neuroscience at Johns Hopkins gives a great intro to the current research in psychedelic medicine.

Psychedelics, by David E. Nichols

For a full scientific deep dive into the world of psychedelic medicine, check out this article published in Pharmacol Review.

Music for Psychedelic Therapy

This new album by Jon Hopkins is released on Nov 12, 2021, but you can get a taste of the tunes with “Sit Around The Fire,” which was inspired by an expedition to Tayos Caves in Ecuador. A collaboration with Ram Dass, the song promises to take on a “new dimension entirely when brought into a psychedelic ceremony.”

Transcript

Daniel Scrivner:

Jack Swain, welcome to Outlier Academy. I'm so excited to have you on the podcast.

Jack Swain:

Yeah. Thank you so much for having me.

Daniel Scrivner:

So preparing for this interview has been one of the most fun times I've had preparing for any interview in my memory, because this is a really deep topic. And what we're going to talk about today is a specific company that you work for called Mindbloom, but kind of zooming way out, it's about a new space that is emerging that I think is super interesting, I also don't know a ton about it, so I'm excited to dig in with you, which is psychedelic therapy. And I thought to start, if you could just describe Mindbloom, its mission, and your role at the company?

Jack Swain:

Yeah. Mindbloom is a mental health and wellbeing platform that provides at-home, clinician-prescribed, psychedelic therapy for people with anxiety and depression. Our six-session ketamine therapy program combines software content, medication, and five-plus hours of guiding clinician support to deliver far better outcomes and experiences than traditional mental healthcare treatments, at costs, a fraction of what other ketamine providers are charging.

Daniel Scrivner:

It's incredible, and we're going to dig into all that because there's a lot to dig into there. Just to kind of set up your own experience, your own background, what was your path to Mindbloom? I know you've been in the medical space for a while, so maybe compare and contrast that experience and the culture at Mindbloom. And then I'm also curious just the significance that psychedelic therapy has had on your life.

Jack Swain:

Prior to Mindbloom, I worked at a healthcare consulting company called The Chartist Group and had really cool experiences working for the leading health systems in our country, like Cleveland Clinic and Michigan Medicine, helping with projects like adopting value-based care, mergers and acquisitions, payer-provider partnerships. I really got to see our healthcare system from the top level and see how the most well-funded, sophisticated healthcare institutions really struggle to provide high-quality affordable community health.

Jack Swain:

I thought I would be there for a long time, but Mindbloom kind of popped up back in early 2019. I've always thought that my path would lead towards mental health specifically because I come from a family where that's always been really top of mind. Like my mom's struggled with depression, my dad has been an alcoholic for most of his life. He's now 10 years sober. I'm so proud of him, but-

Daniel Scrivner:

Amazing.

Jack Swain:

... it's been a journey. I'm no stranger to anxiety. So I've seen how 12-step programs, antidepressants, therapy, just don't get so many people where they need to go. Psychedelic medicine is a whole different thing. I've had profound transformative experiences with psychedelics in the past and so I knew anecdotally how powerful these therapies could be. And then there's been this resurgence in research in the past 10 to 20 years, kind of reproving a lot of the things that we saw back in the mid-20th century, before a lot of research was shut down kind of around the time of the Vietnam War.

Jack Swain:

So all of this led to ... One of my lifelong closest friends is our CEO, Dylan Beynon. And he approached me. He was looking for a healthcare consultant, coincidentally, to help launch this psychedelic care, the company that he wanted to start called Mindbloom. And my personal experience, interest in mental healthcare, the research... And Dylan is the smartest person I've ever met. Even before Mindbloom, even before. Even before I was saying this on podcasts, like I would tell people Dylan is the most impressive smartest person I know.

Jack Swain:

So being able to combine that and go work for someone who's, this is his third startup. He's had two successful runs in the past. And so it was just a total dream job to be on the front lines our head of clinical operations, working directly with Dylan and our science director, Casey Paleos to launch Mindbloom back in 2019.

Daniel Scrivner:

That's incredible. Want to ask one question based off of that experience you had directly before Mindbloom of kind of doing this broad consulting with a lot of the top operations throughout the United States. I guess my sense would be that, generally, people are pretty bearish on medicine and the medical system in the U.S.

Daniel Scrivner:

And so I'm curious for your take on what gave you hope while you were there and what is improving or exciting about where medicine is heading? And then what did you walk away with also a sense that things were broken? And can you share a little bit of context of kind of like what that looked like and felt like as you were trying to in that system?

Jack Swain:

It's like everybody in that system knows the system is broken and you have a lot of people with the best intentions and who are just hyper-talented trying to solve these massive problems in our healthcare system. Like our healthcare costs are 17% of GDP, way higher than any other country, and our outcomes are nowhere near commensurate with the amount that we spend. And that's kind of systemic, just kind of the way our system has evolved with this third-party payer landscape.

Jack Swain:

And so what gave me hope is that so many really smart, well-intentioned people are working so hard to solve the problems in our healthcare system. And there is progress. So the company I worked for, Chartis, was... Everybody there was very mission-driven. And so that's what's been really cool going from Chartis to Mindbloom. It's just been surrounded by people who really drink the Kool-Aid of what we're doing and are so mission-focused.

Jack Swain:

And so there is innovation in the healthcare space. There's a move towards value-based care. So our healthcare system, traditionally, has been fee-for-service, where you give a doctor money, they provide a service. It doesn't matter if you get better. And that helps to drive up cost and not really increase a lot of accountability. There's this move to value. We don't give the government credit for innovation, but CMS, the Centers for Medicare and Medicaid often lead the way in payer reimbursement innovation with value-based care like bundled payments.

Jack Swain:

So there is progress and I got to work on a cool value-based care project at Cleveland Clinic in my last couple of years at Chartis. So there is hope. So it's clearly broken and there's so much room for innovation, specifically in the mental healthcare space where, if you look at surgery, you might now be operated on by a robot, which is incredible. If you look at mental health care, we're still using a lot of the same tools in therapy and antidepressants that we've used for decades.

Jack Swain:

It's broken, but there's definitely hope. And the research around psychedelics is just unreal. The potential of these medicines to completely transform the way that we provide mental health care and help people who are putting the big changes in their life is really exciting.

Daniel Scrivner:

Yeah. It's exciting to me, too, as well too, that it just feels like in the last few years, I think this was definitely accelerated by COVID-19 in some ways, but that mental health is now a topic that a lot of people are a lot more open about. Not only in the last few years have I had discussions with some of my friends about dealing with depression, them dealing with depression, my abouts with depression. It seems like just, culturally, as well too, things are evolving. Is that your sense?

Jack Swain:

Yeah. Absolutely. I think we're going to look back 10, 20 years from now and think it's crazy that we didn't treat mental health just like physical health. Like when you think about people starting to exercise for health in like the mid-20th century that really took off in the eighties and thinking about, I think, for so many of us not exercising now is just crazy.

Jack Swain:

And so the fact that we're not treating our brains like we're treating our bodies, I think we're just going to feel really down when we look back and are like, why weren't we more open and taking time and carving out time in the day to really focus on something that's so clearly important to our happiness and effectiveness in life/

Daniel Scrivner:

We're going to spend a lot of this episode talking about Mindbloom , but something that's definitely become clear to me the more I've talked with you, the more research I've done is I think everyone could use a bit of foundation just to help get people from zero to one in terms of the space in general.

Daniel Scrivner:

And so I wanted to start with just, you touched on it a little bit in some of the notes you made earlier, but I'd love to just stop for a second and just define what psychedelic therapy is. And then we can compare and contrast that. But maybe just start with what is it and why is it a novel or different or interesting way.

