In recent years, a promising new modality for trauma healing has emerged on the frontier of mental health treatment—psychedelic-assisted therapy. Although it was once heavily stigmatized, this approach is gaining recognition and credibility as a powerful tool for facilitating psychological healing and growth. This post will explore the promise of psychedelic-assisted therapy for trauma healing from a clinical perspective.
Understanding Psychedelic-Assisted Therapy
Psychedelic-assisted therapy combines the use of psychedelic substances with psychotherapy. This approach typically involves a series of preparatory psychotherapy sessions, a supervised psychedelic session, and follow-up integration sessions.
The psychedelic substances most commonly used in this form of therapy are psilocybin (the active ingredient in "magic mushrooms"), MDMA (3,4-Methylenedioxymethamphetamine), and LSD (Lysergic acid diethylamide). These substances can facilitate deep psychological exploration and can bring to the surface memories or emotions that are often inaccessible during traditional talk therapy (Mithoefer et al., 2016).
The Role of Psychedelics in Trauma Healing
Psychedelic substances, in the context of a therapeutic setting, can facilitate profound experiences that aid in trauma resolution. They can catalyze a range of experiences, including reliving trauma, releasing suppressed emotions, gaining new perspectives, and fostering a deep sense of connection and unity (Grof, 2001; Carhart-Harris et al., 2016).
Research suggests that psychedelics might enhance the effectiveness of psychotherapy by increasing emotional access, enhancing therapeutic alliance, and facilitating transformative experiences (Nichols et al., 2017).
MDMA-Assisted Psychotherapy for PTSD
MDMA-assisted psychotherapy has shown considerable promise for the treatment of post-traumatic stress disorder (PTSD). MDMA increases the release of hormones and neurotransmitters—like oxytocin, prolactin, and serotonin—that foster trust, bonding, and wellbeing. This can help individuals feel safe and supported as they revisit traumatic memories and work through difficult emotions (Mithoefer et al., 2018).
Preliminary studies indicate that MDMA-assisted psychotherapy can significantly reduce PTSD symptoms and improve quality of life, with effects often sustained over long-term follow-up (Mithoefer et al., 2013; Feduccia et al., 2019).
Psilocybin Therapy for Trauma
While psilocybin has not been researched as extensively as MDMA for trauma, it shows promise as a therapeutic tool. Psilocybin can facilitate profound shifts in consciousness, often leading to insights and emotional release that can help individuals heal from traumatic experiences (Griffiths et al., 2016).
LSD in Psychotherapy
Although LSD was widely used in psychotherapy in the mid-20th century, its use became restricted due to societal and political pressures. Today, researchers are re-exploring its potential therapeutic benefits. Like psilocybin, LSD can induce powerful alterations in consciousness, which can facilitate deep psychological exploration and healing (Gasser et al., 2014).
Considerations and Future Directions
While psychedelic-assisted therapy shows promise, it is crucial to consider the potential risks and challenges. These can include challenging or distressing experiences during the psychedelic session, potential mental health risks (particularly for individuals with a predisposition to psychosis), and potential misuse or abuse of psychedelic substances (Johnson et al., 2008).
Moreover, the integration of these experiences into one's life is crucial for realizing the potential benefits of psychedelic-assisted therapy. Integration involves making sense of the experiences during the psychedelic session and applying insights to everyday life, often with the help of a trained therapist (Schenberg, 2018).
Looking ahead, more rigorous, and large-scale studies are needed to further establish the safety and efficacy of psychedelic-assisted therapy for trauma healing. Additionally, work is needed to develop best-practice guidelines, therapist training programs, and policies to facilitate the responsible use of this promising therapeutic approach.
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References
Mithoefer,M. C., Mithoefer, A. T., Feduccia, A. A., Jerome, L., Wagner, M., Wymer, J., Holland, J., Hamilton, S., Yazar-Klosinski, B., Emerson, A., & Doblin, R. (2018). 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for post-traumatic stress disorder in military veterans, firefighters, and police officers: a randomised, double-blind, dose-response, phase 2 clinical trial. The Lancet Psychiatry, 5(6), 486-497.
Grof, S. (2001). LSD Psychotherapy (The Healing Potential Potential of Psychedelic Medicine). MAPS.
Carhart-Harris, R. L., Bolstridge, M., Rucker, J., Day, C. M., Erritzoe, D., Kaelen, M., Bloomfield, M., Rickard, J. A., Forbes, B., Feilding, A., Taylor, D., Pilling, S., Curran, V. H., & Nutt, D. J. (2016). Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study. The Lancet Psychiatry, 3(7), 619-627.
Nichols, D. E., Johnson, M. W., & Nichols, C. D. (2017). Psychedelics as medicines: an emerging new paradigm. Clinical Pharmacology & Therapeutics, 101(2), 209-219.
Mithoefer, M. C., Grob, C. S., & Brewerton, T. D. (2016). Novel psychopharmacological therapies for psychiatric disorders: psilocybin and MDMA. The Lancet Psychiatry, 3(5), 481-488.
Mithoefer, M. C., Wagner, M. T., Mithoefer, A. T., Jerome, L., & Doblin, R. (2013). The safety and efficacy of ±3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study. Journal of Psychopharmacology, 25(4), 439-452.
Feduccia, A. A., Mithoefer, M. C., Jerome, L., Holland, J., Emerson, A., Mithoefer, A., & Doblin, R. (2019). MDMA-assisted psychotherapy for treatment of PTSD: study design and rationale for phase 3 trials based on pooled analysis of six phase 2 randomized controlled trials. Psychopharmacology, 236(9), 2735-2745.
Griffiths, R. R., Johnson, M. W., Carducci, M. A., Umbricht, A., Richards, W. A., Richards, B. D., Cosimano, M. P., & Klinedinst, M. A. (2016). Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. Journal of psychopharmacology, 30(12), 1181-1197.
Gasser, P., Kirchner, K., & Passie, T. (2014). LSD-assisted psychotherapy for anxiety associated with a life-threatening disease: A qualitative study of acute and sustained subjective effects. Journal of Psychopharmacology, 29(1), 57-68.
Johnson, M. W., Richards, W. A., & Griffiths, R. R. (2008). Human hallucinogen research: guidelines for safety. Journal of Psychopharmacology, 22(6), 603-620.
Schenberg, E. E. (2018). Psychedelic-Assisted Psychotherapy: A Paradigm Shift in Psychiatric Research and Development. Frontiers in pharmacology, 9, 733.
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