The Clinical Implications of Psychedelic-Assisted Psychotherapy for the Treatment of Trauma: An In-Depth Look at the Promising Results and the Unanswered Questions
with Bessel van der Kolk, MD; Richard Schwartz, PhD; Michael Mithoefer, MD; Rachel Yehuda, PhD; Gita Vaid, MD; Peter Addy, PhD; Rick Doblin, PhD; Ron Siegel, PsyD; Janis Phelps, PhD; Eboni Webb, PsyD; Megan Schmidt, PsyD; Ruth Buczynski, PhD
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Thank you! The risks at the close of this session are my takeaway: comprehensive, well stated and authentic concerns. It adds to my compassion and understanding of a person whose life was not supported in his ketamine treatments. It affected everyone and accelerated his divorce. Culmination of loss. Had he had the help of his therapist with this risk analysis the outcomes may not have been so damaging. What’s new isn’t always better. Even though we can do things, doesn’t mean we should do things. Thank you!
Very informative. I have learned about the practical uses of Psychedelic-Assited Psychotherapy. I will be able to share with my clients this option and refer them to a clinic that supports this valuable treatment modality.
What an intriguing session. Thank you! One question I often ponder on this subject: Has anyone ever done an in-depth study on the long-term after effects/side-effects of using psychelics?
Thank you. May I express a few “caveats.” It is courageous for Dr. Ruth B. to devote the time and effort required to develop a high-level, balanced discussion about a controversial treatment modality regarding which much preconceived social prejudice exists. As such, it provides a valuable piece of education for a theraist’s “tool box.” It is better to have correct information from researchers, rather than uninformed opinions from “the street.” The presentation is balanced, educational, and does not imply an endorsement. Nevertheless, it requires a “leap-of-faith” for traditionally-trained counselors and psychotherapists to step outside of their own contrarian bias against the use of psychedelics. let alone risk their professional reputation. This experimental therapy seems indicated for a very narrow, specialized range of clients. It is clearly still in an experimental stage of development.
This would probably not be apprpropriate for clients who have difficulty managing to provide basic needs for themselves and are not grounded in reality but tend to fantasize about escapist solutions.
These are merely my personal reflections, as perhaps NICABM is interested in feedback. The comments posted represent a gamut of reactions based on users’ experience. Probably more so than any other topic that NICABM has presented.
Well stated with a global perspective. Even seeing just one failed intervention where the losses are serious immediate irreparable, this tool is to be respected for the power it offers and the dangers inherent to its use.
Thank you for providing such comprehensive and concise educational material. As a psychedelic guide, I have witnessed positive changes in my clients every day, and it’s heartwarming to see the effectiveness of these well-packaged programs. I would love to be part of the referral or the community. Can you please advise me on how to proceed?
Blessings
This was my first real intro to psychedelic (PAP) work and, as one who uses EMDR with many of my patients, I couldn’t help wishing that someone (Bessel?) had spoken to the potential differences and similarities of what arises for clients with PAP vs EMDR … Even when Phelps at the end mentioned alternate therapies that might be seen as having overlapping effects, she named hypnotherapy, art and somatic therapy but not EMDR and yet so many of the effects mentioned made me think of what i’ve seen able to happen with EMDR, sometimes even in just one session of it … So my request would be that some further comparative discussion might be available (in a bonus or future program) ?? Wondering if perhaps anyone commenting here has experience with both PAP and EMDR use and might have some thoughts …
Dr. Bessel has addressed both of those topics in other of his full-length presentations. Perhaps contacting Support at NICABM can advise where to find additional information
I wonder whether developmental trauma and developmental complex Ptsd can also benefit from this form of treatment.
Mdma or ketamine sessions can be 4-6-8
hour sessions. Can Ruth or therapists who have spoken please give an indication of cost? The average client who stretch to do one therapy session a week can’t afford what I fear these sessions would cost…..
Please comment. Thank you
Hello Kathy, I have been working in a ketamine assisted therapy clinic for the last 4 years. Our sessions are scheduled for 2 hours. Clients are under the influence from 20-40 minutes depending on their metabolism. The average cost is $500 in our city. Insurance only pays for the therapy so it is difficult for some clients. We considered offering psilocybin therapy once that has become available, but those sessions do last 6-8 hours and we are not seeing it as a viable option for most clients.
Also, I have witnessed amazing breakthroughs for many clients, and a few who did not benefit from kap.
Very well thought out with systemic steps re PAP
I am fortunate enough to work with such a patient who just finished Ketamine -Induced Psycho therapy with a hospital based a psychiatrist. Having processed Serious Abuse ,he now seemed to be confronting Severe Neglect that was existed in the womb.
