Psychedelic Therapy Through a Trauma-Informed Lens: Promoting Healing and Preventing Harm

Psychedelic substances like psilocybin, MDMA, and ayahuasca have shown tremendous promise in recent years as tools for healing trauma. As research expands and these compounds inch closer to legalization, there is a parallel need to ensure they are used to help rather than harm. This is where the framework of trauma-informed care becomes critically important.

Trauma-informed care is centered around understanding, recognizing and appropriately responding to the impacts of trauma at individual and systemic levels. Core principles include establishing safety, trustworthiness, peer support, collaboration, choice, and empowerment. Psychedelic-assisted therapy that incorporates these foundational elements of trauma-informed care can catalyze deeply healing experiences for those carrying trauma. However, bypassing a trauma-informed approach also introduces risks of re-traumatization for an already exceptionally vulnerable population.

As psychedelic therapy options grow, there is an ethical obligation across the ecosystem to honor the nuances of trauma-related wounds in substance selection, clinical protocols, integration practices and beyond. This blog will explore practical applications of trauma-informed care to psychedelic settings, spotlight training programs adeptly marrying these frameworks, and underscore why a trauma-informed lens is critical for psychedelic therapies to deliver on their paradigm-shifting promises of healing rather than harming.

What is Trauma-Informed Care?

Trauma-informed care recognizes the widespread impact of trauma and understands potential paths for recovery. The Substance Abuse and Mental Health Services Administration (SAMHSA) outlines several key principles of a trauma-informed approach:

1. Realizing the prevalence of trauma - Trauma-informed care understands trauma is remarkably common rather than rare, often has lasting impacts, and can be a driver of substance use, mental health issues and chronic disease.
2. Recognizing signs and symptoms - Trauma can affect emotional regulation, relationships, cognition, self-image and behavior. Trauma-informed systems are adept at recognizing trauma’s diverse manifestations rather than operating through a one-size-fits all diagnostic lens.
3. Integrating knowledge about trauma into policies - From intake questionnaires to clinical protocols and staff training, trauma-informed systems incorporate trauma knowledge at organizational levels rather than solely individual provider levels.
4. Avoiding re-traumatization - Policies and practices proactively consider how to establish safety through both physical and emotional environments. Providers are trained to recognize trauma triggers and support stabilization.

Ultimately, trauma-informed care seeks to counteract power imbalances, promote transparency, and understand symptoms in context rather than isolation. It is just as applicable to psychedelic care environments as frontline social service agencies.

Ketamine and Trauma Treatment

The Ketamine and Trauma Treatment Series is a course offered by Psychedelics Today and Polaris Insight Center that explores the ethical and compassionate uses of ketamine-assisted therapy (KAP) to support optimal outcomes in treating trauma and post-traumatic stress disorder (PTSD).

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Trauma-Informed Psychedelic-Assisted Therapy

This 4-day in-person workshop is designed for therapists who want to learn about trauma-informed psychedelic-assisted therapy. It covers essential topics such as the impact of drug policy and systemic inequality on the provision and practice of psychedelic-assisted therapy, the role of intergenerational trauma and trauma of oppression, and the practitioner’s role in a trauma-informed care model.

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Applying Principles of Trauma-Informed Care to Psychedelic Therapy

Trauma-informed care is not a simple checklist, but rather an overarching orientation that informs everything from screening procedures to substance selection in psychedelic settings. For example, intake questionnaires and assessments would inquire about specific traumatic events that could shape psychedelic experiences rather than just their existence. This allows practitioners to gauge what emergence or reprocessing of certain memories may indicate based on substance choice and dose. Psilocybin tending to elicit more sensory experiences may warrant additional stabilization skills if sexual trauma is prominent.

The setting itself would proactively consider components that communicate safety on emotional and somatic levels. Warm lighting, comfortable seating, art, soft textures and nature sounds all influence the limbic system towards feelings of calm within the environment. Practitioners guide patients in accessing inner resources like spiritual figures before sessions begin to establish internal secure attachments able to nurture during difficult moments. Trust in providers is emphasized as guiding, grounding and remembering, but not directing challenging material.

Integration sessions focus on collaborative meaning-making, empowering self-compassions and opening choices for relating differently to past events. The experiences themselves are framed as harbingers of unlocking adaptive information in the nervous rather than something being inflicted or done to patients without consent. Each element seeks to convey respect, share power, establish transparency, cultivate autonomy and impart hope.

Psychedelic-Assisted Psychotherapy for Trauma

In this in-depth online course, gain knowledge from leading experts on how ketamine, MDMA, and psilocybin-assisted therapies can treat complex trauma.