Jack Swain:

Traditional health care or traditional mental health is, it's this more paternalistic model where you go to a doctor, you explain the issues you're having, they give you a pill or they're kind of helping you work through your problems in therapy. And then you kind of go off and hope you get better. With psychedelic medicine, you're a very active participant in the treatment. And so psychedelic therapy starts with preparation.

Jack Swain:

So setting intentions and really thinking about what you want to get out of treatment, having this psychedelic experience, which is both often profound and perspective shifting, but also has these great benefits to your brain of increasing BDNF, brain-derived neurotropic factor, which increases neuroplasticity, so increases your brain's ability to form and repair neurons, and also decreases function in your default mode network, which is kind of involved in kind of like your day to day automatic processing.

Jack Swain:

And so when you have these negative thought patterns, decreasing activity in your default mode network helps you break free of those negative thought patterns and start to develop new positive thought patterns. And so you have this experience. And then after, integration is crucial to psychedelic therapy. So how do you take this experience you had and then turn it into lasting change. And so that's reflection, journaling, working with a coach or a therapist, a lot of ways that you can really start to reinforce these perspective changes and positive feedback loops that you're developing in your brain so that you can have lasting transformation and behavior change.

Daniel Scrivner:

So it sounds like maybe just to try to repeat that back. If the old system is just trying to give you something, typically a compound you're going to take that just tries to treat the symptoms, one, you're actively engaging in this, two, it seems to be very holistic and that involves a lot of different things, and three, obviously, just from what you said there, everyone getting treatment puts a lot more effort, energy, intention into it?

Jack Swain:

Yeah. That's fair.

Daniel Scrivner:

Just stop for a second, too, and address maybe the cynics point of view. I'm sure some people would maybe look at it and say, oh, well, you're just going you're just maybe tripping on a drug. And I think it would be helpful for a second to talk about why taking a psychedelic is so important.

Daniel Scrivner:

And just a couple of things that, in my own kind of research that have come up over the last few years is, and I will try to dig this up and put this in the show notes because it's a little fuzzy in my memory now. But maybe a year ago, I listened to a really great podcast where someone talking about why psychedelics are important. And their kind of reason was it has a lot to do with deep patterning. Where it's the first time you can kind of disassociate and you can actually maybe look at your life truly objectively.

Daniel Scrivner:

And he gave a bunch of examples about how this has found all over the place in nature, from dolphins playing with puffer fish, to literally get a high and to disassociate. In this interview, he's talking about all of what's going on in your brain. So I don't know if you can build on that, but talk about why the psychedelic part of that experience is so important and what people are really getting that.

Jack Swain:

Yeah, I think he started to summarize it well. So it is that breaking free of those old patterns and putting your brain in this really fertile neuro-plastic state. And so that's just even with something like their IV ketamine clinics, for instance, that are still often using a very medical model where you're not focusing as much on the intention and integration, but still getting the medicine. And it's still wildly effective, like 60 to 70% response rates compared to like 40% for antidepressants.

Jack Swain:

But then when you're coupling it with these pharmacological benefits of the medicine on its own. And then when you take that subjective experience and couple it with intention-setting and integration, you're really amplifying the ability of your fertile brain to make long lasting changes. And so without that both perspective shifting experience and just putting your brain in a great place to change are both really important to the process.

Daniel Scrivner:

Yeah. Maybe another way of saying it that's just super blunt is if you want to change some of your patterns, you kind of have to disassociate, break those patterns, and then use some sort of a state change, I guess, to reinforce new patterns. So just at a high level, it seems to make a lot of sense.

Jack Swain:

And I think it's, right now, as a society, there is a stigma around altered states. I think that's changing, and there's been so much research and positive news coverage which is really helping to break that stigma, but for so many people who've heard drugs about their whole life, they look at a "trip" and it's hard to see that as something that's therapeutic and not hedonistic or recreational.

Daniel Scrivner:

Yeah. That's a good way to put it. I think it would be interesting to talk about for a second... You guys are clearly focused on anxiety and depression. And I'd love for you to maybe talk about that a little bit and why those two areas. But the other question that I had is are there other areas that psychedelic therapy is good for and why aren't those part of the model now? But maybe just talk about what can it treat and why are you focused on anxiety and depression"

Jack Swain:

We started with anxiety and depression because there's, one, just such an epidemic of anxiety and depression hurting people's both happiness and ability to be productive and achieve what they want to in life. And then second, there's the strongest clinical literature right now for ketamine around depression and anxiety. And so we chose those two to start because we are starting an innovative company and there are plenty of others before us who have kind of treaded the path for us to follow in treating these indications with ketamine and other psychedelics.

Jack Swain:

So that's where we started. But the ability of psychedelics to treat a broad spectrum of indications is pretty remarkable. There are studies that show ketamine and other psychedelics are effective for treating PTSD, OCD, substance-use disorder, alcohol-use disorder. Those are certainly indications that we plan to start to treat in the near future at my Mindbloom as well.

Daniel Scrivner:

It's interesting. And I know today you guys are focused on ketamine, and a big part of that is that it's legal.

Jack Swain:

Yeah. Each part.

Daniel Scrivner:

Yeah. That obviously it would be important in a medical practice, but I know, as you look down the road, there's things like MDMA and psilocybin magic mushrooms. Maybe just talk about that, how those other two things are progressing and when people might see those things be options that they have in getting treatment.

Jack Swain:

Yeah. Our science [inaudible 00:14:15] director, Casey Pallia is just... His work with psychedelics in a therapeutic context at MAPS and NYU is remarkable. He's a principal investigator in that MAPS phase three MDMA for PTSD clinical trials. And so it looks like those are one to two years away from FDA approval. Psilocybin, hopefully not too far after. And the work at MAPS showing the efficacy of MDMA for treating PTSD is just crazy effective, and really going to make a lot of positive change for a lot of people who are struggling with PTSD.

Jack Swain:

And researchers at Johns Hopkins and Imperial College of London and other places have done really great work with psilocybin and have shown really, really high percentages of people in the studies are seeing strong improvements in depression symptoms. And the durability is also remarkable. Like some people report symptom relief for six months. There's also something like, I forget how high the percentages, but a really high percentage of people reported as one of the top five most powerful experiences of their life.

Jack Swain:

And so you have both the subjective and the clinical data to show the promise of these medicines. And so it's really exciting to see that we'll have, hopefully, in addition to ketamine, these other compounds in our toolkit in the not so distant future.

Daniel Scrivner:

Yeah. It's amazing just to see the kind of progress in that space and acceptance of it. I'm just curious for your thoughts on why do you feel like psychedelic therapy, people seeking treatment for things like anxiety and depression and its success you're seeing at Mindbloom. Is there anything in your mind that makes it clear why we're seeing all of those things kind of converged now? Is there a cultural element? Is that it kind of a medical element? Just talk about kind of the setup and why we're seeing this resurgence in just the last couple of years. And it seems like, as we look forward, it is just going to continue to accelerate.

Jack Swain:

I think there's a confluence of factors. There's just the mental health epidemic that's becoming more and more clear, but something like over half of the population will have mental health indication in the course of their life. Something like 60% will never get treatment, most because of costs. So you have this problem that's becoming harder and harder to ignore. COVID has certainly brought that to the forefront even more so.

