by Melina Bricker When people hear “psychedelics,” the first image evoked is likely one of Austin Powers-like funkadelic colors, free love, and all the associated visuals of the 1960s and 1970s. This is unfortunate–because during that time, an all-out culture war was raging, and psychedelics were the unfortunate darlings and representation of all things counterculture. They were legally, socially, and scientifically removed from medicinal and recreational use, making research impossible and criminal charges all too common. Plant medicine has been the primary partner in human health prehistorically through today. Whether it’s cave paintings of mushrooms or ancient texts describing spiritual and communal ritual with psychedelic-infused wine, people have been accessing and utilizing psychedelics to navigate grief, understand the world, connect with a higher power, or as a rite of passage into a different stage of maturation. Recreational use happens, too–and this speaks to the powerful importance of set and setting. What do you hope to achieve, and where will you achieve it? These factors are critical in experiencing suspended, altered, and therapeutic realities. These concepts are overlooked in traditional therapeutic models of care, however–traditional therapy is usually all about introspection and behavior change, medication support, counseling and talking, creating meaningful support networks…less about self-healing, more about receiving healing. For people with chronic disorders like PTSD, addiction, and depression, traditional therapy requires the patient to consistently show up and implement the tools and strategies from the therapy session into their daily lives. The issue with this, and why many traditional models fall abysmally short for severe and chronic disorders, is that the underlying mechanism for implementing change consistently is broken by stress and maladaptation. It means that the operating system of the brain that was originally impacted by trauma or toxic stress leading to disorder is still there, and still not functioning properly. It means that when stressors or hardships come up, the maladapted, traumatized circuitry of chronic disorders approaches the issue as a hammer to a nail. The struggle is that while traditional therapy can give you a toolbox of other options to address the complexity of life, a stressed brain has only ever been a hammer. When problems arise that require cognitive flexibility, emotional regulation, consistent adherence to change protocols, even simple organization…instead of a Swiss Army Knife of coping strategies, the trauma-brain is playing whack-a-mole because the only known tool is a stress response hammer. Psychedelics, particularly psilocybin, ketamine, MDMA, ayahuasca, and LSD, are medicines that, with trained facilitation, can regrow the neural circuitry needed to re-adapt hijacked systems of response. This is psychedelic-assisted therapy, or PAT. Where cortisol eats away at neuronal health and connectivity, psychedelics act as neurogenerative medicines, promoting brain plasticity, dendritic spine density, and healthy neural connections. The exact areas of harm by stress and trauma are the exact areas of growth observed with psychedelic therapy. This is monumental–even Deep Brain Stimulation, or DBS, has to be maximally invasive to show such dramatic improvements in symptomatology for treatment-resistant disorders., Studies in the last ten years have shown that after as few as only 1-6 sessions of PAT, an average of 85% of patients previously presenting with severe and complex PTSD no longer met diagnostic criteria. It’s important to speak about psychedelics as medicine, not drugs. Almost all psychedelics are Schedule I substances to the US Government–a felony to possess and distribute. Yet ZERO of these medicines actually meet criteria for Schedule I designation. Schedule I substances must have no currently accepted medical use in the United States, a high potential for abuse, and a lack of accepted safety for use under medical supervision. Psychedelics are not addictive, have wildly effective medical application and use for myriad disorders and disease, and are all but impossible to overdose on. Exceptions are those well outside the bell curve of normative risk–ketamine can be overdosed on in very high doses and in association with polydrug abuse, for example. Ironically, ketamine is one that is NOT Schedule I, as it has been used as an analgesic in medicine for many decades. It’s the reason it’s available more widely in the US–it’s been legal to study, utilize, and prescribe. This is what must happen with other psychedelics. As a behavioral health professional, teacher, administrator, Veteran spouse, and civil servant, I have spent decades trying to understand trauma, motivation, executive functioning, mental illness, and addiction. All of these have roots in the nucleus accumbens, among many other areas of the brain, and it is precisely in these homeostasis mechanisms that psychedelics do their magical