PTSD and psychedelic therapy

What is PTSD?

Trauma comes in many forms. Battlefield trauma, sexual assault, and physical trauma from an accident are all easy to identify. Sometimes, these sorts of traumas are referred to as "trauma with a “Big-T” because they are instantly recognized as life-threatening or life-changing events. But there are other, more subtle forms of trauma, known as "trauma with a small-t’". This group of experiences might include more subtle (but equally traumatic) events, that often occur in childhood, where chronic emotional (or physical) abuse occurred. This often happens in the context of living with a parent  or adult who struggled with addiction or mental illness. Sometimes trauma is something that happens to you, but trauma can also be something that doesn't happen to you. When a child experiences neglect (either physical or emotional), this also leaves an injury. Both “big T” and “little-t “ traumas result in injuries that deeply affect how our lives are experienced, even years later. Together, the effects of trauma can cause an illness in the survivors of trauma, and the illness has become known as Post Traumatic Stress Disorder, or PTSD.

When trauma leaves a mark on our lives, it may manifest in many ways.  One lasting mark is sometimes called 'intrusion'. Intrusion means that that the traumatic experience revisits us with intensity, making us feel like "it" is happening all over again. It can almost be like a flashback. There can intense emotion, and often times, we will say that we have been "triggered" by something. Sometimes we are triggered by a loud noise. Sometimes it is by intimacy. Sometimes it is a by nightmare. Intrusions from PTSD can severely interfere with our ability to live our lives.

Another injury caused by trauma is called 'avoidance'. Sometime after trauma,  we may completely forget about what happened to us, and the memories of the traumatic event(s) become hazy. Sometimes the emotions around what happened to us also become unavailable and we become numb to sadness, anger or fear that are normal responses to what happened. Sometimes we avoid those trauma feelings by medicating ourselves with drugs or alcohol: addiction and alcoholism are common symptoms of trauma. Sometimes, past trauma makes us consciously avoid any circumstances that trigger us, like driving, loud noises, or intimacy. Avoidance really interferes with our capacity to enjoy life.

Trauma can also cause  something known as ‘hypervigilance', which is also known as “hyperarousal”. Hyperarousal is present when we constantly scan the environment for danger, with heightened responses to any movement or noise. Sights, sounds, sensations, and smells can trigger a startle reflex. The trauma we have experienced in the past causes a constant sense of danger in the present (even when there is no danger).  Hyperarousal creates intense anxiety or even panic in the daytime, and hyperarousal also makes sleep difficult at night.

Finally, it is now recognized that many people who have experienced trauma struggle with mood problems (like anxiety, depression, panic, anger or rage).  They are actually experiencing another delayed effect of trauma. While depression and anxiety can be treated with antidepressants and anxiety medications, these medicines do not have the capacity to heal trauma, and so their effects can be limited if PTSD is the underlying mechanism of the mood disorder.

PTSD feels like we are carrying a heavy, invisible backpack filled with memories and emotions that weighs us down, every day. But healing trauma is possible, and psychedelic therapy with medicines like ketamine offer a way of healing that is different.

Psychedelic Therapy for PTSD: What it is

When we talk about psychedelic therapy for PTSD, we’re referring to treatments that go beyond medication.  Traditional psychoactive medicines like antidepressants work to improve the quantity of neurotransmitters like serotonin in the brain, and thus these drugs can relieve  some of the symptoms, like major depression.  The objective of these medications is to relieve symptoms, which can be helpful.  For persons with PTSD, the symptoms can be a long-term problem, and  symptom treatment with psychoactive drugs alone may have to stretch out for years.

Talk-based therapy has also been helpful for trauma, but often times, the symptoms of trauma fail to go away with mere talk therapy.  Psychedelic therapy is not merely talk. Psychedelic therapy is an experience. It is said that it takes an experience to heal an experience.  Even though it includes talk, psychedelic therapy is an experiential therapy that is intended to do more than relieve symptoms. Psychedelic therapy is a method for healing trauma.  Psychedelic therapy with Ketamine Assisted Psychotherapy (KAP), has gained attention because of it’s  potential for life transformation.

