Bridging Psychedelic Psychotherapy and Epigenetics

Psychedelic psychotherapy and epigenetics are growing in influence. Researchers and health professionals are advancing the value of spiritual healing in modern healthcare. Epigenetic changes will be measured after MDMA-assisted psychotherapy in a first of its kind study. Understanding how psychedelic substances work in the body and brain will deepen our knowledge of emotional biology.

This blog was originally posted in 2019. It is now updated with our study findings.

Origins of Psychedelic Psychotherapy and Epigenetics

Many of us have encountered remarkable healing with psychedelic psychotherapy. Now, scientific research is bringing this work into the public eye. In the United States, the Multidisciplinary Association for Psychedelic Studies’ (MAPS) investigation into MDMA-assisted psychotherapy for posttraumatic stress disorder (PTSD) is currently on a fast track with the FDA. As a result, physician prescribed psychedelic psychotherapy may just be a year or two away. Thus far, the results from the MDMA-assisted psychotherapy trials are very impressive. After living with treatment-resistant PTSD for nearly two decades, at one-year follow-up, nearly 70% of those treated no longer meet criteria for PTSD. Longer term follow-up data also looks promising. Many of the study participants benefit from a significant shift, or a healing, if you will.

I have spent years working in the related field of curanderismo. This involves working with Ayahuasca for emotional healing and other master plants in the Peruvian Amazon. I have written about my experiences with sacred ceremony in my book The Fellowship of the River: A Medical Doctor’s Exploration into Traditional Amazonian Plant Medicine. One of the first cases I present in the book is that of my friend Russ. His story gave me new perspective on the power of profound emotional and spiritual healing. Russ is a Vietnam Veteran who had been treated for PTSD at the VA for decades. He had been through a number of medications and therapies but was not satisfied with his progress.

Amazonian Ayahuasca Ceremony

In 2009, he joined me in the Amazon and went through Ayahuasca ceremony within the context of a traditional Amazonian Shipibo healing diet. In just ten days, he made more progress than he had made in a long time. His experience in Peru was mystical. Also at times, it was out of this world. Above all, it was emotionally significant. Through a spiritual process in Peru, Russ made amends with his deceased mother. Additionally, he found forgiveness within himself for the way he had behaved as a father, in regards to his trauma symptoms affecting his family. Ultimately, after his time in the jungle, Russ no longer needed the psychiatric medication. He weaned himself off in preparation for his traditional treatment. He found that he could manage better with some occasional medical marijuana. His blood pressure improved and so did his blood sugar levels.

After the trip, Russ was ready to re-engage in therapy in a more meaningful way. Before, he had been too closed. He subsequently entered an integrative PTSD program at the VA. His healing journey continues, and he shares this healing process with younger vets struggling upon their return to American life.

Emotional Biology and Spiritual Healing

Approaches that access the spiritual dimension and the mystical dimension, offer an incredible opportunity for emotional healing. A spiritual context can open the mind beyond judgement. Consequently, being in integrity, offers a safe place for vulnerability. This is the sacred space healers refine and hold. Moreover, this is the space where seekers find room to move through and recognize unresolved trauma.

Forgiveness starts in the mind but is only completed in the heart.

Love is so important in this process, despite its lack of popularity in academic press. Its role in MDMA-assisted psychotherapy is a bit difficult to ignore. Love, one might say, is the acceptance of all things as they are without reservation. Forgiveness is heartfelt acceptance. Forgiveness starts in the mind but is only completed in the heart. A spiritual context allows for this kind of deep emotional processing.

MAPS MDMA Training Program

I went through the MAPS’ MDMA Training Program and was struck by the MDMA participant session videos. Besides this, the space held by the therapists and their grace impacted me. For me, these therapists appear to practice within a spiritual context. In the spirit of love, psychedelic psychotherapists facilitate profound emotional experiences giving rise to shifts in mental health.

