Meet the neuroscientist & army officer helping veterans get the treatment they need at Heroic Hearts

Dr Grace Blest-Hopley is the research director at Heroic Hearts. After graduating from King’s College London with a Master’s, she earned a PhD studying the neurochemical and neurofunctional effects of cannabinoids. She became a postdoctoral researcher at the same university. Instead of spending her free time relaxing, Grace joined the British army, where she is a reserve Infantry officer.

We had the chance to speak with Grace at Plant Medicine Week to discuss the work she and her colleagues are doing at Heroic Hearts, how psychedelics are helping veterans with traumatic brain injury, and more.

Can you tell me about your experience as an officer in the British army? Given that you’re an academic researcher, what motivated you to join?

I joined because I wanted something completely different from academia. I wanted something that was a challenge with opportunities to learn and hone new skills that you don’t get the chance to develop in academia. 

I have a lot of friends in the army and a lot of respect for what they do. Initially, although academia and the military didn’t go hand in hand, I decided to go down that route anyway. At first, I applied for the military intelligence side of things, but I quickly realised that wasn’t why I wanted to join. I wanted to do the fun bit, the hard bit; running around with a rifle in my hand. 

Being an officer has given me an excellent opportunity to practice my leadership and management skills. Joining the army happened around the same time as joining Heroic Hearts. Being a part of Heroic Hearts and the army helps me understand the journey and experience of many veterans a lot more, but joining them happened independently. 

What impact has Heroic Hearts had to date? How many people have been to retreats? And what change have you seen in people coming back?

There have been roughly 200 people who have been through a Heroic Hearts program. The changes we see are phenomenal and utterly life-changing in most veterans who we have helped. 

After they’ve gone through the program, we also see veterans join together and support each other, almost like a family within Heroic Hearts. Further to that, they inform others about how psychedelic therapy has helped them and begin to teach others about our organisation.

In the U.K., Heroic Hearts is relatively new, so we’re only just starting to send people from the U.K. to retreats and to form a network. We have a database of maybe 50 or 60 veterans in the U.K. who are on a waiting list to go through the programs. In contrast, in the U.S., Heroic Hearts have up to 500 people waiting to take part in our programs. 

Funding restricts how many veterans we can send for therapies. If funding wasn’t an issue, we could be helping thousands of veterans worldwide. 

You are now conducting an observational study alongside the retreats you’re facilitating. Can you elaborate on some of the preliminary evidence you’re finding and maybe some of the early results?

The study was specifically designed to take place alongside our psilocybin retreats based on head trauma and PTSD. The retreats, held with facilitators with years of experience, are designed explicitly for Heroic Hearts and the veterans we serve. However, we have expanded our research to include the other programs Heroic Hearts takes part in. Now, groups that go to Peru to take ayahuasca also have the opportunity to participate in the study. 

The measurements differ slightly depending on which retreat you’re part of. In our retreat for TBI alone, we have cognitive and neurofunctional testing alongside a whole battery of questionnaires that look at the psychological side of things, e.g. depression scores, PTSD symptoms, quality of life, and chronic pain – which are all highly relatable to head trauma. 

The cognitive side of things is fascinating. We use a specific program involving veterans completing several tasks before and after the retreat to evaluate their attention, memory, and motor control performance. One of the final parts of the study is using EEG to explore the functionality of the brain and the rhythms of certain brain waves before and after they go through the retreat program. 

The cognitive and EEG parts of the study are done relatively close to the retreat. In terms of psychological measures, we follow up with the participants for up to 12 months after.  

With delays due to COVID, we have only just started getting veterans back to retreats and gathering data. I’m working with some of our other scientists and interns to get that data processed.

As far as preliminary results are concerned, we have some information to share. From previous work Heroic Hearts has done in collaboration with some universities, the retreats were generally shown to have a positive psychological impact on participants. 

Although not with veterans, our colleagues at Imperial College have shown that the mystical and transient experience of the retreat is very important, which I didn’t fully appreciate initially trying to tackle these problems as a neuroscientist where the approach is often more rigid.

