There is no denying that psychedelic medicines offer potential for healing beyond the reaches of talk therapy. But their tremendous healing potential carries with it equal capacity for abuse. Beyond my own experiences, history supports this view — whether it be the LSD trials of the CIA, Ewan Cameron’s thought control experiments, or the current spate of sexual abuse and iatrogenic harms pertaining to ayahuasca and other realms of psychedelic tourism. The intimacy of my first-hand involvement in the Phase II clinical trial for MDMA-assisted psychotherapy for treatment-resistant PTSD weighs heavily against my desire to challenge every facet of this approach.
I cannot write objectively about psychedelics, if it means denying my subjective experience. But the latter is conflicted: How can I have benefited from psychedelic medicine and yet still feel concern about its expanding use? How is it possible to be convinced of all things flawed in the psychiatric industry and biological paradigm of “mental illness,” while simultaneously allowing for judicious, time-limited drug use as a possible adjunct to ongoing psychotherapy? How can I think there is a place for mind-altering substances in anyone — let alone myself! — despite having experienced incalculable harm from psychiatric drugs? Finally, having researched and written extensively about the flaws of FDA-approved clinical trials, why would I subject myself to the same?!
Ultimately, healing is a deeply personal journey. When it comes to figuring out what’s best for an individual, my view is this: If it’s not unethical, immoral or harmful (or, at least, less harmful than alternatives), and it’s working for you, do it. One man’s Risperidal is another man’s Reiki. In the end, respect is the only way thoughtful conversation can ensue. Educated, evidenced-based and informed decisions emerge from understanding and dialogue, not dogma.
In the end, there are no easy answers.
For the past two years, I’ve felt the pulse of psychedelics in my heart, as a clinical subject and women struggling with PTSD, and in my head, as a researcher and long-time critic of all thing psychiatric. My hope here is to do justice to both perspectives. This essay is the first of a series exploring psychedelic use in trauma. Some pieces will be objective. Others, as with this one, offer an entirely subjective first-person account.
Over the Mountain
“DRIVEN AS A MIGRATING FALCON, I CAN BE BLOWN OFF COURSE YET IF I TURN BACK IT FEELS WRONG. NAVIGATING BY CHART AND CHANCE AND PASSION I WILL KNOW THE SHAPE OF THE MOUNTAINS OF FREEDOM, I WILL KNOW.”
— MARGE PIERCY
Light dances over a moss-covered cabin decomposing into old growth woods. As the sun sinks behind the mountains, a chorus of wolves echoes the haunting cries of loons. On an island cradled by the northern Salish Sea, I am miles from where I ever thought I’d be. I am also – incredibly – home.
Over a year has passed since the clinical tsunami swept across my life. In its aftermath, the stories to which I desperately clung disintegrated. My perceptions of stability did the same. I staggered across the landscape of my thoughts, seeking new paths to replace well-trodden dead ends.
When the tears finally came, they spread like bullet wounds across my therapist’s chest. There were two with me at all times. Hugging me often. Holding me as I cried. Providing the touch I craved as much as feared. Denied yet ached for, with the longing of a child unsure of what was safe.
Therapeutic breakthroughs occur on the edge of consent. They pushed me hard, my toes curling in protest. But each time I fell they were there. Holding my fragments together until the wounds mended enough to carry on.
As we journeyed through that gauntlet of horror, our alliance was forged. I was literally loved back to life.
After years of single-mindedly focusing on critical psychiatry, this foray into psychedelics feels vaguely illicit. In my not-distant past, it would have been unfathomable to contemplate any benefit of mind-altering drugs – let alone their use in treatment. Increasingly, if cautiously, however, I find myself doing precisely that.
It’s impossible to ignore the disparity between what’s lauded as acceptable or rejected as anything but. Especially when such determinations run counter to scientific rationale. Particularly since the topic is deeply personal.
Repetitious and relentless in nature, neither drug nor desperate action can ever fully numb posttraumatic stress. Healing requires venturing deeply into the cauldron of one’s soul, finding passage through fear and the means to transform vulnerability to strength. Doing so requires peeling off countless layers of armor like a skin that once fit but now only strangles. This brings little relief; there is a perception of losing oneself at every turn.
To take a psychedelic, writes Reichel-Dolmatoff, is “to return to the cosmic uterus and be reborn. It is to tear through the placenta of ordinary perception and enter realms where death can be known and life tracked through sensation to the primordial source of all existence.”