Jack Swain:

And then you have this resurgence of research in psychedelics that institutions like Johns Hopkins have done such a great job of kind of paving the way to show in a really clinically-sound manner. And MAPS as well. Just that this isn't something that we think history. This is something that we now have strong clinical data to show is true. There's also been great news coverage of psychedelics. There's the book, How to Change Your Mind by Michael Pollan, that so many people see it as kind of their education on the history and current state of psychedelics in their true medical potential.

Jack Swain:

So I think you have all of these different factors that are helping to reduce the stigma and lead people to want to try these as legitimate mental health treatments. And you even have institutions like the FDA that are giving breakthrough or fast-track designation. So they're saying we want to make it easier to move these through the clinical trial process as fast as we can to get them FDA approved, because it shows such promise clinically. And they've given these designations to psilocybin MDMA and ketamine.

Daniel Scrivner:

That's amazing. I want to ask one more question before we dive into kind of more in the weeds around Mindbloom, and particular in the model that you guys have. And that is... I know, obviously, confidentiality is incredibly important, so I'm not asking for any kind of personal story. But I was wondering if you could kind of generalize a little bit and just help people understand what a traditional success story looks like. And if they're different enough, we could talk about one for anxiety versus one for depression. What are people seeing? And what are you seeing as a company that is just so impactful about the way this treatment is impacting people's life?

Jack Swain:

Let me start generally and then get specific. So in general, 88% of our clients report clinically significant improvements in depression symptoms after four sessions. 77% report clinically significant improvements in anxiety after four sessions. So the broad data, and we've been collecting outcomes data on our clients from day one, just shows how effective this is at a high level.

Jack Swain:

When we dig more into how does this present in specific clients? We see clients often come to Mindbloom because they need relief from depression or anxiety. And then once we're able to address kind of this pain that they're feeling, then it kind of like opens them up to focus on other things like relationships, their jobs, just so many things that have been not top of mind because they've been riddled with this pain related to anxiety or depression. So we see that we're able to kind of free people to focus on things that are so important to themselves, their families, society.

Jack Swain:

In terms of specific stories, we have incredible clients who are open to being champions publicly for Mindbloom, which is great. And so there have been pieces in bustle and women's health, one's coming out in Oprah Magazine. In women's health, for example, is a story of one of our clients who had tried just a grab bag of different antidepressants over decades and hadn't been depression-free as long as she could remember. And then after her first ketamine therapy session, that started to clear. And so she started to feel symptom-free again. And just has this remarkable story of her family members are noticing that she's just this like-buoyant different person that they haven't seen in so long.

Jack Swain:

And so when you see how this is just making transformative changes for people, it's so inspiring. And that's something that is so fun about working at Mindbloom, is you get to see that on a daily, weekly basis. You have people who are just able to achieve so much in such a short period of time, which is, unfortunately, pretty rare in traditional mental health.

Daniel Scrivner:

That's an incredible story that you shared. I imagine being someone or a friend in that woman's life and how incredible it would be to see this person, that you maybe thought was gone, come back. And how impactful that would be. And it's also interesting, even just using that word relief, that's a really heavy word. Anytime someone says they need relief from something, it's clear that that is more than just an annoyance. It's something that is kind of being... It feels like it's pressing down on them.

Jack Swain:

Yeah. And for anyone who's, I mean, I can speak from personal experience from anyone who's experienced acute anxiety or depression, you know you're not yourself. You're not able to work at your normal level. You're not keeping up with the people that you love in your life. And so there's so many manifestations that just can be so crippling to achieving your true potential. And so being able to exactly give relief and kind of free people to focus on the things that really matter is truly fulfilling.

Daniel Scrivner:

Yeah. That's huge. So I want to transition now and really focus on Mindbloom's model. And something that was fascinating to me when we were talking before as we were kind of preparing for this interview is you talked about that the model started out as patients just seeing a clinician. And then you guys had this insight that a clinician paired with a guide, and we'll talk about what a guide is, is a really powerful concept. Maybe talk about that model and why you made that change, and just how important it is and how stark of a difference that is from other treatments people might have.

Jack Swain:

We started as a clinic in New York. So we started with an in-person and telemedicine model, and had a single clinician, our first clinician, Kristin Arden, who's amazing and he's really helped build our program to where they are today, was personally treating our first cohort of 200 clients.

Jack Swain:

And so that was great. But as we think about trying to create this model that's not only going to increase experience and outcomes but also reduce costs, we want to think of, hey, how can we give more hands-on time to clients to really help amplify the results and hold their hand through this kind of new, different process of psychedelic medicine, which, as we've talked about, is quite a bit different and can feel like overwhelming or confusing to someone who's not familiar at first.

Jack Swain:

So we introduced our Guide program. And so we have coaches and people who are really passionate about psychedelic integration, who're our client's primary point of contact. And so our clients are paired with a guide immediately when they sign up for Mindbloom. And that person really shepherds them through their program.

Jack Swain:

So they'll help with preparation, be there on video with them before and after the first session, support their integration throughout their program, and also serve as the liaison between the client and the clinician, which is great for both the clients, because they can text their guide at any time. And also for our clinicians who love having, essentially, direct access to their clients so that they can get updates on how they're doing, check-in. And it's something that, as a clinician, you don't necessarily have the ability to in a more traditional mental health environment.

Jack Swain:

So it's this great dyad of the clinician guide who are working really collaboratively to help our clients get the most out of their treatment. And our clinicians and guides spend collectively over five hours on each who goes through Mindbloom.

Daniel Scrivner:

It's incredible. What is the kind of typical background look like for a guide? You talked about coaching, and I'd love to maybe go a little bit deeper there. Like, what does that look like? What have they been maybe certified in? And then as well, I'm just curious for, maybe more of the personal side. Like, is it important when you're hiring these people that they've had a personal experience with anxiety or depression? Is it more that this is just an important area of their life? How does that factor in?

Jack Swain:

The number one criteria that we hire for is people who are mission-obsessed, who truly believe that this is something that could transform mental health care. And we think that if you don't truly believe that that's true, it's going to be challenging to provide these transformative experiences for our clients.

Jack Swain:

In terms of what the typical guide looks like, there's, of course, the normal answer, there's no typical and there's a range of different backgrounds that we hire. But if I had to say the most typical as somebody who has a coaching certification, there's a lot of like really great coach training programs out there. And has experienced coaching clients either for our company or for their own practice. And it's also really knowledgeable about psychedelic integration.

Jack Swain:

So we provide a lot of onboarding and training when somebody joins the Mindbloom team, but we want people who are educating themselves and really knowledgeable about how to best support these experiences when they join the team. And we've been just blown away at the number of people who are really excited about working in this field. And there haven't been a lot of opportunities before Mindbloom. And so we've just been blown away by the caliber of people who are really excited to work in this space and have just been waiting for it to emerge as a career opportunity.

Daniel Scrivner:

Yeah. I'm sure, as a coach, the coaches that I know they're just obsessed about people and having an impact on someone's life. And I know that, oftentimes, just coaching kind of outside of the context of something as profound as psychedelic therapy, maybe doesn't feel as profound, it doesn't feel like you have that impact. So I imagine that being able to join Mindbloom, and truly feel like each person you work with, you've been able to have a profound impact on. It's just really powerful.

Jack Swain:

Definitely.

Daniel Scrivner:

One thing I was curious is just, and this is a bit of a kind of brainstormed thought experiment, but I was curious to try to extrapolate out the fact that you guys have, clinicians and guides, you have a process that someone is really working with, effectively, a coach that's helping them set intentions, integrate that into their lives. That seems really profound in medicine. And I haven't heard of that before. And I immediately think of like, why doesn't this exist in treatment for diabetes? Why doesn't this exist in treatment for obesity?

