Scientists Are Using Psychedelics to Help People Cope With Racial Trauma
‘The nice thing about ketamine is it gives you this really nice third-person perspective’
At Connecticut’s Behavioral Wellness Clinic, therapist Mailae Halstead keeps a careful eye on her patients as they’re “pulled through time.” She’s there as they watch themselves survive a traumatic moment from a bird’s-eye view, or feel reimmersed in a joyful experience. She’ll ask few questions because there’s another force at work in their brains.
At the beginning of the session, her patients placed a ketamine-laced lozenge in their mouth for a very specific reason: to explore the psychological trauma left by systemic racism.
The ketamine dosing session is the culmination of weeks of preparation. Halstead has learned her patient’s personalities and histories with racism. She’s tweaked the office decor to make a patient feel more at home. She’s set a playlist running in the background. During the dosing session, she and another therapist are there to take notes and address any immediate needs, but they’ll get down to the bulk of the therapy once the drugs wear off. When the drug hits, they let the trip unfold.
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Halstead has completed three ketamine-assisted therapy sessions since she began her research on psychedelic-assisted therapy in 2019. This year, she plans to guide two more patients through the process.
“People are able to go, ‘Oh my goodness, I can’t believe that I endured this,’” Halstead tells Future Human. “‘I have so much empathy and compassion for my lived experience.’”
The ketamine-assisted therapy sessions are the brainchild of Monnica Williams, PhD, a clinical psychologist who runs the Behavioral Wellness Clinic and the Culture and Mental Health Disparities Lab at the University of Ottawa. She’s one of just a handful of scientists who have made a connection that’s obvious to people of color, but has been slow to take hold among psychologists: Racism can cause psychological trauma. That psychological trauma, called racial trauma, is being increasingly recognized by psychologists.
“People of color have known forever that racism is traumatizing — this isn’t news to us. But I think now the mental health field is starting to recognize it,” Williams tells Future Human.
Racial trauma looks a lot like PTSD, which is where drugs like ketamine, MDMA, and psilocybin — the compound found in magic mushrooms — come in.
These drugs, all considered psychedelics, can create out-of-body experiences, hallucinations, and intense spiritual moments. Psilocybin is so intense that users often rank taking it as one of the most meaningful experiences of their lives. Psychedelics are also still illegal: MDMA and psilocybin are Schedule I substances, which means they have “no currently accepted medical uses” in the eyes of the U.S. Drug Enforcement Administration.
Ketamine, another hallucinogen, is used medically as an anesthetic and is the basis of a new Food and Drug Administration (FDA)-approved treatment for depression. But ketamine is a Schedule III drug because it does have medical use and low potential for abuse.
When combined with therapy, psychedelic drugs show promise in their capacity to reduce symptoms of PTSD, typically among veterans or first responders — so much so that the Department of Defense Research Agency (DARPA) has funded research into psychedelic-based drugs. Civilians also see benefits: In one clinical trial on psilocybin, 17 of 24 people who got the drug saw improvements in their depression symptoms (which often occur alongside PTSD) after four weeks.
As more psychologists finally realize that racial trauma not only exists, but is also similar to PTSD, many are embracing psychedelic therapy. Whether it will ultimately prove to be as successful in treating racial trauma is the subject of Williams’ research.
“There’s a lot of reason to believe that these substances can be helpful for racial trauma,” Williams says.
Racial trauma can lead to hypervigilance, hopelessness, or depression, explains Isha Metzger, PhD, an assistant professor of clinical psychology at the University of Georgia. These symptoms are very similar to those of PTSD, but it has taken years for psychologists to recognize them as a consequence of racism.
“It does look much the same way as PTSD,” Metzger tells Future Human. “Our understanding of racial trauma has been emerging but certainly within the last five years the definition has been more solidified in the field.”
An improved understanding of racial trauma has led researchers to adapt existing forms of therapy, like Prolonged Exposure Therapy or Cognitive Processing Therapy, to address it. Neither of these involves hallucinogens, but they have set the stage for Williams’ work.
