Trauma and Psychedelic Research

According to Rowland Griffiths, the “peak experience” of a psychedelic trip can vary from “transcendent and lovely to literally hell realm experiences—as frightening an experience as you have ever had in your life” (CBS News 2020). This hell-realm experience, otherwise known as a ‘bad trip’, needs to be better explored as psychedelic experiences are not always fun (Jones 2016). As the term ‘trip’ refers to the intoxication of psychedelics, a bad trip occurs when these substances induce negative experiences involving intense emotions such as excessive fear, paranoia, agitation, sadness and anger (Richards 2018, 16; McMains 2017).

It is important to discuss the consequences of bad trips because some can be so intense that they can leave lasting effects. One of which is hallucinogen persisting perception disorder (HPPD) – a chronic disorder that occurs post-psychedelic trip where the user has flashbacks of visual hallucinations, distorting reality. HPPD sufferers can develop depressive and anxiety disorders - especially if the condition is chronic (Halpern & Pope, 2002; Halpern et al, 2018; Hermle 2012). Early estimates of the prevalence of HPPD were dismissed as outliers as it was thought that only 1 in 50,000 psychedelic users suffer from it. However, the most recent large-scale survey which surveyed 2,500 users found that over 1 in 25 were considering treatment for HPPD-like symptoms (Baggott, 2011). It is important to note that these participants were recruited from Erowid, a popular website for drug information, meaning the participants did not necessarily represent the average psychedelic user (Baggott, 2011). Only a small portion of them had actively sought medical care. In psychedelic research, it is important to consider the sample groups in question (i.e. Who is being studied? Who is the outlier? Who responds differently?) (Thal et al, 2019)

Moreover, bad trips should be taken more seriously in regard to post-psychedelic therapy, as flashbacks of negative psychedelic experiences may potentially traumatize or retraumatize an individual. This makes the integration aspect of psychedelic therapy extremely crucial, specifically in terms of ensuring the individual has a support system (Fadiman 2011; Zeifman et al, 2020).

Psychedelic language & historical uses and abuses

Perceived changes in a person’s ego are part of the psychedelic experience (Nour et al, 2016). The brain’s default-mode network (DMN), an interconnection of brain regions that are said to show lower levels of activity when focusing on a specific task (paying attention) and higher levels of activity when not engaged in mental exercises. The DMN is known to be responsible for the sense of self: self-monitoring, self-awareness, self-control and self-identification. Psychedelics disrupt the default-mode network, leading to “ego-dissolution” also known colloquially as “ego death”, where the boundaries between the self and others dissolve, and where differences are no longer clear. So, ‘object-representation’ (how things are perceived) and self-representation (how one identifies themselves) become blurred. This loss of self that is responsible for the euphoric feeling of “oneness” and “unity” has been associated with reducing suicidality, addiction, and psychological distress (Nour et al, 2016).

The peak experience is commonly referred to as the “mystical experience” with its transcendental qualities. Walter Stace compiled six basic features of the mystical experience: sacredness, noetic quality (intuition), deeply felt positive mood, ineffability (unexplainable), paradoxicality, and transcendence of time and space. In a study conducted by John Hopkins University, most participants reported encountering these common core features after taking psychedelics. It is important to note, however, that these participants were “well-educated and psychiatrically and medically healthy” (Barrett & Griffiths 2018) so it would be naive to assume that just about anyone would experience the same transcending, mystical effects. For this reason, it is crucial for psychedelic researchers to examine the rhetoric used in the field, specifically, through the core feature of ineffability - the inability to describe the experience in words. As the psychedelic experience is said to transcend ‘the narrow limitations of words and concepts’, it is difficult for those without first-hand experience to understand its intensity (Shortall 2014, 197-98). This gives leaders of psychedelic research an opportunity to claim a sense of authority and expertise in articulating the drug experience to their benefit, to challenge critics of psychedelic drugs (many of whom have never had these experiences).

As ego-dissolution disrupts ego-boundaries, the adult brain becomes child-like, with it’s “hyper-emotional and imaginative nature of an infant’s mind”. This strong level of vulnerability is extremely crucial in psychedelic research, as many psychedelic propagandists are not innocent of deploying these drugs as a form of social control. As psychedelics have been proven to alter rigid ways of thinking about the world, the counterculture movement advocates for psychedelics as revolutionary political tools. In doing so, it is important to keep in mind its historical uses and abuses such as Project MK Ultra, the Narco Farm, and several cult formations.

