Fear is an elemental human experience. It’s essential to our survival, activating us when we need to run, fight, or freeze. We learn from fear and are protected by it. But what happens when our fear goes too far? Over time, fear creates neurobiological trauma and PTSD. But psychedelic therapy may be able to help. Here’s how psychedelic therapy disrupts neurobiological trauma. (Image credit Mush Stock)
People who suffer from trauma-based illnesses have to confront their traumatic experiences repeatedly. Flashbacks, insomnia, and anxiety make daily life challenging. The ineffectiveness of current treatments results in many people dealing with these symptoms for years or decades.
Psychedelic therapy is getting closer to becoming available for people with treatment-resistant PTSD. The most promising treatment is MDMA-assistant psychotherapy. In trials, participants significantly improved their self-reported PTSD symptoms compared to placebo groups.1 These outcomes have been so encouraging that the Biden Administration anticipates regulatory approval within the next two years.
Psychedelic Support is helping to roll out this new movement in medicine. One that combines the powerful psychedelic experience with evidence-based therapy. We’re advocating for better treatment for PTSD, depression, anxiety, eating disorders, and more. Whether you’re looking for psychedelic therapy, want to integrate it into your practice, or just want to learn more, we’ve got resources for you.
MDMA-assisted therapy is one of the most exciting cutting-edge treatments currently in trials. But how does MDMA work on trauma that has written itself into our brains? Let’s explore what neurobiological trauma is.
What Is Neurobiological Trauma?
Neurobiological trauma is the brain’s response to a fearful situation. It activates our “fear circuit,” a protective mechanism that evolved to keep us safe. But if it’s activated repeatedly, this system that protects us goes into overdrive. When this happens chronically, and we’re always nervous or scared, it can lead to post-traumatic stress disorder (PTSD).
The amygdala is one of the essential brain areas for generating a fear response. This is the brain area where we process fear and threats. As soon as our senses make note of a threat, the amygdala sets the fear response in motion – heart rate and blood pressure increase. Cortisol and adrenal are released.
But while the amygdala goes on overdrive, other parts of the brain shut off.
The prefrontal cortex helps us make decisions, think rationally, plan responses, and remember information. But when the fear circuit is turned on, the volume of our prefrontal cortex decreases. We’re less able to plan, think, and decide. In a scary situation, you may make decisions you later regret. It’s not your fault – the decision-making part of your brain wasn’t working.2
You also experience freezing during fear circuit engagement. You’ve probably heard of fight or flight. But the most common response to danger is tonic immobility. We lose the ability to make decisions, so we freeze. Think of a deer in the headlights or a possum that passes out. Even sharks have a mechanism for freezing when they’re scared.2
Dissociation is another example of the fear circuit in action. During a traumatic event, a person may feel like their body is on autopilot. We lose the ability to make decisions and may revert to behaviors that stem more from habit than actual choice. For women, this may look like placating when a more “rational” decision would be to get out of a situation or confront someone.2
And the fear circuit’s job isn’t done once an event is over. During trauma, the prefrontal cortex isn’t encoding memories the same way it usually does. So accessing accurate memories of an event afterward can be hard. There may be gaps in the story, or memories may be focused on irrelevant information. Chronological order is often skewed in memories of trauma.2
PTSD is thought to come from the over-activation of this fear circuit. People with PTSD will be put back into a fear response without being in a dangerous situation. They may see an object or smell something they associate with their trauma and be triggered into a flashback.3 Their heart may start racing when they hear a specific song. In this way, trauma writes itself into our brains neurobiologically.
The Origins of Neurobiological Trauma
Scholars used to think PTSD was directly linked to how scary or traumatic an experience was. The closer a situation brings a person to harm or death, the more likely they thought that person would develop PTSD.
Now researchers believe that traumatic events and trauma-associated illnesses aren’t 1-to-1. In other words, it’s not just trauma that causes PTSD. It’s how our bodies respond to and interpret trauma that determines whether we’ll recover from a traumatic event.4 By this reasoning, PTSD may be more heavily based on neurobiological mechanisms than on trauma.