Daniel Scrivner:

It seems like in so many other areas, pairing up someone who is kind of hard-focused on the medical side and someone that's focused on the kind of software in your brain emotions, who you are side is really powerful. Is that true? Do you think there's opportunities for this model to make its way into other areas of medicine?

Jack Swain:

Yeah, it is. There are a lot of companies that have really grown recently. Like if you look at Noom, they're doing health coaching, predominantly weight loss coaching, and they just had a huge IPO. And they have a few thousand coaches. And then there are other evolving healthcare startups as well that are really relying on coaches to help clients get the most out of treatment.

Jack Swain:

So I think we are seeing it emerge more and more. And it's just such an important component of so many of these clinical models where you're trying to increase client experience and bring down costs. And working with a psychiatrist is really powerful, but it's also really expensive. And so if you can pair somebody who's still able to help create really powerful outcomes through whatever it is, whether it's psychedelic integration or just supporting you through your weight loss journey, I think we're going to see more and more of this in the next few years.

Daniel Scrivner:

It seems like an incredible way to drive impactful outcomes. We've talked about this a little bit in what a patient's journey looks like from initial consultation through treatment, but I want to ask one question around that. Which is, for anyone listening that has struggled with anxiety or depression before, or is struggling with anxiety or depression now, something I'm interested in is just what the bar is for treatment.

Daniel Scrivner:

And we talked about this a little when we were kind of preparing for this. And I'd love it if you could maybe just set up what that is. So people, one, if it affects them, they have an idea of kind of how that might play into what they're experiencing. But also just so everyone knows generally that there is a bar for being treated and what that bar is.

Jack Swain:

Yeah, of course. So we are a medical company. So we treat people who have a diagnosis of anxiety or depression. And I think, because of the stigma around mental health, there's this kind of view that if you're not cripplingly anxious or depressed that you don't qualify for a diagnosis of anxiety or depression, but-

Daniel Scrivner:

If you're like stuck in bed.

Jack Swain:

Yeah, exactly.

Daniel Scrivner:

Get up.

Jack Swain:

Yeah. Which, again, is this just stigma that we need to break. Because if you have, like for example, symptoms of anxiety could be overly focused on your worries, stress, these things that I think we all go through at times that prevent us from functioning at our highest level. And so many of us are now working on through like, meditation, through mindfulness, exercise, whatever it is you do to like help you cope. I know I personally had kind of confused standard workplace stress with what I now know is a diagnosable level of anxiety.

Jack Swain:

And so we treat clients with mild, moderate, or severe anxiety or depression. And we provide a initial assessment on our website. So you can take a quick four-question questionnaire to see if it's something that could potentially be a fit. And I think for a lot of people who think that you need this crippling level of anxiety or depression to be eligible for treatment, that's certainly not the case. There's a lot of in-between that our clinicians have seen really great success with ketamine therapy when working with our clients.

Daniel Scrivner:

I want to talk about, and this is switching over to pretty tactical, but I want to talk a little bit about the mechanics of scaling something like Mindbloom. And you talked about, at the beginning, you guys started out as an in-person clinic. Obviously much harder to scale. Easier to scale if you're doing something like telemedicine. But I had a couple of questions around that.

Daniel Scrivner:

I know when we talked last, you guys were around 20 clinicians and 40 guides, which, in my sense, is that's pretty significant scale, especially the number of patients you can treat with that. But how does scaling work? And I guess some of the questions I wanted to ask there, and these may be completely dumb questions, but that's part of my job is.

Jack Swain:

No such thing.

Daniel Scrivner:

So things like, are there regulatory issues in terms of rolling this out? Is any of this still state-by-state different regulatory environments and kind of legal environments? Just talk a little bit about what the journey has been like scaling, what it's like scaling a telemedicine practice and any of the kind of weird mechanics around legal regulatory issues people might not know.

Jack Swain:

I could talk for the rest of this podcast and several more about the regulatory considerations of expanding a telemedicine practice. I'll spare your listeners.

Daniel Scrivner:

They're considerable, I guess.

Jack Swain:

But yeah, there are states... Each state has their own regulations around telemedicine, telemedicine prescribing, scope of practice for providers. So these are all things that we have to navigate. Unfortunately, we're not the first who's had to navigate it. So we are able to learn from other companies who have paved the way. And of course we spend lavishly on telemedicine attorneys and have a great general counsel to help us navigate this as well. So, a lot of that.

Jack Swain:

Once you kind of tackle that, the scaling is, I think what's really been exciting and perhaps surprising to us is how much our clinicians love this work, because I think it's a dirty secret in psychiatry that things don't work very well. Like the traditional medications don't work very well. And with antidepressants, it's 40/40. There's 40% chance that an antidepressant is going to work and 40% chance that you're going to have side effects.

Daniel Scrivner:

Terrible.

Jack Swain:

And it takes four to six weeks to figure out if an antidepressant is working. So as a clinician, it can be a slog to work with someone over a long period of time and tweak medication to find something that works. And when it does, it's amazing. And our clinicians love working in mental health for that reason, they're able to see real progress in their clients over time.

Jack Swain:

In Mindbloom, our clinicians and our guides are seeing progress at the end of the first session, at times. For some people, it might take a few sessions to start to see benefit, but still you're working on a timeline of days or weeks as to months. And the percentage of our clients who are having positive experiences in clinical benefit, as we talked before, is 88% of our clients see improvement in depression. And, like our NPS is 70, which is crazy high for healthcare. So our clients are also having really great experiences.

Jack Swain:

And so that creates a really great positive environment for our guides and clinicians. So scaling telemedicine is kind of, as you referenced before, great, because you don't need a physical practice. So what we can do is hire clinicians, hook them up to our platform once they're trained in our protocols and in our tools. And that opens up their schedule for clients to schedule with them.

Jack Swain:

So we can really rapidly add coaches and clinicians to our platform. And then of course, we navigate the state-by-state regulatory environments as we go, but it does make it possible to scale very quickly. And so we're, of course, priority number one is safety. So scaling at a rate that we can maintain quality and safety for our clients. But even since we last spoke, we're now out to 30 clinicians and 50 guides.

Jack Swain:

So now that we've proven that the model works and we can scale it safely while maintaining these incredible client outcomes, we want to help as many people as we can and get this to people across the country. We're in 12 states and serving 50% of the population right now. And we expect to be available to 75% of the population by the end of the year.

Daniel Scrivner:

Those are just staggeringly impressive stats in terms of penetration with how early you guys are and just the impact that you're able to have. It's amazing, too, you said you were at 30 clinicians and 50 guides now?

Jack Swain:

Yes.

Daniel Scrivner:

Significant bumping from the last talk. So it's clearly scaling. I want to ask one question. This may be a little bit esoteric, but we've talked a couple of times about telemedicine. And I thought it would be interesting just to explore that for a little bit. And I'm hoping maybe some of your consulting background has given you a little bit more color in telemedicine. But what I wanted to ask there is, similar to kind of psychedelic therapy, that's something that I've heard of, I assume other people have heard of, people have probably even maybe had a telemedicine experience. But actually, I haven't had a telemedicine experience, I don't know many people that have-

Jack Swain:

Oh, man.

Daniel Scrivner:

... and I didn't really even hear that word.

Jack Swain:

That's shame.

