- 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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