His 2 cancers are in check, Hypertension is cured as his Diabetes
Yet his Chronic Dysthymia to Alexithymia persists ; Not able to feel Pleasure. He is incorporating Loss of his successful Business now as Post PAP phase of the growth.
Thank you for explaining this complicated material
Thank you for another informative lecture. I come from one of those countries where we don’t readily have access to current thinking and practice and Nicamb has informed my work for years. I am also blessed to work with psychedelics in my work and personal life and this talk has been very helpful, especially with its focus on which patients might not benefit. I am very interested in the potential for MDMA to treat PTSD, and I like the focus on psychotherapy assisted ketamine. There are a number of ketamine clinics around where I live and none of them incorporates therapy into the administration of ketamine and I feel the clinical environment in which they are administered is exposing and “unsafe” with no therapeutic follow up. This talk has bolstered my belief that ketamine administered alone can be unhelpful and destabilising for patients.
I am wondering how to find clinicians or research studies for this treatment – so perhaps I can participate in a clinical trial.
Thanks to everyone involved. PAP therapy for trauma was a really interesting topic.
Fascinating session – with very interesting potential for providing excellent tools to “soften the repression barrier” and open pathways to healing. The therapeutic structure used in research into PAP seems critical to maximizing safety – and strikes me as one that will find great difficulty in being reimbursed outside of a research environment, especially for the many traumatized neighbors availing themselves of the publicly funded system. I will be very interested in how the field can work to ensure equitable availability of such interventions to those in need of assistance, regardless of individual ability to pay, while maintaining the structures of safety.
this was fascinating session for me to watch. I am a somatic practitioner and I use somatics to help people with chronic pain. I have trained my awareness and tolerance of uncomfortable feelings with thousands of hours of embodied practise. I also have complex PTSD and don’t have a therapist I can rely on. I use somatic classes to self heal. This session blew my mind. I have recently become obsessed in watching Charlie Sheen interviews, movies, looking at images of him. I have a rather vivid curiosity and often go on a rabbit hole research but this obsession with Charlie has woke me up that it is unusual as my whole lifestyle is rather on the healthy side – don’t some, don’t drink, have never taken drugs. I have been deeply curious what is driving me to feel so comforted towards Charlie Sheen. His narcissism, his drug use, daddy issues on my part. This sessions has made me realise maybe there are parts of me I am repressing. Even though these days I am less hypervigilant than in the past I still keep myself on a tight leash to connecting to others.
With hypnosis ( regression to the cause or therapy of the parts) and reframing, reparenting…, I can have the same results as what I heard in several comments.
Thank you for the in-depth session. I’ve been working with San Pedro cactus in traditional ceremonial settings. San Pedro contains mescaline, one of the psychoactive compounds found in the plant. The experience with San Pedro can be similar to MDMA: it evokes feelings of self-love and interconnectedness. Some observations and questions:
– Dr. Peter Addy: I really appreciated the advice he gives his patients going outside a clinical setting to experience psychedelics. I’d also encourage anyone doing this to obey any diet restrictions the medicine facilitator has established before/during/after the experience.
– Dr. Gita Vaid: I believe I heard her say it’s a motto, or “words to live by” that therapists don’t encourage to let things out of the box, even if it’s in the patient’s genetic makeup, if they don’t need to be….? That sounded like repression to me but maybe I heard that wrong
– Dr. Yehuda expressed concern about all the time required for MDMA treatment… what time frame was she comparing this to? Six
I am not a therapist, just an ordinary person to he who believes we are here to help each other out in what can be a difficult journey in this crazy life on earth. Many of my friends, and I have and are experiencing traumatic events. Some are using or considering using psychedelics. What I got from this presentation is a feeling of hope and reassurance that there is help available and significant scientific research into these possibilities for healing. As a lay person I offer you my thanks and gratitude for sharing your wisdom.
Sincerely,
Cyndi Scott
I’m VERY excited about the progress that has been and is being made within the mental health community to accept and include psychedelics like, MDMA, ketamine, and psilocybin as legitimate treatment options. I have long been an advocate for the use of MDMA in therapeutic settings to allow individuals to, not only, gain a deeper understanding of themselves and their past (traumas), but also to help them (re)connect to the world outside of themselves.
Regarding the use of MDMA, I’m interested to know what precautions are being taken to prevent (1) possible serotonin syndrome during treatment and (2) the extreme depression that can occur once the MDMA has worn off and there is a very low supply of serotonin in the brain due to the neurobiological effects of the MDMA.
I joined these sessions only today, and as a person who experienced psychedelics on my own back in the 70s,I deeply appreciate what I heard. The advice given at the end of the session is right on track, seems to me. I look forward to the coming units.
