Research on the use of psychedelics for mental health issues has been publicized quite a bit recently. Experiments in the use of psychedelics are demonstrating benefits in healing for chronic conditions such as Post-Traumatic Stress Disorder (PTSD), addictions, end of life processes, depression, anxiety (Miller, 2017; Pollan, 2018). The use of these medicines has recently received research breakthrough status (MAPS Press Release, 2018). From a therapeutic standpoint, a lot of questions have been raised as to its veracity because people have been using these substances recreationally for centuries. Shouldn’t we have a lot of “healed” people running around the world? Well, like most things, the answer is yes and no.
The fact is that most people do not know how to use these powerful medicines, when to use them, and for what purpose, when they start taking them recreationally. This then is what causes unhealthy relationships to form. Historically, these drugs have provided more healing/inspiration then negative outcomes and rarely have they directly killed people. What has killed people is the societal suppression of these medicines due to perceived fear and ignorance. This fear and ignorance, societally produced, prevent proper education on the use of psychedelics. This has helped create the toxic relationship to these substances. Also, our culture has failed to manage or provide proper assessment and guidance for people seeking what these medicines intrinsically offer due to these suppression tactics. This is a failure of society and culture, not the individuals.
When people ask me about how taking these medicines to heal addiction can be true, I say, we weren’t only doing them because they were “fun.” The topic on the use of psychedelics in therapy offers me the opportunity to reflect upon the underlying psychological process being accessed. As people understand the psychological process of healing that is at work in all therapies, they find that it is not much different then a deep conversation with a friend or loved one, fasting, floating, yoga, or dancing. The therapies of Eye Movement Desensitization and Reprocessing (EMDR) and Brainspotting are the ones that I use because they were effective for my own substance use disorder on stabilized in recovery. To me, the application of psychedelic medicines can address an underlying process of healing that happens in all trauma resolution therapies (and all therapies in general when done properly) once the therapeutic relationship has created the safe space to open up. So, I would like to explore the use of psychedelics as a trauma resolution method.
As a person in recovery from abusing substances, I have taken more than my fair share of psychedelics. As a trauma and addiction clinician who utilizes the trauma resolution methods of EMDR, Progressive Counting, Mindfulness, somatic therapies, Expressive Arts, and Brainspotting to help people heal from their traumas and addictions, I can say without a doubt that the underlying process of memory reconsolidation (which is what produces trauma resolution) is being activated when psychedelic medicines are being used.
Memory consolidation is how we naturally store our memories for the day and memory reconsolidation is when we revisit or reactivate memories in order to resolve and stored them accordingly (Ecker, Ticic, & Hulley, 2012). Both memory consolidation and memory reconsolidation are processes that we do naturally. Every night in our REM sleep we do bilateral stimulation (left to right movements) which is believed to be storing our memories for the day (Shapiro, 2001). Bilateral movements also happen when we walk, run, write, read, cook, play music, and when we are making art. This is why exercise, hobbies, creative arts, and expressive arts are effective ways to help people with trauma healing. Similarly, effective talk-therapy will reduce symptoms of anxiety, depression, panic, and anything else because memories are continually being retriggered to reconsolidate when the client talk about what is going on for them. If you have ever had difficult experience which you replay over and over again, you have engaged in the basic premise for Progressive Counting (Greenwald, 2013). If you have ever stared or gazed off into space in a focused and intentional way like in Brainspotting (Grand, 2012) then you have done memory reconsolidation. If you find yourself doodling and not consciously knowing why, you are expressing your self creatively.
Since these processes are happening naturally and in some instances, automatically, they can also be replicated in therapy. While there is a lot more to them that this rather simple explanation, the fact that we do these naturally means they happen more regularly than not. So, it can also be inferred that they are naturally happening when one takes a psychedelic but psychedelics offer more of an opportunity for memory reconsolidation because they provide access through the removal of our psychological defenses.
It has long been understood that recreational drugs lower inhibitions, social correctness, or ego defenses. The mechanisms in the brain that are either turned on or off during these processes vary depending on the drug but for the most part, a person is more open to experiences or ideas when on a psychedelic substance, for better or worse. This is where the psychedelic drug turns into medicine. We can use psychedelic states to help open people to their emotions or confront the psyches manifestations. Without going into the brain mechanisms that may or not be activated when someone is under the influence of a psychedelic, one thing is for sure: what needs to be addressed is going to come up. So, the skillful means of planning, preparation, and guidance is necessary.
What is so often reported after a psychedelic use is that people gained insights into themselves, their past, or the nature of being or existence because their psychological material comes up and got worked through. It is often reported during or after taking a psychedelic that visual representation of the past present, sense of time is altered, feelings of floating, and videotapes of old memories are played out to a point of resolution. My clinical experience, particularly with EMDR and Brainspotting, collects similar reports from clients doing these therapies. So, it is not surprising that MDMA trials for PTSD are showing positive outcomes.
My question is this: if a memory created in dissociative state, does one need to be in a dissociative state to resolve it? An interesting aspect of the trauma resolution therapies of EMDR and Brainspotting is that they are really predicated on the act of dissociating into a memory but with dual attention (Shapiro, 2001) and dual attunement (Grant, 2012). Because of this, my answer to my question is yes. The vehicle of how one gets there, is players choice. However, skill and the art of therapeutic means are inevitably needed for successful outcomes because the relationship provides the opportunity for dual attention and dual attunement in the form of having a witness.
