Post-traumatic stress disorder (PTSD) is, for many people, a treatment resistant condition. Psychable, an online community focused on psychedelic therapy, hopes to connect those seeking legal psychedelic therapy for PTSD with practitioners that can support them.
How is PTSD diagnosed?
The Diagnostic and Statistical Manual of Mental Disorders (5th ed; DSM-5; American Psychiatric Association, 2013) defines PTSD as being exposed to actual or threatened death, serious injury, or sexual violence. A typical symptom profile of PTSD includes reexperiencing of the event (sometimes through nightmares or flashbacks), avoidance of stimuli related to the event, and increased arousal levels. 7.8% of Americans are estimated to experience PTSD at some point in their life.
Most people with PTSD will experience a persistent experience of fight-or-flight syndrome. Other symptoms may include intrusive thoughts, insomnia, anxiety, obsessive compulsive thought patterns, and a persistent confrontation with fear due to experiencing an increased number of perceived threats. PTSD is a psychological condition and is diagnosed by a doctor, psychiatrist, psychologist or mental health therapist.
Treatment of PTSD
Typical treatment models suggest a combination of psychotherapy and medication in the treatment of PTSD. Cognitive behavioral therapy (CBT), trauma focused-CBT (TF-CBT), stress inoculation therapy (SIT), dialectical behavioral therapy (DBT or DBT-PTSD), and desensitization therapy using exposure therapy or eye movement desensitization reprocessing (EMDR) are typical evidence-based psychotherapy methods to treat PTSD. EMDR is an evidence-based therapy that quickly treats repressed or unprocessed memories of traumatic life events. Integrative models can include trauma informed yoga, therapeutic massage and acupuncture to aid in the treatment of PTSD.
PTSD specialist, Bessel Van Der Kolk, MD, believes that emotional trauma can cause chronic stress and also cause physiological changes in the brain and body. Van der Kolk believes in treating causes over symptoms and integrating trauma instead of reliving it through common therapy practices. Van der Kolk is an advocate for somatic experiencing as well as EMDR. He is the Principle Investigator for MAPS MDMA trials in Boston. He’s also an advocate for MDMA, ketamine, and ayahuasca for PTSD. Van der Kolk, in the treatment of trauma, writes in his book The Body Keeps The Score:
Nobody can “treat” a war, or abuse, rape, molestation, or any other horrendous event, for that matter; what has happened cannot be undone. But what can be dealt with are the imprints of the trauma on body, mind, and soul: the crushing sensations in your chest that you may label as anxiety or depression…The challenge of recovery is to reestablish ownership of your body and your mind — of yourself.
PTSD and Somatic Therapy
Somatic therapies are body based therapies. Gabor Mate, MD believes chronic stress and trauma can manifest as physical illness in the body. Somatic therapies bypass typical cognitive processing and resolve trauma by drawing attention to sensations in the body when a traumatic memory arises. Somatic therapy can take clients deeper because it accesses subcortical limbic regions of the brain. Emotional trauma can also have physical manifestations so entertaining a body based therapy can help clients who feel “stuck” or hopeless as other therapy models have failed.
Somatic therapy and psychedelic therapy have similarities and both require high levels of trust of self and “letting go” of control. The client is deemed to connect to their inner healing intelligence and follow the process, regardless of what comes up and without controlling or directing the experience. Somatic therapies like EMDR allow traumatic memories to arise and express themselves in whatever way appears most natural. The memories arise and the client is instructed to allow the body to move as it needs to. Oftentimes emotions of sadness, grief, devastation, and panic will arise and the clients experience these emotions fully without diverting from their experience.
Finding a Practitioner
When searching for a practitioner, it can be helpful to find a practitioner who is familiar with PTSD and has specialty training, certifications, and years of experience working with the condition.
Questions to ask oneself:
- What is important to me specifically in a PTSD practitioner?
- What is important to me in terms of gender identity and cultural background?
- What type of support am I desiring?
- Write this down so you can communicate this to your provider!
- Have I been diagnosed previously with PTSD?
- Have I explored treatment for PTSD in the past?
- If so, what type of treatment?
- What is my level of nervous system regulation (in other words what resources have I developed to manage symptoms of anxiety?)
- What other attributes are important to me in a relationship with a practitioner?
- Have I been diagnosed or need to be diagnosed for any comorbidities (i.e., substance use disorder) that my practitioner should be qualified in?
- Am I open to exploring pharmaceutical interventions to aid my PTSD recovery process?
- Am I open to exploring alternative therapies or psychedelic therapies in areas they are approved?
- Is the practitioner open to supporting my interest in alternative and new psychedelic therapies as they become available or in the area they are legal?
- Am I willing to travel for the right treatment?
Questions to ask the practitioner:
- What is your experience with working with PTSD or PTSD populations?
- Do you consider yourself trauma informed?
- What types of trauma do you work with (sexual trauma, racial trauma, first responder trauma, natural disaster trauma, combat trauma, single event trauma, complex PTSD)?
- What approaches or modalities do you use in your treatment models?
- What is your experience with psychedelic integration?
- Do you have a relationship with a psychiatrist in the event we decide to explore pharmaceutical interventions?
- What is your experience with working with dissociation?
- What other mental health disorders do you feel proficient working with?
- Do you have options for remote therapy sessions?
Making the selection
Before making the selection it will help to think through specific desires, type of support, and types of services clients are seeking. Most PTSD practitioners will offer an initial consultation to determine if the relationship is a mutually good fit. There are also facilities with a number of practitioners and an intake process that matches you to someone that will be a good fit. Be honest and descriptive about what you are looking for and why you need help. If something doesn’t feel right or isn’t the best fit for you, speak up! Be an advocate for your own mental health. Not everyone is going to be the correct fit for you and that is okay. This is a process.
PTSD treatmentwill likely involve challenging content and emotional vulnerability requiring a high level of trust in the provider. Trust isn’t built in one session, but treatment seekers can ask themselves if the initial interaction contained warmth, kindness, and positive regard for them.
Psychable’s online directory
Take a look at Psychable’s online directory to help in your search for a psychedelic therapy practitioner for PTSD