Widespread, serious study of psychedelics for the treatment of mental health conditions is relatively new in the 21st century, and many conditions, substances and practices remain understudied in Western medicine, leaving low hanging fruit.
Take the potential use of psychedelics to treat complex childhood trauma. Clinical trials with MDMA have explored the drug’s potential for treating Post Traumatic Stress Disorder (PTSD) for instance, but such trials haven’t distinguished between types of trauma or studied if other drugs such as psilocybin could help such patients. The studies have also been conducted in controlled, clinical settings, and may not address whether MDMA or other substances effectively treat trauma when people take them on their own outside of the clinic — known as “naturalistic” use.
But a new study by the Wendy D’Andrea lab at the New School in New York suggests new approaches researchers might pursue regarding childhood trauma and the potential for studies of naturalistic psychedelic use to guide clinical investigations. Published July 11 in the journal Chronic Stress, the paper surveyed people with histories of childhood mistreatment and resulting trauma and found some people who reported using psychedelics also reported fewer complex trauma symptoms than those who did not use psychedelics.
More specifically, the study found that people who had experienced childhood abuse, and also reported using psychedelics with “therapeutic intent,” reported fewer symptoms of complex trauma and less internalized shame than people with similar backgrounds who hadn’t used psychedelics in this manner.
“There were participants who endorsed a history of having used psychedelics,” said C.J. Healy, a clinical psychology Ph.D. student in the D’Andrea lab and first author of the paper, “but did not endorse a history of having used them with the intention of healing and processing childhood trauma.”
Importantly, Healy adds, while around one third of participants reported using psychedelics with therapeutic intent, “It was a kind of subgroup of people who had used [psychedelics] more than five times that was driving that result,” they said.
The study was conducted via an online survey, which 166 people completed. Of those, 52 people reported using psychedelics with therapeutic intent, and of those people, 21 reported having done so five or more times. Of the substances participants reported using, psilocybin mushrooms, LSD and MDMA were the most common, but some reported using ketamine, DMT, ayahuasca, mescaline or peyote, and 2C-B as well.
Participants were also assessed for symptoms of internalized shame, a common symptom in survivors of childhood mistreatment, and for the self-reported severity of their traumatic childhood experiences. Participants were given the International Trauma Questionnaire, a 12 item measure that distinguishes between PTSD and complex PTSD.
“Complex PTSD is not recognized in the DSM, the Diagnostic and Statistical Manual, which is the most commonly used diagnostic manual in the [U.S.],” Healy said, adding that the International Classification of Diseases 11th Revision, “the newest diagnostic manual of the World Health Organization, does include complex PTSD.”
While PTSD is typically associated with single incident traumas, like a car accident, complex PTSD stems from ongoing traumatic experiences, like those of a prisoner of war or a child in an abusive environment. PTSD symptoms tend to involve intrusive memories, flashbacks, or nightmares, while complex PTSD symptoms involve distortions of “self concept,” Healy said, with people having negative views of themselves and difficulty relating to others.
The D’Andrea lab is largely focused on distinguishing the psychological and physiological profiles of these different types of trauma. Considering recent and historical evidence that psychedelics could be helpful in treating trauma, Healy designed the study to gauge the effectiveness of these substances in treating complex trauma.
Healy’s hypothesis was that there’s something about the psychedelic experience that is inherently helpful for people seeking to heal from childhood trauma. The strength of results among participants who used psychedelics five or more times “suggest that repeated uses of psychedelics are more efficacious than just a handful,” Healy said.
But it’s also possible that participants willing to take psychedelics five or more times with the expressed intent of healing past traumas had other life factors that contributed to their reduction in symptoms. “Maybe in general, these are people who are just more motivated to heal, and maybe they’re engaging in other healing modalities,” Healy said. “It might not be the psychedelic experiences alone, and might not even be the psychedelic experiences at all.”
It’s a preliminary survey study, Healy added, so it’s not definitive, “but hopefully it will point the way towards future research.”
That research will, they hope, focus on learning more about the potential benefits of naturalistic use of psychedelics, as well as their clinical use in treating complex trauma. But Healy added, such a statement “almost sounds a little ridiculous, because there are people around the world who have known that for thousands of years, and it’s just a given,” they said. “There’s a certain, I think, epistemic arrogance to say that we can’t yet say conclusively that using psychedelics, outside of formal clinical settings has therapeutic benefit.”