Furthermore, if we take a neutral point of view, the question of whether memory is either traumatic or a peak experience is debatable because it is subjective to the observer. I argue that the survival brain retains memories or experience of value in addiction vs. a memory that gets stuck in the memory system as in PTSD. Either way, a memory is held until reprocessed because of its value.
Here is how I know addiction is held as a “traumatic” memory. I have targeted my own drug use as well as that of hundreds of clients with EMDR and Brainspotting and have resolved them. This is not to say that I am (or they are) “cured” but I can say the recovery created on resolving addiction/traumatic memory is firmly situated on principles of healing. For this reason, I am open to utilizing whatever means necessary for clients to gain access to healing.
Another reason why I know that psychedelics activate memory reconsolidation and the Adaptive Information Process (AIP) with specific drugs like LSD is due to my training as an EMDR therapist. We had to test-drive the techniques on each other, meaning that we also got to experience them. When I first did EMDR, I had a similar experience to the first time that I did with LSD and felt the awe-inspired relief, as if I understood the meaning of life or at least my role in it. I felt connected and insightfully present as is often reported by people who have done LSD. In EMDR terms, this is the accessing of the AIP in the brain and is the foundational theory of EMDR (Shapiro, 2001). AIP is activated when new information is introduced by revisiting the memory which allows us to make a connection that was not available before and allows for a paradigm shift happen in cognitions, beliefs, somatic memory, and personality structures. This, in turn, allows us to become more adaptive in our thinking, hence in your lives and actions. However, one of the more difficult parts to therapy is when we are not open to the new information or the process they are engaging in.
My personal experiences with taking psychedelics speak to the same mechanism being activated like when I am watching clients do their trauma healing and when I do mine because the feedback is the same. All trauma resolution therapies activate memory reconsolidation when done properly but what they all have in common is that they are experiential (this is why Mindfulness, Yoga, and somatic therapies/breathwork are effective too) and ultimately psychedelics are experiential too. Any experience that lowers our defense mechanisms and allows us to find out more about ourselves, our true nature, or allows us to be open to new information is going to allow our natural healing energies to be activated can be turned into therapy. Psychedelics open up our psychological processes, which are based on the experiences that we have had i.e., memories and since the brain works through associations a lot of the symbolism, representations, and manifestations that a psychedelic trip can take one on are grounded in one’s psychological makeup and past experiences. If our psychological makeups have unresolved attachment issues, traumas, or addictions they are going to come up because the ego defenses are down, due to the opening of psychological processes. This is why set and setting are critical to a smooth trip but also why a mental health screening is worth doing before taking these substances freely. I personally believe that people should not do drugs before the age of 25 because the brain has not had the chance to fully develop and the effects on the emotional maturation process typically becomes delayed.
When it comes down to it, healing happens when you engage in solutions. Yet, with addiction, we are often over-healing to the point of hurting ourselves. I will address my concerns for addiction/recovery and the use of psychedelics in another post, but at the end of the day, psychedelic healing can offer another avenue for people to utilize under the guidance of a skilled practitioner. I believe that psychedelics, when used properly and under the proper guidance, can provide the healing needed to resolve traumas and our addictions because they lower ego defenses, AIP, and activate the memory reconsolidation process.
What is different from recreational psychedelic use is the intention setting pre-session, therapeutic structure, and guide during the session, and post-session follow-ups to help apply the insights. Also, dosage and purity of substances are maintained to maximum healing effect. If we do not set appropriate intentions, have an experienced guide who knows the lay of the land, or apply what we learn, then we remain in our own ignorance (this also applies culturally as well). This is why I am in support of having psychedelic medicines available to professionals. What psychedelic integration services offer are psychedelic assessment and evaluation, pre/post integration, and crisis services.
In summary, the use of psychedelics offers willing participants an access to the state of mind needed to heal because they create a state of defenseless ego that allows trauma resolution. Once the person is open to the therapeutic process, memory reconsolidation is more available; and when that happens people are able to get relief from their suffering.
Ecker, B., Ticic, R., & Hulley, L. (2012). Unlocking the emotional brain: Eliminating symptoms at their roots using memory reconsolidation. New York, NY: Routledge.
Greenwald, R. (2013). Progressive Counting: Within a phase model of trauma-informed treatment. New York, NY: Routledge.
MAPS Press Release, (2018). https://maps.org/news/media/6786-press-release-fda-grants-breakthrough-therapy-designation-for-mdma-assisted-psychotherapy-for-ptsd,-agrees-on-special-protocol-assessment-for-phase-3-trials Retrieved on 12/28/18.
Miller, R. (2017). Psychedelic Medicine: The healing powers of LSD, MDMA, Psilocybin, and Ayahuasca. Rochester, VT: Park Street Press.
Shapiro, F. (2001). Eye Movement Desensitization and Reprocessing: Basic principles, protocols, and procedures. New York, NY: Guilford Press.
Pollan, M. (2018). How to Change Your Mind: What the new science of psychedelics teaches us about consciousness, dying, addiction, depression, and transcendence. New York, NY: Penguin Press.
Other Psychedelic Research can be found at https://maps.org/research