Daniel Scrivner:

I know. And i didn't even hear that word until really kind of 2020, which I heard that first from some of our doctors who've got a couple of kids and was like, let's do a home appointment over a video call. So I'm curious, how long has telemedicine been a thing? And I guess you talked about telemedicine attorneys. I imagine that 2020, us all being stuck at home, helped move telemedicine forward. Do you see real momentum behind that now? And you think that's going to be a force that's going to have a really big impact in years to come.

Jack Swain:

Absolutely. Which is probably, as no surprise, my answer since I worked for a telemedicine company. But I started my consulting career in 2010 at Accenture. And we had this perk where we could use Teladoc, which was one of the early telemedicine company.

Daniel Scrivner:

I didn't know it was even around in 2010. That's incredible. Wow.

Jack Swain:

And nobody used it except me. I was like the one person in my hotel room. I tried to figure out how to use Teladoc to see if I could figure out why I had this crazy cough while I was on the road. But yeah, it didn't pick up. And even when I was in business school, I was on a team for an entrepreneurship project. And we explored launching a telemedicine company, coincidentally. And so we did the things you do to create your minimum viable product and surveyed our friends and family to see if this is something they'd be into. And they were like, no.

Daniel Scrivner:

Zero percent responses.

Jack Swain:

Yeah. Why wouldn't I just Google it or go see a doctor? Why do I need telemedicine? And so we were like, okay, I guess this idea is busted. But that was a while ago. And now with COVID, it has, of course, just really, really pushed people towards telemedicine.

Jack Swain:

And I have a former coworker who now works for a data company in healthcare and is saying that something like low single-digit percent of consults were telemedicine prior to COVID, and then it shot up to like 50, maybe 50-plus percent with telemedicine during the peak of COVID. And that's come down, but not nearly to where it was before.

Jack Swain:

So I think now that so many patients now see the benefits of telemedicine and how many things you don't actually need to be seen in person by a doctor in order to get a really reliable clinical decision. And we've seen providers... It's great to be a provider if you can have treatment by telemedicine, because it gives you so much more flexibility instead of being tied to an office.

Jack Swain:

And we think about where so much more germ conscious now. So going to a doctor's office is... It can be like filthy. You're going around where a bunch of sick people have already been to go see if you are sick. And if you weren't, maybe you will do when you leave. And the number of hospital-acquired infections is alarming.

Jack Swain:

And so when you can kind of stay in the comfort of your own home and protect yourself from germs, it seems like a no brainer. And I'm so glad that one of the silver linings of this horrible pandemic has been an accelerated adoption of telemedicine, which has certainly been powerful for Mindbloom, our clients as well.

Daniel Scrivner:

Yeah. It's fascinating. Just upon a couple of threads there. You talked about, and I just want to underscore it because I think it's really interesting, that, obviously, if the medical system is broken, if things need to be reinvented, similar to technology, we need a bunch of things that bring down the barriers to invention and innovation and disruption coming in. And a big one of those is reducing costs.

Daniel Scrivner:

And so something like telemedicine, obviously, allows a company like Mindbloom to start and scale with much less capital. But the other piece, and this is one I really want to talk a little bit about, is there are also, and I haven't heard anybody really have this conversation, there are also a lot of ways in which telemedicine can be profoundly better than going to the doctor's office. And one, which obviously makes a ton of sense in the context of Mindbloom is you don't have to go have a potentially weird, uncomfortable experience in someone else's environment that's not yours. You can actually have that at home.

Daniel Scrivner:

And if you extrapolate that out, you can just be in a much more comfortable environment as you're having these consultations. At least speaking for myself, literally my least favorite place in the world is being in any sort of hospital. I just hate everything from the waiting-

Jack Swain:

You're not alone.

Daniel Scrivner:

... to the way it feels like. It's not a good place, at least not in kind of my experience. So maybe just talk a little bit about that and like the things in which people might not know or understand that telemedicine actually helps deliver a profoundly better experience.

Jack Swain:

I actually liked being in hospitals from my time at Chartis, but I'm probably weird. I mean, a couple of other ways where I think telemedicine is so powerful is, and we talked about this in our prior conversation, but white coat syndrome, a lot of people see doctors and their blood pressure goes up. Because, usually when you're interacting with a doctor, it means something's wrong. So that's certainly a benefit of telemedicine.

Jack Swain:

Another is access. There's a shortage of mental health care professionals, so mental health. The access problem is even higher, but it spreads across many specialties within healthcare. But if you live in a rural area or someplace that's not close to the doctor's office or to a hospital, it's tough to get care. So even if you want to get psychiatric treatment, you may not be able to if you have to drive an hour and a half each way, maybe they're not in your insurance plan, who knows. And so when you have telemedicine, suddenly it allows anybody with an internet connection to get care.

Daniel Scrivner:

Yeah. It's profound. It obviously levels the playing field there in a pretty significant way. I want to know... Just get into the weeds a little bit. Because when we were talking before there just some fascinating little things that popped up that I'd love to explore to kind of round out the conversation.

Daniel Scrivner:

And one of those was you shared that, back in the 1960s, there was this wave of psychedelic therapy that was happening. And this was like really important research. You can still go back and read those studies and their really profound effects, but things just kind of stopped and that never moved forward. And that wasn't accepted. Talk a little bit about the history of psychedelic therapy and kind of what a shame it is that some of this has kind of been decades in the making.

Jack Swain:

Michael Pollan talks a lot about this and How to Change Your Mind, how there's no other example of research with as much promise as psychedelic medicine showed in the mid-20th century being just wiped away. And that was for cultural or political reasons. And we've been kind of in this decades dead zone of advancement in psychedelic research.

Jack Swain:

And the cost to our society is so high, when you consider that suicide is the top 10 leading cause of death, you have 50,000 deaths a year due to suicide, and how much more lost happiness, productivity because people just aren't able to function at their peak, either at their job, with their family, for themselves. There's just so much loss potential by shutting down research in this space. And so it's really, really sad.

Jack Swain:

And so the resurgence of this research and ability for us to show with, like brain scans, what's happening, again with like BDNF and your default-mode network, and kind of these leading evidence-backed hypothesis for why psychedelics are creating such transformational mental health outcomes is really exciting. And so we're back on the right path. It looks like the FDA is on board. Great institutions like MAPS, Johns Hopkins are really leading the charge. And we're really excited to play our role in the clinical delivery of these medications by increasing affordability, access, and approachability to psychedelic treatments.

Daniel Scrivner:

That's the second time you've mentioned Michael Pollan's How to Change Your Mind. And I'm guessing I might not the last, but I wanted to ask one question around that, which is, so clearly, if anyone is interested in psychedelic therapy, they should go read this book. And it sounds like it's a fantastic kind of primer on the history of it.

Jack Swain:

It's great. Especially if you liked Michael Pollan as an author, which... I mean, who doesn't?

Daniel Scrivner:

I know. I feel like I need to do more research and I definitely need to read the book because I haven't gone down that particular rabbit hole. I'm curious... So, obviously, the note is kind of, if this is interesting to you, you should absolutely go and read that book. What are some of the surprising things, most interesting things that you came across in that book that still stick with you?

Jack Swain:

Some of the research in that book. And The Psychedelic Explorer's Guide gets into some of the research as well, but there's just this like broad swath of research, not just for mental health indications, but also people using psychedelics to solve problems that they were stumped on at work. And so you had these like scientists, and engineers, and people that have these really heady jobs who are able to just make progress after taking a psychedelic.

Jack Swain:

And I think that's counterintuitive. You think that you're going to have this trip that kind of distorts your ability to think clearly and, of course, it wasn't at the peak of a psychedelic experience, but the ability for psychedelics to increase creativity and its effects on neuroplasticity and your ability to, as you mentioned before, break old thought patterns and thinking new creative ways was just so cool.

