Psychedelics could heal your trauma, says neuroscientist Rachel Yehuda

• Trauma exposure seems to be everywhere. And increasingly, the more we seem to be learning about the effects of trauma, the more stuck we're getting as a society. We've done such a good job of validating the experience of trauma exposure and of letting people know that traumatic experiences can result in mental health symptoms, and that it's not stigmatizing to develop symptoms of anxiety or depression.

But, perhaps we've done too good a job because I think people automatically assume that if they're exposed to trauma, they're going to develop a mental health problem. We see it as sort of an insurmountable burden or barrier when in fact trauma is something that is survivable. And we have tools to help people who have been exposed to trauma recalibrate.

For example, the idea of giving someone a psychedelic is that it helps put the person in a different frame of mind where they might be able to see what happened in a different way and use the lessons of trauma to really achieve resilience and post-traumatic growth.

I'm Rachel Yehuda, and I study post-traumatic stress disorder and the effects of trauma including intergenerational trauma. I think what's really helpful is to make the distinction between the experience of stress and the experience of trauma. Many people see it as a kind of continuum, with stress being a less serious version of trauma and trauma sort of at the other end of the spectrum—and that's not entirely wrong.

A stressful event is something that is challenging to you in the moment. It could be things aren't going so well at work, or we have an illness that we have to cope with, or financial troubles. When most people talk about a traumatic experience, they're talking more in the order of life threat: interpersonal violence, childhood abuse, being in a natural disaster.

The kind of events that are capable of eliciting a post-traumatic stress disorder are way more common than we think. About 70% of people have experienced at least one of these traumatic experiences, and about 25% have experienced multiple life-threatening events. Clearly, there is a range of challenging events with trauma being at the other end of the spectrum, but the differences go even deeper than that.

When we talk about a stressful situation, once you remove the stressor, usually you can relax, but I think with trauma it's different. The way that I like to think about a traumatic experience is an event that really divides your life; it's a watershed because the effects of trauma can remain with you even after the event is in the rear view mirror, even if there's no active threat; traumatic events have a bigger power to transform us.

When we look at some of the hormonal changes that we see in people that have post-traumatic stress disorder, you don't really see the kind of things you would see in someone that is undergoing stress. But it wasn't until we began looking at epigenetic mechanisms that we began to understand that in response to a very big traumatic event, there can actually be epigenetic changes that can change the way that the stress receptor genes function, and really in some way, keep alive a stress response.

But a lot of excitement occurred a few decades ago when people began to understand the experience of treatment is also an environmental experience that can have profound effects on epigenetics. And some of the work that we have done in the last decade has really demonstrated that there are epigenetic changes that are associated with an improved response to treatment, even to psychotherapy.

One of the ways that I like to think about how a psychedelic assists the psychotherapy process is really based on a quote from Stan Grof which says that "A psychedelic is to the brain what the telescope is to astronomy or the microscope is to biology." It just allows you to go deeper and see things that perhaps you couldn't ordinarily see. And I think that's exactly why these compounds have so much potential, and particularly MDMA for PTSD.

The idea of the cognitive behavioral therapies for PTSD has always been really correct and can work quite well for people, but also, equally, many people find that these therapies are just too emotionally draining or too distressing for them; many times they give up on the therapy. There's a lot of room after a traumatic exposure to kind of second-guess yourself.

What happens is that this narrative can be perpetuated every time you think about the traumatic event, which can be very often, and you start to believe that the problem isn't only what happened, but it's you. Being in a state that is induced by a psychedelic such as MDMA may enhance your empathy for yourself, your introspection, your ability to see things differently, and also make you feel part of the world.

And this last thing is really very important because a lot of trauma survivors with PTSD feel really alienated, they feel different, they try to avoid people. MDMA is now undergoing the last stage before FDA approval, and in phase two and phase three studies, MDMA has shown remarkable efficacy for reducing symptoms of PTSD.

About two-thirds of people that are treated with MDMA-assisted psychotherapy report no longer having PTSD, and also report feeling changed in a very positive direction. That's a very, very high rate of recovery for any kind of a treatment, and that's why it's exciting.

MDMA is not a classic psychedelic. It works very differently than say, psilocybin or ayahuasca. Those experiences produce a much more dramatic out-of-body experience, and I think those kinds of psychedelics can and should be tried for PTSD in clinical trials.

But they're different because while you're having those kind of experiences, it's hard to do psychotherapy; it's hard to be coherent in a sentence. With those kind of classic psychedelics, a lot of the healing work is recurring really after in integration.

With MDMA-assisted psychotherapy, a lot of the therapeutic work is being done in the session while you're in the altered state because you can be coherent because you are not having an ego dissolution experience. But for anyone that thinks this is a quick fix, that's a perception that needs to be corrected because it's a commitment that somebody is making towards their own healing and working in a very non-passive way so that they can tackle their lives in a different way.

What's fascinating about psychedelics is that the same person can have remarkably different responses in different settings. Even though this treatment has been found to work in two-thirds of people with PTSD, there's this other third. So everyone that tries this treatment has to understand that people respond very differently to different kind of medications and to make sure that you're working with people of the highest, not only therapeutic skill, but ethical standards.

So much of how they're going to work has to do with where you are, who you're with, what your intention is, and also probably your internal biochemistry. So, when we talk about MDMA-assisted psychotherapy for PTSD, we're talking about a process where there's readiness, where we prepare people to work with the medicine.

Ideally, therapists who really know how to work with trauma in an ordinary state can use those tools and techniques to help you do the work of pushing forward while you are in the state induced by MDMA, and really help you supercharge the psychotherapy.

I think what this public education message is all about is letting people know that there are so many ways to begin to deal with even the most severe PTSD cases. If you're watching this and you or someone that you know or love is struggling because a traumatic experience occurred to them, there is help.

We don't all respond to trauma with PTSD; our own experiences, the way that we were raised, biologic risk factors, genetic risk factors, experiential risk factors, all kind of come together at that moment to help determine what our response to a trauma is going to be.

We can use the power of culture and society to help each other cope from adversity rather than use it to make us feel more isolated and stigmatized. The beauty of the psychedelic-assisted psychotherapy experience is that it's restoring, repairing, achieving resilience, achieving growth, and really understanding how to go forward despite being exposed to trauma; it's beyond just surviving to living.

It's not about just dampening symptoms. It's really about going deep and correcting and changing this narrative that you got stuck in. Now, you're having a different narrative about how you can take your rightful place in society; that you are part of the world, you are part of the Earth, and you have more compassion for yourself—and having that legacy can be profound.

Traumatic experiences are here to stay, and we shouldn't view them as a prison. There are ways to also be resilient. There are ways to cope with trauma, and there are ways to do amazing things, not only despite the trauma, but because of the trauma.

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