healing. The reknitting of unraveled neural strands of perception and identity is the medicine needed to support treatment-resistant patients’ internally-derived healing. Psychedelics have the ability to not only help people reveal original hurts and unresolved emotional pain. They also have the ability to support patients picking up other tools to deal with stress and hardship–many tools that are also used in diminishing and eliminating recurrent symptoms that hurt daily life. I wrote a book on this following my doctoral work on the topic, and it quickly became a work of advocacy–let’s get PAT accessible to those who need it most. Veterans, individuals with treatment resistant diagnoses, and people struggling with addiction must have access to this medicine. We must be able to study it, as it should be studied, with the set and setting established and all deception in research removed. Reclassifying is a critical first step: talk to people, talk to your representatives, and talk to policy makers. Write an email. Make a call. Attend a town hall. You don’t have to be a sign-waving screamer on the sidewalk demanding LSD be available at the grocery store. You can do incredible good by sharing your own experiences, sharing the positive outcomes for others, and telling the truth about what a Schedule I actually is, and how it’s NOT psychedelics. Share my book, print and audio. Email me. I’ll talk to anyone, anytime, about this wonderful therapy and its incredible ability to support healing and change in the darkest of circumstances. I want to tell you one story in closing about PAT. During my research, I interviewed a young woman that was completely different from the patient she described–the change in her was so profound. She had a lifelong abusive relationship with her mother. She was born her mother’s extended self–a doll, almost–and was required to be perfect in every way. This was, of course, impossible, and the psychological abuse extended into trauma-induced pathology that led to alcoholism, anorexia/bulimia, binge behaviors, repeated victimization, job loss, school issues, unreasonable and inappropriate sobbing in public, and overall incredibly poor health. She had tried EMDR, CBT, medication, meditation, counseling, all of it. She’d had more than one suicide attempt. She found psychedelic-assisted therapy out of sheer desperation. During one of her most memorable sessions, she opened a door whilst on her journey. Behind the door was a little girl, and she immediately recognized her as her child-self. “What did you say to her?” I asked. Her reply has resonated with me since the moment I heard it. “I told her she was enough. That she was loved.” Something important to point out from my experience in addiction treatment and behavioral health is typical recidivism rates. For alcoholism, it’s around 50% relapse following a decision to abstain, and for bulimia, it’s around 30-40% relapse following treatment (usually inpatient or intensive outpatient). When I was speaking to this patient, it had been 18 months since her first treatment with ketamine, and she was microdosing with fractional psilocybin once or twice per month with her clinician’s support. She had not had a relapse in her addictive, compulsive, and destructive behavior since–and has now finished an advanced degree, is happily remarried, and her health issues completely eradicated. Eighteen months post therapy, without prescription medications, without daily therapy, without inpatient or intensive outpatient care, she sat before me a healed, whole person. During her session, this young woman was able to submerge herself into her mind and root out an unmet need that had been festering inside of her psyche, driving compulsion and destruction. That need was for a grownup, a caregiver, to tell her what her mother never did: you are enough, and you are loved. It was as though she opened a time tunnel into her development, entered, and repaired what was missing and broken in her development. More than twenty years after the vulnerable, broken, unloved child fractured psychologically, psychedelics allowed her to pop the hood, reattach the hoses, and heal the little girl driving the sputtering mind. She was able to reset. It is time that this is available to all of us–to take back our health, our happiness, our healing. I believe PAT can do that; it will take all of us to bring this to the fore. _________________________ Melina Bricker is a writer, trauma researcher, and advocate for improved behavioral health access and services for Veterans. She is a civil servant working and living in Colorado with her husband and their five children. She is the author of: The Reset: Trauma, Treatment Resistance, and How Psychedelics Could Save America. As the Voice of the Veteran Community, The Havok Journal seeks to publish a variety of perspectives on a number of sensitive subjects. Unless specifically noted otherwise, nothing we publish is an official point of view of The Havok Journal or any part of the U.S. government.