Jack Swain:

And so we're still confined as a society to using these chemicals medically. Some states are moving towards making them more broadly available. We have this kind of risk mitigation, often what feels like at-all-costs cultural stance on chemicals that induce altered states. And so hopefully, sometime in the future, there will be the ability for people to use these chemicals for personal growth and for creativity in solving sticky work problems in addition to treating diagnoses for mental health conditions. Assuming that the safety profile continues to look like it does today, we're able to educate people on how to use them safely and in the right container.

Jack Swain:

That was one of the coolest lessons of the book. Another is that the default mode network effects of psychedelics are similar to what you see in really experienced meditators. So it's just kind of turning off that part of your brain that's involved in normal day-to-day processing and these thought patterns. There's another great book called Stealing Fire.

Daniel Scrivner:

Great book.

Jack Swain:

Yeah. Yeah. Great. That talks about how entrepreneurs and extreme athletes have been able to use psychedelics to access flow states and enhance creativity. There's a lot of really cool applications of these medicines in addition to mental health. It'll be really exciting to see how, hopefully, the stigma continues to fade and we're able to move in a responsible but progressive direction towards getting the most out of these really remarkable chemicals.

Daniel Scrivner:

I for one extremely bullish on that longterm. I don't know anyone that's tried psychedelics that's had a life-wrecking experience. I know many people that have had a life-working experience with alcohol and other substances that are freely available.

Jack Swain:

That touches close to our home, for sure.

Daniel Scrivner:

Yeah. I hope that logic wins out at some point. I want to ask about one more thing, which is we talked a lot about neuro-plasticity. And one of the things I know that's an important part of the process that clients go through is journaling. So they're journaling as they're coming out of that experience, they're journaling in the days afterwards.

Daniel Scrivner:

And I want to focus on that for a second, because I'm sure everyone at this point has listened to some interview where someone's talked about the importance of journaling on their own life or something they do in the morning. That's often just to kind of regurgitate these thoughts, just kind of dump what's in your brain, get it out on paper and/or be able to kind of use that as something like therapy where you can kind of talk to yourself, have a conversation with yourself, make some observations while you're journaling.

Daniel Scrivner:

Why is journaling an important part of your process? And what do you think is happening when someone is doing that journaling, that's really helping this kind of a lock into place.

Jack Swain:

We have a great blog on our site on the benefits of journaling and some of the science behind journaling and how it applies to psychedelic therapy. So for any interested, check it out. That-

Daniel Scrivner:

We'll link into that.

Jack Swain:

... Does will log that does a much better job than I'm about to do. But with a ketamine therapy treatment, a lot of our clients... I'm a Mindbloom client myself, so I've had this experience. You have all of these thoughts that come up during your session. It's almost like a dream where you wake up from a dream and oftentimes you don't remember your dream, or if you don't write it down right away, it's really fleeting. And so journaling is important just to get those thoughts and insights down on paper.

Jack Swain:

And then there's also, kind of as you mentioned, this process of consolidating your thoughts. And really by writing them down on paper, you're starting this process of taking advantage of that neuro-plastic state to turn a fleeting thought into something that you can look back on. remember is true, and can really create change. Because there's... I'm going to do it again. I'm going to mention Michael Pollan's book again just because he summarizes so much of this so well. But when you hear something like love is beautiful, you know it's true but you don't really feel it. I mean, at certain times you do, but during a psychedelic experience, you may have these profound thoughts of something that seemed obvious. Like, now I really feel and believe to be true. Like, the most important thing in my life is my relationship with my partner. Or something.

Jack Swain:

And so when you write that down and then you look back at it and you remember how profoundly that thought impacted you during that session, it can bring you back and kind of reinforce how important that is. So, again, it's all this whole therapeutic process around taking what could be a fleeting experience and turning it into thought or behavior change.

Daniel Scrivner:

It's fascinating. I want to ask one more question. It could totally be a shot in the dark, but we've covered a lot of ground. So we've set kind of the foundation of what psychedelic therapy is, drugs that are used, who can treat effectively, how that treatment works. Talked about Mindbloom, the model you guys have pairing clinicians with guides and this kind of telemedicine approach. Is there anything that you feel like we haven't covered that this interview is wouldn't be complete if we didn't touch on it?

Jack Swain:

One thing that I think is important is that I'm, as our head of clinical operations at Mindbloom, really excited about is the research we're doing. And so we have, from day one, we've collected all of this really valuable outcomes data from our clients. And that's been part of our strategy from the beginning, is we know this is true from the clinical data, but now we want to prove that it's true so that we can really demonstrate that this is a safe and effective treatment as we scale.

Jack Swain:

And so we have baseline, mid, and end of program data from our clients. And we're launching what I believe will be the largest study of psychedelic medicine ever in the second half of this year. And so we're really excited to write this up and contribute to the body of knowledge in the field so that we can continue to see the field move more towards using these treatments that we believe provide just a 10X better experience and better outcomes than traditional treatments.

Daniel Scrivner:

Yeah. That's an incredible point. And it's amazing I had a conversation a couple of months ago with Josh, one of the founders of Levels, which has constant [crosstalk 00:50:39]-

Jack Swain:

Yeah, great interview.

Daniel Scrivner:

Yeah. Which is another friend. But one thing that's profound, just the connection between levels in Mindbloom, is it's so cool to me. I obviously am a huge believer in entrepreneurs building businesses and just the power of passionate people to kind of have an impact on the world. But it's amazing to me that Levels is set to have the largest, basically, constant glucose monitoring data set in the world. You guys now have this largest dataset of psychedelic therapy outcomes in the world. It is so cool to start seeing that private businesses are actually doing leading research, pushing fields forward and it's not just kind of contained in the research world or the medical world.

Jack Swain:

It's so important to have the data behind these decisions that we're making. And I think that's what's really exciting to be doing this for a company at scale, is now we have access to all of this data that we can use to refine treatments over time, find the right treatment, or, as we're able to use additional psychedelics down the road, what's the right treatment for the right person at the right time and having the data to really back it up. And that's been hard to in the past. And so using scientific method approach to really find out how we can harness what we've truly believe is the remarkable power of these medicines is really exciting.

Daniel Scrivner:

That's credible. And for anyone that's interested, people can go and visit mindbloom.com. And you talked about a quiz at the beginning. I guess, just to reiterate, for anyone listening that this seems interesting, where can they go? What should they do as a kind of next step?

Jack Swain:

Go to the website. Just right there on our homepage is "Get Started." And we put a lot of time into developing helpful educational content for our clients. So you can learn a lot about psychedelic medicine in general, the Mindbloom treatment model, how you work with your guide. So if you're curious, hopefully, anything you'd want to know is there on the site. And it's really easy to get started if you're interested in being a client.

Daniel Scrivner:

Jack, this has been a phenomenal interview. Thank you so much for your time. It's been so cool.

Jack Swain:

Yeah. Thanks so much, Daniel.

‍

Part Two: Jack Swain’s Habits, Influences, and Life Lessons

‍

Daniel Scrivner:

Jack's Swain, thank you so much for a little bit of extra time so I can ask you some of these bonus questions we ask every guest.

Jack Swain:

Great.

Daniel Scrivner:

The first question we always start with is some sort of connecting question. And since so much of what we were talking with revolves around mental health, I was curious just to ask if you have any practices that are important to you or that you try to do daily that are kind of centered around mental health?