In January 2015, a Health Canada-approved Phase II pilot study of 3, 4-methylenedioxy-N-methylamphetamine (MDMA)-assisted psychotherapy in chronic posttraumatic stress disorder (PTSD) began in Vancouver, British Columbia. Sponsored by the Multidisciplinary Association for Psychedelic Sciences, this study marked the first psychedelic research in Canada in 41 years.
Six Canadians were selected as participants.
I was subject number one.(1)
There is no other word to describe the impact of trauma: The gut-wrenching awfulness of falling apart, no matter how fervent the efforts to hold together. Lapses in ability to remember countered only by an inability to forget. Triggers that surge without notice then dissolve into a haze of humiliation. Terror-filled sleepless nights on a mattress turning mouldy from repeatedly sodden sheets. Socially alienating behaviours. Socially isolating fears. Addictions. The effect on family and friends. The shame. Most of all, the shame.
Clawing oneself forwards in painstaking effort brings moments of normalcy. Interludes measured by the ability to function. Manage. Cope.
“Cope,” that is, until the next trigger or self-inflicted wound starting with the word ‘should’ turns peace into pieces as fragile walls come crashing down.
Countless appointments, therapies and pills mark an agonizing trajectory through the medical system. Diagnoses are flung like sophisticated insults by health providers too unconscious to notice the irony of their own triggered states. Complex trauma doesn’t fit neatly into a Cartesian box.
At last, all the drugs, adjuncts, hospitals, programs, doctors, therapists, therapies, are exhausted. Despite innumerable attempts at eradication, the symptoms wreaking havoc on this subject’s life persist. The final diagnosis slams down like a personal failure: “treatment-resistant PTSD.”
Those who bear their wounds present an awkward social commentary. Acknowledging all that lead to trauma in an individual requires admitting something deeply concerning at a systemic social level. Posttraumatic stress disorder is a perfectly normal response to abnormal, overwhelming trauma–much of which happened long before the focal event. Acute trauma hooks onto developmental wounds. To be expected to ‘recover’ in a medical system that ignores this, operating instead on a reductive model that alienates, isolates, or seeks to eradicate without addressing the underlying causes, is itself both iatrogenic and deeply traumatizing.
Fittingly, the words cure and curiosity share the same root. Both come from Latin; cura. To care.
No ‘technique’ that ignores the caring influence of the interpersonal relationship can wholly dissolve the roots of trauma. Whether biological, mind/body, acronym soup (DBT, CBT, MBSR, EMDR etc.) or even psychedelic, any method that measures recovery rate by symptom reduction alone is simply covering the underlying pathology — to wit, literally, re-cover. A dependency on the therapeutic relationship alone, however, is equally limiting in nature. Trauma lodged deeply in the limbic system lies well beyond the reach of talk therapy.
While supported, ultimately, healing is a deeply personal journey. From connection to caring, curiosity to cure, we each carry within us our own map over the mountains of freedom. The temptation is strong to seek another’s. But any ideology, if clutched with the fervour of rigid dogma, risks becoming a cage.
The fluidity of my own path winds through fear, anger and grief, seeking an ephemeral balance point. This lies somewhere between the consuming ache to not have every moment somehow defined or close to trauma and reality that wishing doesn’t make it so. It’s the point when the realization dawns that all the fervent efforts in the world can’t “fix this.” It’s accepting what I most fiercely reject: the reality that for once in my life, I can’t think my way through this. It’s the moment when the trying stops and the real curiosity begins.
When life explodes and the shrapnel destroys all external measures of validation, acceptability and success – what’s left? Who AM I?
I still don’t know. The best I can do is to muster the belief that my unexpected foray through the vicissitudes of trauma and discovery does have meaning, if only as an unwittingly gateway to that overarching question, and whatever purpose ensues. If a life can swing wildly off kilter from all it was ‘supposed’ to be, after all, logic follows that so too can it find a new equilibrium.
That’s not the same thing as buying into that over-used platitude “God (or the universe) doesn’t give more than you can handle.” Rubbish. People get slammed with far more than they can handle all the time. That’s how they wind up buried on Pickton’s farm. Standing on the corner of Hastings and Main. Shooting up crack cocaine in their high-rise corner office suites. Or even ‘just’ dealing with cancer or some other autoimmune condition from deeply repressed or unresolved trauma.
Truth is, not everyone gets their happy ending. But that doesn’t mean we can’t fight like hell to rewrite our scripts.
A whole lot of stuff happened that was out of my control. There’s some degree of control in this.
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- The subject number has been changed.