Why do I think of KAP as a holistic treatment? It is because KAP is not a treatment aimed at correcting a neurotransmitter imbalance in the brain.  Instead, KAP  is an experience that helps us reprocess the trauma that has happened to us.  When traumatic memories heal, our symptoms regress, or disappear.  With KAP, the whole person guides the treatment.  When I first see someone, I often say, “I don’t know what you need, in order to heal:  But there is part of you that does know”. That part of you that I am referring to is known as “the healing intelligence”.

The healing intelligence is the part of you that helps to create your psychedelic experience.  The healing intelligence engages when we prepare for KAP:  we begin by asking a client to set an intention for their session.  I will ask the person, “What is it that you would like to get from your KAP session?  What would you like to heal?”  These are key questions that involve the whole person.  Intentions involve our minds, and what we think about, and the thoughts that are downstream from the trauma we have been through.  These questions of intentions also involve our emotions, and the feelings that come up for us  over and over, as a result of our trauma. The question of intentions even involves our body, and the physical ways that trauma may linger on in our lives.  KAP therapy is a holistic treatment that involves the mind, heart, and body.

Integration for the mind and body

One of the most profound parts of KAP therapy happens after the ketamine journey, and is referred to as “integration”.  Integration takes place after the ketamine experience is over.  Integration actually begins at home. I counsel KAP clients to give themselves “A Spa Day” after their KAP session.  This means minimizing stimulation, like from cell phones and internet.  I tell them to try to find a quiet, nurturing space after they get home, preferably with a sense of nature.  I suggest that they take time to sit in the quiet, and allow their thoughts and new ideas to surface, in any way that seems safe and nurturing. . . I ask them to consider, “what did you just experience? What could it mean to you?” Many clients will journal about their experience.   Usually, the on next day we will plan another visit with me, which is called the “integration session.”  Together, we try to consider  together those images, sounds, or feelings that occurred during the KAP journey. . . we also try to explore how these things might be related to their intentions.  And this is where the magic happens.

A KAP journey can be like a message from your higher self.  It might be faint, distant message that requires patience and silence to understand, at first.  But when it becomes clear, the message can be one that unlocks trauma, and reshapes the things that we have learned from  our trauma.  Integration is an essential part of KAP work, because it helps us to reconnect with our bodies, our minds, and our hearts.  The outward manifestation of this internal reconnection is a kind of thoughtful calm, peacefulness that previously seemed impossible.

Is Ketamine Assisted Therapy right for me?

If you’re curious to learn about how KAP might fit into your healing journey, it’s worth exploring a medical consultation to see if KAP would be safe and appropriate for you.  A consultation with a specialist in ketamine therapy involves a careful intake of your entire history, including your psychiatric history (if any), your medical and surgical history, your social history, and your family history.  It also includes a physical examination with a check of your blood pressure, and a listen to your heart and lungs.  It takes careful review to make sure that ketamine will be safe for you.  Healing is not one-size-fits-all event. It’s about finding  the right path that nurtures your inner self.

When the consultation is over, then we then have space to answer questions, and to talk about the ways that KAP can be administered. We always talk about the side effects and the risks of therapy, and about safety measures that are in place for KAP sessions. And we also talk about the potential benefits for your case in specific, and how it might help you with the things that you are struggling with.  KAP is gaining recognition for its ability to help people with PTSD because they are able to find  meaningful relief, when other methods have fallen short.

Gregory Loewen DO FCCP is located in Buffalo NY, and is a leading provider of KAP in the Buffalo community, working closely with an allied team of trauma therapists, offering a compassionate and expert approach to this innovative treatment. If you’re exploring options, a consultation might be the next step to learn about whether KAP could be right for you.