Jack Swain:

The first few things are pretty standard. In priority orders, sleep, exercise, and diet. If I don't get seven hours of sleep, if I go a few days without exercising, I have a pretty high fat protein, low-carb diet. And those things are all really important to me for maintaining my energy levels like low stress. And I can definitely feel my mood and cognitive function just get really quickly out of whack if I'm not tending to those things.

Jack Swain:

I'm a periodic meditator. I don't have a daily practice, but it's something that I do as needed when I just feel that I need kind of a dose of mindfulness if I'm in a particularly stressful time or feel like I'm starting to lose that ability to kind of zoom out and have perspective on how I'm feeling.

Jack Swain:

And then what has been really helpful for me over the past two years is my ketamine therapy sessions. And so as, I mentioned in our last interview, I'm a Mindbloom client myself and my monthly sessions are just such a powerful reset and a great tool just in times of acute anxiety as they pop up as well, which has been more frequent during the past year during COVID than they've been in the past. So it's been a great tool to have in my disposal.

Daniel Scrivner:

Yeah. Unsurprising that stress levels have been higher for multiple reasons.

Jack Swain:

COVID Plus startup are a great recipe for unique levels of stress.

Daniel Scrivner:

Yeah. Turn that knob up to like 12 out of 10. So we always ask everyone on the show, this is a little bit of a repeat or an extension, but just to kind of broaden out. The question is around habits and routines. And you can take this question any way you want. It can be, I don't have habits and routines. It can be, I have them, or I've tried them, or here's what I'm doing now or here's what hasn't worked. I'm curious, are there things you do daily, weekly, monthly, that help you show up as your best self that you can share with everyone listening?

Jack Swain:

Yeah. The most powerful are the three I mentioned before; diet, exercise, sleep. Another thing that's a little weird is I'm very regimented in my caffeine intake. I find it just fascinating how many coffee drinkers don't have awareness of how much caffeine they're consuming. Grande's Starbucks is 300-plus milligrams of caffeine, which is a lot. And so in my early work years, I'd have these big morning spikes, afternoon spikes. And so I now take a hundred milligrams of caffeine at 6:00, 9:00, 12:00, and 3:00 PM. And so that-

Daniel Scrivner:

[crosstalk 00:56:04] the drink or is that a pill?

Jack Swain:

Could be either, but typically a pill. And so that's just how I kind of maintain this level of caffeination throughout the day. And that's, with experimentation over time, been just the right level.

Daniel Scrivner:

I'm blinking, too, but I've looked at some of those supplements and they not only typically have caffeine, but they also have something else.

Jack Swain:

[crosstalk 00:56:25]?

Daniel Scrivner:

Yes. That helps kind of regulate that. So is that what you take? It's a pill that has both of those?

Jack Swain:

I do take [inaudible 00:56:30] as well.

Daniel Scrivner:

That's fascinating. So talking about tools then, are there physical, digital tools that you love using? And these can be things in your personal life, things in your work life.

Jack Swain:

Okay. I'm obsessed with OneNote. So whatever your note-taking app. They seem to be pretty interchangeable, but I learned long ago that anything I don't write down, I will forget. And so I've been just religious about using my note app. And this kind of all crystallized. I read Getting Things Done, which is a widely applauded productivity and personal organization book. And that really helped to crystallize taking an approach that I thought worked pretty well. And then seeing like the best-in-class approach to personal organization. So email management, getting through your inbox, prioritizing your tasks, how you follow up with people, how you record agendas. And so kind of OneNote, and then applying the Getting Things Done methodology to that has gotten me to, I think my peak level of personal organization and productivity.

Daniel Scrivner:

That's great. I'm so glad you brought up getting things done. My experience when I read that book is I feel like I walked away being like, "Man, I must be the most unproductive person in the world." Because I wasn't doing anything in that book. It kind of lets you know where the bar is. And the bar is much higher than what most people think is.

Jack Swain:

Yeah. It's so nice, too, because it's one of those things we all come up with our own strategies for productivity. And so when someone's like, "Oh, hey, would you like to read the best one?" "Yeah, for sure." Again, now I don't even ask to think about it and I just know what the best method is and try my best to implement it.

Daniel Scrivner:

I've similarly had conversations with friends who have tried getting things done, tried other methodologies and ended up coming back. It's interesting, too, that it is... In the same way that you're trying to come up with the best approach to psychedelic therapy, getting things done is the best approach or the best system for kind of productivity. We ask one question of every guest that comes on, which I love. And you can again take this any way you like, but what do you think your super powers are? And where do they show up in your life?

Jack Swain:

I think my superpower is positivity. I'm a super optimist. I'm generally pretty buoyant. I see the silver lining in just about everything. And so I think just throughout life, as things have come up, I've always viewed like, how is this a good thing versus how is this a setback? And so I think that's a characteristic that I certainly hope that I can hold on to as I continue this journey in life.

Daniel Scrivner:

That's one of my favorite super powers. And no one has said that so far. So-

Jack Swain:

Oh, right on.

Daniel Scrivner:

... pus one for originality. So kind of the flip side of that coin, what do you struggle with? When I know, speaking for myself, there's kind of these themes in my life of things that have butted my head up against it that's taken me, unfortunately, 30-plus years figure and start moving the needle on. So the question is, what do you struggle with and how have you worked on those things over time?

Jack Swain:

One thing that's been a recent, past year or two, focus of mine is being present, working for a startup that you pour so much of your mental energy and time into. It can be really hard to turn that off. And so when you want to really show up for your partner, your family, stay in touch with people you really care about, that's something that I'm constantly focusing on.

Jack Swain:

And so ways that I've tried to improve there are like meditation, kind of trying to control the radio station that's playing in your brain. Sometimes I forget that that's something that I have control over. And so being mindful about what station is playing in my brain and consciously trying to change it has been helpful. And then just protecting time for the people I love, which I know you have a couple of young kids. So I'm sure that's something that you're working on, too.

Daniel Scrivner:

It's super important. And yeah, the only thing I would add there that I've kind of noticed over time is I think that the people who find the most energy, and meaning, and excitement in their professional lives. And that's not to say everyone, if you're a well-rounded individual, you should have that in all areas of your life, not just in your work. But if you have that, it feels especially important to find ways to shut that off. It really is kind of an on-off system. And I know a lot of people that can be things like turning off your phone when you get home, closing your laptop, not even bringing it into the house. Those are some things I've tried, but to be super honest, that's still something I'm struggling with.

Jack Swain:

Yeah. And working from home.

Daniel Scrivner:

Yes. That doesn't help.

Jack Swain:

You can't not bring your laptop into your house when that's your office, too.

Daniel Scrivner:

It's true.

Jack Swain:

But you brought up some good ways to kind of hack that.

Daniel Scrivner:

My hope is that the work-from-home movement helps people... Well, I think maybe better said, forces people to grapple with that and figure out a solution that works for them, because-

Jack Swain:

We'll have to. Or if this mental health epidemic isn't going to get any better if working from home just pauses deeper into the things that stress a lot of people.

Daniel Scrivner:

So we asked this question of everyone that comes on the show as well. Do you have any favorite books? And these can be books, these can be articles, but I think what we're really searching for is things that have had a profound impact on you that you can continue to kind of bubble up in your mind.