It is awesome that you provide all this information for free, this allows anyone interested in the topic to inform himself or herself about new therapy approaches that might help resolve experienced trauma and also enables therapists to consider learning about psychedelic assisted therapy and expanding their offerings to clients.
As a trained practitioner of EMDR and Mindfulness based, trauma informed psychotherapy, this module on the use of psychedelic assisted psychotherapy gave me an excellent insight into the risk-benefit dynamic of incorporating PAP into trauma treatment. The module carefully titrated the risks, benefits, contraindications and the stages of treatment with medicines like MDMA or ketamine. As with all therapeutic modalities, establishing a safe and secure relationship with the client is primary; followed by appropriate education of the client about PAP; managing the client’s expectations and intentions and having time to help the client integrate the experiences and insights they are gaining from PAP. This module offered a cautionary approach to this newer tool in helping to relieve our clients from the intense suffering of traumatic life experiences.
Thank you. This was very organizing. It confirmed what I knew regarding the extensive need to use psychotherapy as the framework in work with psychedelics, that being engaged with a therapist one trusts is vital and mundane in a good way.
The program has motivated me to research and connect with practitioners/clinics that provide this work. Do have information on resources?
The best directory for finding practitioners and clinics is Psychedelic Support. They also have courses and a speaker series!
Very Useful and Valuable information on accessing non ordinary state of consciousness to heal Trauma. The statement by Dr Peter that you can help your client touch the pain and yet feel safe was a beautiful perspective. Thanks to the whole team who made this happen and reach it to the world outside. Need of the hour with all the crises going around and more and more people in intense pain.
I found the psychedelic module fascinating, particularly the neurobiological effects of MDMA. I would have liked more information about the neurobiological components of ketamine; i.e., does it have similar results on patients with respect to more self-compassion, openness to experience, etc. Although they are both psychedelics, it’s not clear to me whether all psychedelics have the same neurobiological effects.
Thank you and thank you for all the useful info NICABM has provided over the years!!
This has been extremely valuable.
I am semi retired and although I wont be working in this field I now feel I would be able to refer clients who wanted Psychedelic assistance in therapy.
I am sorry my finances do not allow me to purchase the package.
Thank you for what you do.
Very helpful, informative webinar. In addition to potential benefits, this webinar gave me more language to educate clients who mention wanting to use psychedelics on their own. In the past I have encouraged them to contact a local clinic that offers KAP (Ketamine Assisted Psychotherapy) legally in California. I will continue doing that and have more info to share as a result of this webinar. Thank you NICABM for all that you offer.
Unfortunately, I haven’t seen the session yet. Am in Mexico to support a friend who is receiving stem cell treatment for MS. But I want to see! I struggle a bit with psychedelics as a form of therapy. I also struggle to accept Neuroleptics and “anti” depressants. As this can shut down natural feelings in the patient/client, and they are addictive. I work with drug addicts…. Therapy with psychedelics is to lead people into a form of psychosis? For me, natural psychoses are a way – for many – to cope with trauma. But this is being sickened in mainstream psychiatry today. Instead of meeting the person with psychosis in a safe, trauma-informed and good way, one meets psychosis patients with forced treatment. I wish we start with a humane psychiatry for psychosis patients and understand this. I am skeptical about yet another preparation (Ketamin, MDMA, etc.) that will “fix” the patient/client. Such preparations can quickly get out of control. These are my thoughts as an IoPT therapist. (Identity-oriented psychotrauma theory/therapy)
I caught the second half this morning, hoping to hear the full tonight or tomorrow, but the biggest message was: doing a psychedelic once does not heal the trauma. They also make clear that certain substances can activate overwhelming psychosis (like marijuana use in certain developing brains experience terrifying highs, some of which don’t know how to cope and turn to suicide) in individuals, or cause hidden traumas to be revealed by experiencing them fully. Which the latter can have different internal parts to be even more at odds with each other.
Also it was pointed out that if someone takes psychedelics and it’s a positive experience overall puts that person in a position of isolation, either because they tell people close to them whom will be bewildered to a point that they might behave towards the individual in a negative way to “restore” them to being traumatized again, or have no one to share what they are doing or experiencing.