A very clever part of the observational study takes place whilst participants are at the retreat and dives into the mystical experience and what it means to the participants. We’re seeing that this experience is often correlated to the improvements in people’s psychology. 

Regarding the EEG measures, is there anything you’re looking for or seeing that could be considered specific to people with a TBI or veterans that suffer PTSD as a whole?

The protocol we’re using could be considered broad. Given that it’s a newly developed protocol, we are taking more of an investigatory approach. In people with traumatic brain injuries, we see particular alterations in certain brain waves like delta waves, which appear to be disturbed as a result of injury and are not very rhythmic. 

We’re using resting states to look at these delta waves that have been reported to be very erratic in one-off cases, which, in turn, have become more rhythmic as a result of psychedelics in some case studies. I don’t think anyone knows exactly why or how this happens, but we are in the early stages. 

In the U.S., we’re seeing a lot of work going on in clinics developing new technologies for the treatment of head trauma that directly stimulate these brainwaves to be more rhythmic as a treatment program. It may be the case that psychedelics are doing this internally instead of using an external stimulation, but there isn’t enough evidence to be sure. 

The EEG part of the research is one of the most novel aspects of our work, so it is pretty challenging to say what we expect. Initially, we will have to start slow and look at these things in quite a primitive way, but doing so will give us the necessary results to inform more extensive trials and better understand what’s going on. 

In the observational study, are the retreats only taking place with psilocybin or other medicines like ayahuasca included?

Ayahuasca retreats are very close to the hearts of the founders of Heroic Hearts (US and UK), Jesse and Keith. We gather much of the data for the ayahuasca retreats, just like in the psilocybin retreats. However, the psilocybin retreats included more novel measures ( cognitive and neurofunctional) and have been focused more on TBI. 

After the observational study, is Heroic Hearts planning to run an interventional study to understand the treatment effects better?

We would love to do that 100%. We’ve tried to incorporate a form of a waiting list that could act as a control with our current protocol for the observational study. I’m not sure how meaningful it will be when we get down to the numbers, but it will give us some kind of control group to compare the data with. 

Once we have done the observation trial and if we have the results that we think we are going to get, we would love to go down the route of designing further interventional trials and being more specific regarding people with different diagnoses of head trauma and perhaps involving more neuroimaging. 

It all comes down to whether or not we can get the funding for it and can we get ethical clearance. We would all love to do these things. Still, the reality of the situation when using these scheduled substances is that a lot of time, effort and money is required to get protocols off the ground. 

Academic studies take a long time to do. There’s an internal review board (IRB), government approval, and the peer-review process. As a researcher, is it frustrating that it takes so long to get these types of studies up and running?  

Yes, absolutely. I’m constantly amazed, and not in a good way, about the slowness of this process and how incredibly frustrating it is. I’ve also done a lot of research in the cannabis world, and it’s the same. You have to go to the Home Office and get everything approved under ridiculous circumstances if you want to do anything that might involve a scheduled substance being present. And I won’t even get started on the joys of the peer-review process at times.

What we are trying to do at Heroic Hearts is essential to formulate a hearts and mind piece where we take veterans through our programs, and they come out at the end with genuine personal stories regarding how our program and psychedelics have helped them to heal. 

It is evidence such as this that governments will listen to as opposed to the research data. The government is more concerned about what these therapies look like, so we’re hoping that our work will be one of the most powerful tools to break down the barriers, change public perception, and make research that much easier. 

Realistically, it’s not going to be a scientist with the world’s best protocol that will change the government’s mind. It will more likely be a veteran turning around and saying, “this therapy changed my life and the lives of my fellow soldiers”.

In a recent blog for Heroic Hearts, you hypothesise that the co-morbidity between traumatic brain injury and PTSD might result from similar brain structures such as the hippocampus and the amygdala being affected. In what way do you think psychedelics can help the brain recover? 

In both cases, we see these brain regions becoming quite rigid in how they work. Particularly in head trauma, we see that these regions lack plasticity and cannot adapt and change to the situation. A lot of the reasoning behind this is due to inflammation.