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Healing the Healer

Healing the Healer: Compassion Fatigue, Vicarious Trauma, and Self-Care is an essential workshop designed to address the importance of self-care for those working in psychotherapy, particularly in the context of non-ordinary states of consciousness and psychedelic-assisted psychotherapy.

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The Risks of Psychedelics Without A Trauma-Informed Approach

Psychedelics are powerful tools that can bypass ordinary defense mechanisms and patterns of control around traumatic material. This quick dismantling enables the potential for cathartic release, reprocessing, insight and reconciliation when adequate support is provided through the experience. However, without proper screening, preparation, support and integration, psychedelics also introduce risks of re-traumatization.

Patients with unresolved trauma are vulnerable to being emotionally flooded, feeling powerless and losing a sense of safety during sessions. This retraumatization can reinforce negative self-perceptions, erode trust in others, and validate unhealthy avoidance coping strategies. Experiences where traumatic memories or sensations surface without resolution often sear the memories deeper into the nervous system through kindling effects.

Certain psychedelics also influence memory reconsolidation processes through the 5HT-2a (serotonin 2a) receptors they activate. While this can enable positive transformation of traumatic memories under optimal conditions, lacking integration practices means unwanted elements can also be strengthened. The inability to find higher meaning in traumatic material brought into awareness or transform negative self-narratives leaves patients feeling the past has been dredged up without adequate tools to improve the present.

Without recognizing the neurobiological roots of trauma responses and establishing environments designed to nurture safety within both set and setting, psychedelics risk causing more harm than healing. Failing to screen, prepare and integrate adequately by dismissing principles of trauma-informed care is ethically negligent for this exceptional population. The risks are tangible, and the outcomes tragic.

The Future of Trauma-Informed Psychedelic Therapy

While caution is still warranted, there are promising signs trauma-informed principles are permeating psychedelic therapy models. MDMA received breakthrough therapy designation from the FDA for PTSD treatment based on Phase II trials demonstrating substantial relief from a trauma-focused approach. Participants showed reduced avoidance and hypervigilance with improved sleep, work/social functioning, and reduced suicidal ideation.

Psilocybin therapy models are also evolving to recognize trauma complexes at biological levels. Psilocybin’s mystical qualities can activate context-dependent extinction learning helping unpair triggers from traumatic responses. Simultaneously, new environmental associations of safety and loving presence help constructive alternative narratives emerge.

The world’s first Master’s program focused on psychedelic-assisted therapy and research began at CIIS in California last year, featuring courses like “Psychedelic-Assisted Therapies and Research” and “Trauma-Informed Psychedelic Therapy.” While hundreds of psychedelic-specific training certificates exist, accredited graduate programs legitimize curriculums critically analyzing substance choice, screening, neuroplasticity, experiential methods and integration informed by trauma.

As the landscape expands, we must honor the role trauma plays in mental illness beyond a checklist to move through. While psychedelics offer hope, their very power necessitates an ecosystem trauma-inftormed at its deepest roots to heal rather than harm.

Certificate in Psychedelic-Assisted Therapies and Research

The Psychedelic-Assisted Therapies and Research Certificate Program at the California Institute for Integral Studies (CIIS) Center for Psychedelic Therapies and Research (CPTR) is designed to meet the growing need for the training of skilled therapists and researchers in the field of psychedelic-assisted and entactogen-assisted psychotherapy research and clinical work.

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EMBARK Open Access

EMBARK Open Access is a comprehensive course designed to equip care providers with the skills and knowledge to provide ethical, culturally competent, and trauma-informed psychedelic facilitation.

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As psychedelic therapy options grow, there is an ethical responsibility across the ecosystem to approach these powerful compounds through a trauma-informed lens. Trauma often plays a central yet overlooked role in mental illness, addiction, and personal suffering these therapies aim to alleviate.

Trauma-informed care recognizes the prevalence of traumatic experiences and need for environments that proactively establish emotional and physical safety throughout screening, preparation, dosing and integration. Psychedelic experiences can enable healing of past traumas, but also introduce risks of re-traumatization if inadequate support exists.

Fortunately, emerging training opportunities like the courses featured here are centering trauma-informed frameworks at the foundation of psychedelic education models. Whether aspiring clinicians or community facilitators, informed trauma knowledge equips providers to honor vulnerability, share power, and impart hope more responsibly when unleashing psychedelics transformative potential.

As the landscape continues expanding, trauma-informed principles in policies, protocols and practices enable psychedelics to deliver on long-awaited promises of healing rather than harming those who have suffered most. The future of ethical, sustainable psychedelic therapy necessitates a trauma-informed ecosystem from the societal level down to the sanctuary room.