I am so thankful for this session. Unfortunately I missed the The previous sessions on trauma. I have been in therapy for years and taking medication for my depression, anxiety, and sometimes panic attacks. My therapist suggested I look into psychedelic therapy. Based on this session I’m definitely not ready for MDMA. I have to say though that EMDR has done wonders. Thanks again for all the work you do and for allowing everyone to benefit from these sessions
Biggest takeaways:
– The term “medicine session” for the sessions in which a psychedelic is administered to the subject/patient and supported with a therapist present
– That Psychedelic-Assisted Psychotherapy therapy involves several preparation sessions before multiple rounds of medicine sessions and processing/follow up sessions
– That patients have been known to spontaneously engage with their internal “Parts” during medicine sessions (as is facilitated in Internal Family Systems or “parts work”)
– That it can take up to a year for a patient to fully process the breakthroughs that they experienced in the medicine sessions
Everything I learned made sense. As a holistic career coach, I use family systems constellations and parts work. While I don’t use psychedelics or plan to facilitate those kinds of sessions, it was fascinating to learn the cutting-edge research directly from some of the experts. And helpful so I can help clients understand the risks if they bring this up. As with everything from NIACBM,
Throughout the presentations tonight I kept on thinking about a client with complex PTSD whom I have been working with for years. I thinks she’s functioning better but the traumas have not been worked through in any kind of systematic way. These presentations tonight made me feel more hopeful about the possibility of her getting a different, supplementary kind of treatment that may be enormously helpful to her. I feel more knowledgeable and confidant that I could recommend that she and I research this possibility together, so thank you.
I always thought of psychadelic drugs in a negative light but thanks to this training video I’ve learned something new and very interesting. I am intrigued by the MDMA approach to treatment for PTSD. THank you!
This was very interesting and I am pleased to hear from the experts about the risks and benefits of treatment. I have talked to some clients who thinkg that PAP is going to be a quicker answer than other therapies. I now feel better prepared to discuss risks and information about harm reduction with people who ask. Thank you for this program. This was an introduction to the topic.
As a private practice psychologist, I feel more open to the therapeutic value of psychedelic psychotherapy and also see the overlap with other psychotherapy modalities, such as somatic, meditation, hypnosis, all of which I have employed at times with my primary cognitive psychotherapy orientation. I have already signed up for the Gold package and will re-watch this module but wanted to take the time to view this broadcast.
NICABM puts together so many really thoughtful, useful programs. There is a lot that is useful here. I wish Ruth Buczynski could relax a bit when she is presenting. I find her speech intonation to be all over the map, even shrill at times and her extreme head movements are distracting. Furthermore her presenters generally are more soft spoken and I have to turn up their volume or turn down hers. Please correct this.
“In a world where you can be anything, be kind.”
~James Anderson
As a layperson, working my journey, I find NICABM’s trauma-informed programmes hugely beneficial. And it feels heart-warming every time Ruth tells lay people “you are welcome here”. Thank you so much. Ruth also brings great clarity to the summaries, when very occasionally I find I have no idea what the therapist just said. It is a great privilege to have access to the latest insights from such wise, compassionate professionals (and I subscribe when I can). And, helpful shifts are happening with this Mastering Trauma programme. On psychedelics, I already knew they would not be for me, yet it is good to feel better informed about them. Thank you for everything.
Very helpful information. Great start to be able to support clients who have questions. Thank you.
One beautiful concept, thank you Dr. Ron Siegel: “soften the repression barrier”…that’s where healing begins, and there-in lies so much hope.
As pt and former clinician turned advocate, this will definitely help with explaining to other consumers whilst also advocating for increased trauma awareness and the translation of TIC to clinical practice in the real settings (inc reducing additional traumas and medical trauma, both factors in my ceasing clinical practice)
This was fantastic information – psychedelic assisted therapy is new to me and this has been extremely helpful to my clinical practice.
Self-regulation and the overlap with other modalities.
Thank you.
REALLY informative, thank you. I now feel that I would be able to better inform and guide my clients and patients who are exploring this new treatment.
Ruth, Ron, Peter & Bessel are clear. Some of the others, not so much
As lay person in long term treatment, and as a child of the 50s who has seen the popularity of psychedelic drugs rise and fall and rise again, I applaud your approach of integrating the drug into a larger treatment paradigm. Too often, I see pharmaceuticals of all kinds presented as the sole treatment, rather than as a tool to augment long term treatment methods. This is a great series, and I have much to discuss with my therapist from it.
Thank you for the information on the proper and beneficial use of Psychedelic-assisted therapy. I will definitely refer patients to trained professional therapists as a resource for the patient’s healing from trauma. Healing from trauma is to the benefit for the patient and all who are in community with the patient.
What a wonderful and resourceful session. I now empowered to work closely with a psychedelic- therapist to assist my clients that I feel need it. Thank you for this great information.
As always, I am SO appreciative that you do these sessions. I’ve had clients asking me about psychedelics. Unfortunately I’ve had a local psychiatrist pushing them on some of my clients, without any dialogue with me. This session has given me more language to use, for one. It was also relieving to know that I am doing some harm reduction type discussions. So thank you for the normalization of what I’m already doing! I want to read the studies you cited just so that I can become more familiar with the research. It was great to hear where the research is, particularly for MDMA. I think I have a better understanding now to be able to articulate ways that this can be useful and also ways that it may be de-stabilizing. Again, thank you!