This one really is a hypothesis because we don’t have much evidence beyond the idea that psychedelics increase plasticity in these areas due to the change in functioning resulting from the injury. But, from the evidence we have, I believe that some psychedelics alter inflammation markers, reducing inflammation, particularly in parts of the brain, like the hippocampus, which is vital in learning and memory. 

I don’t think we realise how much memory plays a part in everything we do and how much memory is required to contextualise everything we do. By reducing inflammation in that area, you free up that part of the brain to work better. 

Additionally, you get changes in the transcription of genes, altering the way genes express and the production of proteins, producing growth factors and transcription factors that allow that part of the brain to grow and adjust as required. 

We tend to believe that the brain grows to a certain point and then won’t grow anymore. But in particular parts of the brain, like the hippocampus, we are continuously laying down new memories every minute of every day, so it has to be quite plastic to work effectively. Therefore the hippocampus can be one of the most affected regions when you lose plasticity. 

Heroic Hearts jumps in when someone is suffering for the long term. Do you have any hypotheses if psychedelics can help if someone has a brain injury immediately after the injury? For example, if someone becomes concussed as the result of a blast.

I don’t think anybody knows, but this is quite close to my heart at the moment. My brother had a car accident and sustained a head injury. Obviously, in my mind, I’m thinking, okay, well, we can sort this out. We can treat this. 

But when you have a head injury, the immediate point afterwards is that you have that acute inflammation and those acute reactions in the brain due to the insult. Do we think psychedelics could be helpful at that moment? At the moment, I’m not sure. 

I think acute inflammation is important. That’s the mechanism through which the brain protects itself. It’s a mechanism that’s there for a reason. If you applied psychedelics at that time, would it be beneficial or harmful to a brain homeostatic reaction that has evolved to protect us? 

You probably remember when Michael Schumacher had that skiing accident, and he was put into an induced coma. The point of that is you almost want just to let the brain be still, allow the regulatory parts of the brain to do their homeostatic thing to try and clean up the mess and put things back together.

I can’t see how psychedelics would be applicable at that moment. Still, once we’re talking four, five or six months down the line, the acute components of inflammation have done their work. You’re now dealing with a brain that deals with the initial insult and has become more rigid. Through chronic inflammation, parts of the brain that need to regrow cannot do so. This is where psychedelics become a tool but the exact moment when such a tool could be applied is a question above my pay grade at this moment in time.

What does the future of Heroic Hearts look hold? Where do you see Heroic Hearts in five years? 

If we talk way into the future, in a way, I guess we don’t want to be working. Given our primary aim is to help veterans who are really in a bad way, we’re not like a typical company where we want more growth and more customers. Instead, we want fewer customers. That’s the whole point; we want to make people better. That is sadly probably a bit utopian at this point.

I can’t answer the long-term future, but we want to carry out more retreats in the medium term. We’ve only been operating for two years in the U.K., and we are still trying to get our charitable status to do a lot more work there. We also hope to expand our operations. For instance, we now have a Heroic Hearts in Canada. In the military, we very often work multi-nationally, we are brothers in war, and we are brothers in the difficulties many face once those wars are over. 

We want to become more prominent advocates for veterans in the space and be a mouthpiece for these new forms of treatment. There are a lot of charities out there that are for veterans and the treatment of veterans with PTSD. Still, in the U.K. at least, we are one of the very few charities talking about using these potentially much more effective ways to treat PTSD.

We also want to conduct and participate in more research. With all the research we do, we’re delighted to collaborate with different universities and for other companies to come and work with us, but it has to be about integrity and doing what feels right for the charities’ ethos to do good. It’s not about helping anyone for commercial gain. It’s about getting veterans better and getting better research around what works and advocating for this research so that treatments can be available for everyone that needs them. This is not a commercial endeavour. We’re here because we want to serve those who have served their countries and whose needs are not being met.

This interview is part of our ‘Psychedelics & Traumatic Brain Injury Report,’ find out more information on our TBI page.