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As co-creator of New York's Sexuality Speaker Series, a think tank for cutting-edge, out-of-the-box discussions around sexuality, psychology, and society, I'm always looking for new ideas that challenge the way we are conditioned to see things. Recently, we had psychotherapist Dee Dee Goldpaugh speak about current research on the use of psychedelics as a potential clinical adjunct to treatment resistant conditions such as depression and PTSD, and particularly the implications towards the treatment of sexual trauma.
Most people associate psychedelics with illicit drug use and 1960s era free-spirited optimism. At the time, the psychiatric establishment was busy studying the mind-enhancing aspect of psychedelics, and most of the prominent LSD advocates, such as Dr. Timothy Leary were respected psychiatrists. Since then, psychedelics have fallen out of favor; LSD was made illegal in 1966, and most of the others followed suit in the early 1970s with the passage of Richard Nixon's Controlled Substances Act. Currently, most psychedelics, including LSD, psilocybin, MDMA, and peyote are considered Schedule I substances, meaning they are considered by the government to have little medical value and high risk for abuse. However, times are changing again, and it is incorrect to assume that these same psychedelics have been placed in the dustbin of psychological history. Many folks don't realize that in psychiatric research, psychedelics are making a comeback.
Research on such chemicals as psilocybin (the psychoactive ingredient in "magic mushrooms") and MDMA ("ecstasy") are now in Phase 3 FDA-approved trials, with significant preliminary results. Psilocybin research at Johns Hopkins University and NYU, for example, have found that patients with terminal cancer experienced a reduction in mortality related depression and anxiety and heightened levels of well-being.
The Johns Hopkins study found that even "at 6-month follow-up, these changes were sustained, with about 80% of participants continuing to show clinically significant decreases in depressed mood and anxiety. Participants attributed improvements in attitudes about life/self, mood, relationships, and spirituality to the high-dose experience, with [more than] 80% endorsing moderately or greater increased well-being/life satisfaction."
According to the NYU study, "Psilocybin produced immediate, substantial, and sustained improvements in anxiety and depression and led to decreases in cancer-related demoralization and hopelessness, improved spiritual well-being, and increased quality of life. At the 6.5-month followup, psilocybin was associated with enduring anti-anxiety and anti-depressant effects (approximately 60–80% of participants continued with clinically significant reductions in depression or anxiety), sustained benefits in existential distress and quality of life, as well as improved attitudes towards death."
Similarly, MDMA has also shown to be highly effective in clinical research on PTSD. The Multidisciplinary Association for Psychedelic Studies (MAPS), an advocacy organization for the medical use of psychedelics, sponsored research with 130 PTSD patients. War veterans struggling with PTSD reported a significant reduction of symptoms after MDMA-assisted psychotherapy, in which they had psychotherapy sessions in real-time while experiencing MDMA. According to one such study, "after three doses of MDMA administered under a psychiatrist’s guidance, the patients reported a 56 percent decrease in the severity of symptoms on average. By the end of the study, two-thirds no longer met the criteria for having PTSD. Follow-up examinations found that improvements lasted more than a year after therapy." Clearly, psychedelics appear to be an untapped resource in the treatment of a wide variety of mental health conditions.
Let's go back to psilocybin, as the most interesting finding for the purposes of this article was that psilocybin showed a positive change in expanding the psychological trait of openness to new experiences. As I've written about before, psychologists currently divide personality into five key dimensions, using the acronym OCEAN- Openness to new experiences, Conscientiousness, Extroversion, Agreeableness, and Neuroticism. Openness and comfort with sexual exploration are likely correlated to the personality trait of openness. In one psilocybin study, in particular, 61 percent of 51 participants demonstrated a lasting and measurable change in openness.
Why this is extremely important is that individuals that have suffered trauma often close down, as their world shrinks due to fear and anxiety. Those who have suffered sexual trauma, often close down sexually. Their bodies may tense up, and rather than being able to surrender to the moment, they enter a sexual encounter with extreme hypervigilance. In this way, trauma changes personality.
What this new research suggests is that the clinical use of psilocybin may change personality traits back in a way that reduces some of the negative personality changes experienced due to PTSD. Specifically, more openness may allow the individual to take more risks and feel more comfortable in situations that they previously would have been too avoidant to even try.
This is especially groundbreaking because lasting personality change has always seemed elusive through talk therapy alone or through any of the existing available psychotropic medications. Interestingly, a new meta-analysis was recently published that seemed to indicate that neuroticism and extroversion could be improved via psychotherapy, particularly in anxious patients. At any rate, numerous studies, here, here, and here suggest that openness is one of the most important traits linked to positive sexual experience, and psilocybin appears to influence this dimension. If positive personality change can occur through the clinical administration of psychedelics, that may very well be one of the biggest breakthroughs in psychiatry in years. And it could also have significant implications in helping individuals heal from sexual trauma.