In those sessions, therapists help people see their own racial trauma in a new way through specific lines of questioning. During prolonged exposure therapy, Metzger might ask someone to describe the night they went through a traumatic event, and examine how they tell that story. “What we find is that as they’re retelling the story, they’re starting to poke holes in it,” she says.
Cognitive processing therapy focuses less on the specifics of the event and more on larger questions about how the event has impacted the victim. Metzger might ask: “Who do you feel is at fault for a traumatic experience and why?” Often, she says, patients with PTSD-like symptoms may feel they’re to blame.
Psychedelics are no replacement for these therapeutic approaches. However, the promise of psychedelic-based therapy for PTSD has suggested that it might work well when combined with therapy designed for racial trauma.
“There’s a lot to be said about the work that Dr. Williams is doing,” Metzger says. “I think that certainly at least the research needs to be done.”
Even though a June 2020 survey found that people who took psychedelics on their own (without the guidance of a therapist) experienced fewer traumatic stress symptoms, Williams still envisions these treatments taking place in a therapist’s office.
A therapist can help a patient take a trip and help turn it into a learning experience that lasts long after hallucinogenic effects wear off. Halstead does this in follow-up meetings called integration sessions, where she asks patients to identify what they’ve actually learned during a trip.
There are also safety issues to consider. Psychedelics are generally considered safe, but they aren’t risk-free. For instance, using psychedelics has been linked to panic attacks. And therapy without drugs is already an established treatment for racial trauma, Metzger notes. If the drugs prove useful, it’s as an enhancer, “not a magic pill.”
“The nice thing about ketamine is it gives you this really nice third-person perspective,” Halstead says.
That third-person perspective can be intense. When “Robyn” — a patient described in one of Halstead’s case studies — took her second dose of ketamine, she described a childhood experience where someone had called her the N-word. She discussed stressful relationships with her family. She felt pain in her stomach and hips that she knew had a psychological rather than physical cause, and she used controlled breathing to soothe them.
The ketamine, she told her therapists, “is waking everything up.”
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The hype around psychedelics sometimes runs the risk of outpacing the evidence. Even though psychedelic shows promise for PTSD — and by extension, racial trauma — studying these drugs is difficult. For one thing, it’s pretty obvious in trials who gets the drug and who gets the placebo. Trials also tend to be small and not particularly diverse. Though people of color have historically been exploited in psychedelics studies, they’ve been left out of the new wave of research. A review of 16 psychedelics studies conducted between 1993 and 2017 found that over 80% of participants were white.
Williams is looking to remedy that bias in her studies on race-based trauma, but it’s not a smooth process. She has faced roadblocks obtaining approval for her psilocybin trial, which has to be approved by her own university’s ethics board and Canada’s health department. Her trial has been sent to two different ethics boards at her university, both of which raised questions about how one would obtain psychedelic drugs for research. Such trials, it should be noted, have happened in the past in the U.S. and Canada. Williams says she gets psilocybin for her research legally from a partner in Jamaica, where psilocybin is legal. But to ship psilocybin to Canada, a permit has to be obtained through Health Canada.
The illegality of psychedelics not only presents roadblocks but also makes these treatments seem radical — the drugs are difficult to obtain, and getting regulatory approval to even do these studies takes extra time. Halstead is careful to remind people not to lose sight of the central problem her work is trying to address. “Psychedelics are incredible, and they do provide these great healing effects, but I think the issue is really more systemic. It’s about how society treats people of color,” she says.
If psychedelics really can help people heal, it will be because they complement or enhance approaches like those that Metzger has researched. Therapy for racial trauma, whether it has a psychedelic component or not, has to give people the tools to exist in an unjust world.
Williams is betting that in the future, psychedelics may kick-start that healing process.
“We’re not going to eliminate racism from our society anytime soon,” she says, “but hopefully people will feel healed and stronger.”
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