Jack Swain:

One is Freakonomics. I've read Freakonomics, I think in my senior year of high school, and that book just very much influenced both the way that I thought and my career path as well. The book is just such an incredible manifesto on incentives and how they can influence behavior, often in ways that you wouldn't expect, and always being cognizant of causation versus correlation. So Dubner and Levitt just do such a great job of laying out these concepts. And I had gone into college thinking I would major in political science and be a lawyer. And I switched to economics. And I think that a lot of the reason was reading that book when I did. So that's something that I think has potentially very profoundly shifted my career path in addition to the way I think.

Jack Swain:

Another, I won't talk anymore about this, but as we talked before, How to Change Your Mind. And the reason that I put that at the top is that was really foundational for my kind of understanding of how potentially profound psychedelics could be in the mental healthcare space. And it really kind of propelled me to jump at the opportunity to join Mindbloom when Dylan approached me. So again, without having that foundation, I still think I'd be here, but I'm not as confident as I am without that perspective going in.

Daniel Scrivner:

Yeah. You might not be here here, meaning in this role, at this company.

Jack Swain:

That's exactly what I meant. And then third... So one that's been really powerful as we've built out our culture at Mindbloom is No Rules Rules, which is the Netflix culture book. And it's awesome. It lays out how Netflix builds this culture of freedom and responsibility, and emphasizes the importance of candid feedback. The radical candor framework of challenge directly, care personally.

Jack Swain:

And then also that once you have that in place, it makes it really easy to remove policies and procedures because you have this self-governing organization and when you can remove policies and procedures and allow people to do what they think is best for the company and everybody has the experience of bureaucracy holding up, making progress on a project or getting your driver's license or whatever it might be.

Jack Swain:

So at Mindbloom we've really, really resisted developing policies and procedures and emphasizing this culture of candor. I think it's helped us all to be really comfortable providing and receiving constructive feedback, which is so important to growing and building an organization, and letting people just really thrive without too many restrictions and controls.

Daniel Scrivner:

Yeah. It's huge. I always find... I mean, just one comment on No Rules Rules. So I got that correct. I have to look at my notes to make sure I got that right.

Jack Swain:

It's tongue twister.

Daniel Scrivner:

Yeah, exactly. But just the one comment I was going to make on that is I have never met anyone at a hyper-fast growing company, so you could think of like a startup, that doesn't think they have an incredibly high bar for hiring. So this kind of commonality is everyone's like, we hire the best talent. But what's fascinating to me is if you then follow that through and see how they treat candidates once they join the vast majority of people say they hire the best people then they come in and they babysit them and they micromanage them. And it's always felt like a profound disconnect to me.

Jack Swain:

Totally.

Daniel Scrivner:

If you're hiring the best people, shouldn't you have an environment that allows them to thrive? So I love that books like that are being written. That's changing.

Jack Swain:

Netflix uses the concept of, I think it's called the informed captain. And so on any given project, the informed captain is the person who's ultimately making the decision. So it's not the person's manager who almost certainly doesn't have as much context about the project that their direct report has been pouring all of their time and energy into. And so if you truly believe, as you said, that you're hiring the best people, you should free them to make decisions, understanding that they have the most applicable information. And so it's like context over control as well.

Jack Swain:

And Dylan's great at that at constantly distributing how he's thinking about things and what our top priorities are throughout the organization. Then we cascade those down to our respective departments. And that's actually not even true. Cascading is a concept that we are very transparent at making things visible to the whole organization so that we can prevent the need for cascading, which you never want to play telephone.

Jack Swain:

I think Elon Musk had, there was... I think the Business Insider pointed out that he had a letter to his department where he said anyone who controls the flow of communication should find somewhere else to work more or less. And like the best path for communication is the shortest path. So if you need to tell someone, don't tell their boss, tell them directly.

Daniel Scrivner:

Absolutely agree.

Jack Swain:

So we really try to embody a lot of those principles of transparency and autonomy at Mindbloom.

Daniel Scrivner:

That's amazing. So we always have same two closing questions. And the first one is one of my favorites, which is if you can share a favorite failure.

Jack Swain:

I'll give one that's a throwback. So growing up, I was obsessed with baseball. And I had delusions one day being a professional baseball player. And then high school rolled around and everybody grew except me. I was very late to hit my growth spurt. And found myself as like one of three people cut from the sophomore team. And so on high school, you're in this so much of your identity and how you yourself socially is wrapped up in how you view yourself.

Jack Swain:

And so that was... I had to very quickly grapple with the death of my view of myself as a serious athlete. But then was able to kind of refocus that time in school and extracurriculars, which it turned out I was relatively much better at anyway. And so I think kind of that early setback and just jumping to being buoyant and kind of an optimist and, as I said before, I think my super power is positivity.

Jack Swain:

So I think that's kind of crafted the way that I think about my career, which is like opportunistically taking the most promising path and not getting too caught up in where I thought I would be, or being too focused on a path that I thought was important years ago. And I think that kind of path is also what led me to Chartis, and healthcare consulting, and then to Mindbloom.

Daniel Scrivner:

I love that perspective. And I love that point of view because it's so true. I mean, we all have those moments in our lives where it's like we think that our life is a book and we have the pen and we're writing the story ourselves. It's like that's so not true. You live in a world where there's so many other forces at play. And I think your point there that if you can detach a little bit from what you want and just be open and explore and accept whatever is most exciting that comes your way feels like a really great place to be in.

Jack Swain:

I love biographies. I'm reading the George Washington biography right now. And it's like how many things had to go right for him to be in the position he was. How many of his relatives had to tragically die for him to be in a financial situation. To go like lead the Continental Army.

Daniel Scrivner:

Wow.

Jack Swain:

It's just crazy. And so you think of somebody who's arguably the greatest figure in U.S. history and how many things had to go right for him to be in that position. And I think anytime you read a biography, there's our rare person who's just truly knocked down every wall to get to where they want it to be. But so many times, there's a lot of luck involved. And a lot of things have to go right in order for you to end up in the right place. And you certainly can't predict that upfront. So being opportunistic and rolling with the punches and just making the best of the situation is just like crucial to staying same, being happy.

Daniel Scrivner:

It seems like a timeless skill, given that biography. I'll find that and link to it. That sounds super fascinating. So the last question is, what is your definition of success?

Jack Swain:

My definition of success is what would need to be true in order for me to look back on my life in my later years and be proud of what I accomplished. And so knowing that I'm on that path or thinking that I'm putting myself in a path to accomplish those things is how I view whether or not I think I'm successful at any given time.

Jack Swain:

I think the three things that will have to be true in order for me to feel that way are, one, developing really strong relationships with the people around me, really mutually beneficial relationships. Two is making an impact in the world, like leaving the world a better place than I found it. And three is just often experiencing joy.

Jack Swain:

I'm trying to blank on his name, but there's a Harvard professor who writes about happiness. And he talks about how happiness is more a function of the frequency of how often you're happy, not the peaks of happiness. And so just spending a lot of time in that state. And so I think I have shied away from kind of pursuing paths that would be really hard, rough, long-term investments for some peak joy down the road and really focusing on making sure that at any given time I'm happy, enjoying what I'm doing.

Daniel Scrivner:

That seems like a huge plus one for what's about the journey and not necessarily the destination, because you need to be excited and happy all along the way.

Jack Swain:

Totally.

Daniel Scrivner:

This has been an incredible interview. So thank you so much for your time, Jack. I really appreciate it.

Jack Swain:

Yeah. This has been a blast. Thanks so much for having me.

On Outlier Academy, Daniel Scrivner explores the tactics, routines, and habits of world-class performers working at the edge—in business, investing, entertainment, and more. In each episode, he decodes what they've mastered and what they've learned along the way. Start learning from the world’s best today.

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