The concept of emotional biology fascinates me. We have learned a great deal about emotional biology, and about how fear and rage affect our physiology. Moreover, we have learned a lot about how emotional attachment affects our immune function. Lastly, we have learned how severe emotional trauma affects our fight-or-flight response. We know that severe emotional trauma can lead to post-traumatic stress disorder (PTSD). PTSD is a disorder which impacts psychology, autonomic nervous system function, hormonal function and immune function.

Epigenetics and Stored Trauma

Science is now exploring where the body stores such emotional trauma. A growing body of evidence indicates that at the cellular level epigenetics stores the memory of trauma. Basically, epigenetics refers to the biochemical machinery that sits “upon” the genes. As a result, experiences that impact epigenetics alter emotional biology.

Modern Spirit Podcast

Candace Lewis, PhD, joins us for a fascinating interview. Candace earned her PhD in Behavioral Neuroscience at
Arizona State University while investigating the effects of early life stress on addiction behavior and neuroepigenetics. Dr. Lewis is also a member of the Modern Spirit Research Team, please support her work through the Modern Spirit Epigenetics Project Crowdfund.

Epigenetics refers to both the biochemistry and to the study of the processes that regulate the way our genes are expressed in response to the environment. Stressful experiences can affect the way our genes are expressed. Scientific research is revealing that traumatic experiences can be associated with epigenetic changes. For example, these include traumatic experiences from war and childhood. These epigenetic imprints can become stabilized and likely play a role in a number of chronic diseases (for example, treatment-resistant PTSD).

Psychedelic Psychotherapy and Epigenetics Impact

There is reason to believe that psychedelic psychotherapy has the potential to facilitate stable changes in our emotional biology through epigenetic changes at the level of our DNA.

We are now learning that therapeutic experiences can also alter our epigenetics. Consider processes like psychotherapy and meditative practice. A shift at the epigenetic level would help to explain the dramatic shifts observed in participants in the MDMA-assisted psychotherapy trial. Thus, there is reason to believe that psychedelic psychotherapy has the potential to facilitate stable changes in our emotional biology through epigenetic changes at the level of our DNA.

Psychedelic Psychotherapy and Epigenetics with MDMA Therapy

We recently had the opportunity to investigate this very interesting possibility. The Modern Spirit research team, in collaboration with MAPS investigators and led by Dr. Rael Cahn at the University of Southern California, Department of Psychiatry, collected saliva samples on study participants in the MAPS MDMA-assisted psychotherapy phase 3 trials. These samples underwent laboratory analysis.

We investigated whether or not epigenetic changes are involved in the therapeutic benefit of psychedelic psychotherapy. The epigenetic MDMA study results are published¹. Sixteen participants treated with MDMA were included in our pilot study which assessed epigenetic modifications in genes associated with the hypothalamic-pituitary-adrenal (HPA)_². Compared to seven placebo control participants, two HPA genes showed methylation changes that predicted PTSD symptom reduction, and one site (NR3C1 gene) showed greater methylation in the MDMA group compared to the control group.

These findings suggest epigenetic (DNA methylation) changes occurring in HPA genes may be associated with PTSD symptom improvement. However, the study sample and group sizes were very small and conclusions can not be drawn until tested in a larger number of people.

Here is a presentation I gave on the potential role of epigenetics in psychedelic psychotherapy.

References

1. Lewis, C. R., Tafur, J., Spencer, S., Green, J. M., Harrison, C., Kelmendi, B., … & Cahn, B. R. (2023). Pilot study suggests DNA methylation of the glucocorticoid receptor gene (NR3C1) is associated with MDMA-assisted therapy treatment response for severe PTSD. Frontiers in Psychiatry, 14, 101. https://doi.org/10.3389/fpsyt.2023.959590
2. Sheng, J. A., Bales, N. J., Myers, S. A., Bautista, A. I., Roueinfar, M., Hale, T. M., & Handa, R. J. (2021). The hypothalamic-pituitary-adrenal axis: development, programming actions of hormones, and maternal-fetal interactions. Frontiers in behavioral neuroscience, 14, 601939. https://doi.org/10.3389/fnbeh.2020.601939