MK Ultra CIA Experiments  Source: BuzzFeed Unsolved Network, 22 Nov 2020

Much of the research on post-traumatic stress disorder (PTSD) is focused on war veterans, however PTSD can be found in many other contexts. After investigating genetic and trauma-related risk factors for PTSD in an urban population of low-income, highly traumatized, predominantly Black women and men from ages 18-75 years from 2005 to 2012, an Emory University study determined that there were higher rates of PTSD in African American and Latino populations living in economically disadvantaged urban areas compared to returning war veterans.

Symptoms of PTSD and Ongoing-Traumatic Stress Disorder (OTSD) manifest differently in different cultures. Because of this, symptoms of race and cultural-based trauma do not always meet the criteria for the Diagnostic and Statistical Manual of Mental Disorders (DSM) - despite their significant distress - and therefore, fail to recognize the diverse range of experiences of communities struggling with collective historical and intergenerational trauma.

When looking at the effectiveness of psychotherapy for treating PTSD, most studies also focus on veterans. More recently, organisations and researchers in the field of psychedelic studies have advocated for the medicalization of psychedelics, claiming that these substances have immense healing potential for a range of mental illnesses -- including PTSD -- which nonetheless have focused on the treatment of war veterans.

Jacob’s Ladder (1990), Adrian Lynne’s film based off of stories of the US Army’s experimentation of psychedelics and dissociatives on soldiers.

Yet whilst these developments may seem hopeful, psychedelic science - like numerous other fields of medicine and psychotherapy -- is severely lacking in terms of its recognition of diversity of experience and access between different classes and racialised groups within society. According to Williams and Labate, current models of psychedelic therapy are deeply resource-intensive, and therefore likely inaccessible to those who are socioeconomically disadvantaged once medicalized. Psychedelic research is largely grounded in a white-dominant medical framework, and this calls for more inclusion and diversity in the field. It is also important to remember the historical injustices of psychedelic research, as many people of color were used as experimental subjects in early psychedelic trials. In the 1960s, there was a series of experiments done at the Research Center in Lexington, Kentucky where incarcerated black men were used as subjects for researchers to observe how much LSD the human brain can handle before it ‘melted’. These experiments were justified due to the men’s incarceration for drug crimes and the assumption that they could handle it because of their affiliation with drugs. They were paid in heroin for their participation in the study. Because of the dark history of research participation among African Americans, many people of color are hesitant to participate in clinical trials today. Furthermore, they are seldom in positions of leadership in the psychedelic research community and are thus underrepresented and underserved at all levels of psychedelic research.

The American National Institute of Health’s (NIH) Revitalization Act requires government funded research to include women and minorities in proportion to their representation in the general population. Psychedelic research is largely privately funded and not compelled to include minority populations in representative. In 2018, the Multidisciplinary Association for Psychedelic Studies (MAPS) researchers conducted a meta-analysis of 18 studies of psychedelic-assisted therapy from 1993 to 2017 and found that out of 282 participants, 82.3% were white, 2.5% were African-American, 2.1% were of Latino origin, 1.8% were of Asian origin, 4.6% were of indigenous origin, 4.6% were of mixed race, 1.8% identified their race as “other,” and the ethnicity of 8.2% of participants was unknown.

The normalisation of race and class disparities in psychedelic research simultaneously underrepresents these groups in research and maintains their absence from research positions: psychedelic discourse is by and large dominated by white experience. The fact that those of different races and ethnic groups are absent from the conversation is a contingent effect of stigma, economic inequality, culture, and different drug experiences. This topic remains relatively unaddressed in institutional psychedelic discourse. Researchers must go beyond trying to recruit diverse populations into studies that have been devised by and for white people.

In order to broaden the conceptualization of how research is designed, it’s necessary to go beyond “representative sampling” and ground psychedelic experience of marginalized communities. Where in mainstream psychedelic discourse, there seems to be a tendency to downplay the intensity of effects that bad trips can have on a person. This must be taken more seriously, as flashbacks of bad trips may potentially be traumatizing or can reinforce old wounds by re-traumatizing an individual. This makes the social integration aspect of psychedelic therapy crucial: individual participants need to have equal access to a strong post-treatment support system. This is an issue -- intimately related to class and racialisation -- which is often sidelined, simplified, or outright ignored.

Psychedelic language & historical uses and abuses

Sources

Chronic Pain and Psychedelics

June 2021 Newsletter

Psychedelic Chronicles