Most people will have an acute response after trauma. This may look like anxiety, flashbacks, insomnia, and hypervigilance. These are unpleasant symptoms and can be distressing. But for most people, they pass within a few weeks. For a small portion of the population, trauma symptoms linger and can cause considerable disruptions to their quality of life.
Traumatic events can leave an imprint on us psychologically and biologically. Especially when abuse happens early in life, this can create a cascade event that makes people more vulnerable. Treatments like SSRIs and psychotherapy have been frustratingly ineffective for people with PTSD. How can psychedelic therapy help these people?
How Psychedelic Therapy Disrupts Neurobiological Trauma
Trauma-based illnesses have historically been difficult to treat. Traditional therapy methods require talking about an event with a therapist. But for people with PTSD, this can trigger them into the fear circuit. Instead of being able to process their memories, they feel like they’re living the trauma all over again.
MDMA-assisted psychotherapy has helped people to improve their symptoms of PTSD in trials. We’re still not totally clear how psychedelics re-wire trauma-based illness. But we have some pretty good guesses.
MDMA causes serotonin to release in the brain. This vital neurotransmitter is essential for sleep, mood regulation, pain processing, and appetite. At the same time, it quiets activity in the amygdala. The result is deep feelings of safety and connection – the opposite of a PTSD attack when people feel scared and alone.1
During an MDMA experience, people are very relaxed. In this state, people can see their traumatic experiences with new eyes. Instead of activating the fear circuit of their neurobiological trauma, they can write a new circuit instead. One of acceptance that allows them to move on from their trauma and recover from PTSD.1
Another theory is that MDMA actively helps people reconsolidate their memories. During an MDMA session, memories may be more malleable than normal. Long-term memories, usually thought to be solidified in our brains, may be up for reinterpretation during an MDMA session.5
Before and after an MDMA session, integration therapy helps patients solidify their experience with MDMA. This essential component ensures patients have the tools to understand their progress and solidify their experience for the future.
Psychedelic Therapy and Trauma
Our previous treatment methods for trauma-based illnesses have come up short. Despite lots of medication, hours of therapy, and other treatments, many people still feel like victims of PTSD. They remain impaired in their relationships, careers, and quality of life. We have to do better for this patient population.
Psychedelic therapy is a new model. It’s different from anything we’ve seen before – and it works. We believe that psychedelic medicines could create a new wave of healing in medicine and the community. And with FDA approval on the horizon, there’s never been a better time to learn more.
No matter where you are in your journey, we can help you get to the next steps. If you’re looking for therapy, check out our provider network. Pursuing supervision or connection? Go to our provider community page. And if you want to stay up-to-date on the current world of psychedelic therapy and medicine, subscribe to our newsletter.
References
- Yazar-Klosinski, B.; Mitchell, J. (2021). A randomized, double-blind, placebo controlled phase 3 study assessing efficacy and safety of MDMA-assisted therapy for the treatment of severe PTSD. Biological Psychiatry, 89(9). https://doi.org/10.1016/j.biopsych.2021.02.270
- Neurobiology of trauma. Assault Survivors Advocacy Program. (n.d.). Retrieved September 26, 2022, from https://www.unco.edu/assault-survivors-advocacy-program/learn_more/neurobiology_of_trauma.aspx#:~:text=When%20someone%20experiences%20a%20traumatic,all%20have%20inside%20of%20us.
- Maeng, L. Y., & Milad, M. R. (2017). Post-traumatic stress disorder: The relationship between the fear response and chronic stress. Chronic Stress, 1, 247054701771329. https://doi.org/10.1177/2470547017713297
- Sherin JE, Nemeroff CB. Post-traumatic stress disorder: the neurobiological impact of psychological trauma. Dialogues Clin Neurosci. 2011;13(3):263-78. doi: 10.31887/DCNS.2011.13.2/jsherin. PMID: 22034143; PMCID: PMC3182008.
- Feduccia, A. A., & Mithoefer, M. C. (2018). MDMA-Assisted psychotherapy for PTSD: Are memory reconsolidation and fear extinction underlying mechanisms? Progress in Neuro-Psychopharmacology and Biological Psychiatry, 84, 221–228. https://doi.org/10.1016/j.pnpbp.2018.03.003
