Trauma Needs a Rebrand
Updated: Nov 19
Trauma, Psychedelics, the Limitations of Our Current Models, and Exciting Alternatives
I’ll dive straight in with the four main intentions for this essay:
Clarify what trauma is and isn’t, and how various 'disorders', including depression and anxiety, might sometimes be symptoms of unresolved trauma responses.
Discuss the limitations of how we ‘get well’ in the West: we take pills and ‘talk it through’ in talking therapies, yet overcoming trauma is primarily a physiological process (we can’t think our way out of it), and where nervous system dysregulation - caused by both our personal histories and the environments in which we live - is often at the root.
Present three revolutionary, trauma-informed interventions that address the root: Somatic Experiencing, Internal Family Systems, and MDMA.
Offer a compelling research opportunity to study a trauma-informed, transdiagnostic protocol that combines Somatic Experiencing, Internal Family Systems, and MDMA in order to treat a range of disorders, including depression and anxiety. Further, one that ethically diverges from the 'lie back with headphones and eyeshades' model we’ve seen so far in psychedelic-assisted therapy protocols, and which, I argue, has the potential to bypass the root at the nervous system level.
“Trauma is a fact of life, but it doesn’t need to be a life sentence” - Dr Peter Levine
Trauma is certainly in the zeitgeist at the moment. Everyone seems to be talking about it these days (guilty as charged). There appears to be a bottomless well of conferences on trauma, and endless Instagram accounts discussing it. The Body Keeps the Score, an academic book about trauma by psychiatrist Bessel van der Kolk, has spent almost three years (and counting) at the top of the New York Times best-seller list, selling almost two million copies globally. Vox even called trauma the word of the decade.
As a legal psychedelic guide whose training includes Somatic Experiencing and Internal Family Systems, two increasingly popular trauma-informed therapeutic modalities, what has become clear to me over the years is that trauma is not well understood at all. In many respects it needs a rebrand. Instagram therapists often describe trauma as being at the root of all our issues, which isn’t true. But the response, usually something along the lines of “of course trauma doesn’t explain everything. Only PTSD is real trauma”, also isn’t true. Whilst the DSM-5 defines ‘trauma’ as requiring ‘actual or threatened death, serious injury, or sexual violence’ this is an outdated definition, as I’ll explain. And although the DSM has some benefits, if you want to explore the questionable origins of it, then I recommend watching this video by Dr James Davies (spoiler: it was created by a small, homogeneous group of people with very little research or supervision). Even the ex-chairman of the DSM-IV Task Force has become a vocal critic of the DSM, where committee members often reflect the interests of pharmaceutical companies that push for disease-specific solutions within an over-medicalised and flawed biomedical model.
There is clearly a distinction to be made between understanding and healing, where the former often doesn’t lead to the latter
It’s also worth mentioning that I wouldn’t have been diagnosed with PTSD. And yet, it was only once I started to take an embodied, trauma-informed approach to my own healing process that I finally started to thrive. I’m not alone in this. Many of my clients, like me, have tried antidepressants and conventional talk therapy, and it didn’t work for them either. They tell me antidepressants numbed them or created more unwanted symptoms, and talk therapy either helped them to a certain point, or didn’t help much at all. There is clearly a distinction to be made between understanding and healing, where the former often doesn’t lead to the latter. The mind is of course a wonderful tool, but we are an organism of interconnected and interdependent systems, of which the mind is simply one element, and certainly not the whole picture. Taking a trauma-informed approach returns us home to this broader, embodied truth.
So with that aside, what is trauma?
We can think of trauma existing across a continuum. The simplest way I’ve come to frame trauma is that it’s the protective response to overwhelm/adversity (an event or period of time that is too much, too fast, or too soon) in which we breach our unique window of tolerance in the nervous system and get stuck in protect-mode. Unique, because what overwhelms one person might not another. This is somewhat in line with the Freudian definition, where Freud defined trauma as “a breach in the protective barrier against stimulation”. Although knowing what we now know about the nervous system (see the next section), I believe it’s more accurate to say overstimulation.
Again in the simplest terms, we can also say that the ‘body keeps the score’, and the ‘mind hides the score’ of trauma. But what does that mean exactly?
The Body Keeps the Score
Dr Peter Levine, leading trauma expert and creator of Somatic Experiencing, a radical approach to healing trauma, says “trauma originates as a response in the nervous system, and does not originate in an event”. So to understand trauma we first need to understand the nervous system, and more specifically, the Autonomic Nervous System (ANS).
The ANS has two branches, the Sympathetic Nervous System (SNS) and the Parasympathetic Nervous System (PNS), and runs from the brainstem all the way down to the genitals, connecting to most of our major organs along the way. The SNS is like an accelerator pedal, and is commonly noted as controlling our ‘fight or flight’ systems. It’s designed to protect us - when there’s a threat (or the perception of a threat) it mobilises our organism to take action. Survival energy (adrenaline, noradrenaline, and cortisol) is generated and we enter protect-mode in order to fight our way out of danger, or flee. Whereas the PNS, also oriented towards protection, is like the brake pedal, and is commonly noted as controlling our ‘rest and digest’ systems. It goes a bit deeper, however.
The PNS in fact has two of its own branches - the Ventral Vagal Complex (VVC) and the Dorsal Vagal Complex (DVC). The VVC is where we want to be hanging out most of the time. When this system is engaged we’re social, connected, compassionate, grounded, present, curious, and we feel safe. Essentially, we’re in a heart-centred (the nerve literally ends at the heart) state of Self, a concept I’ll explain later.
And when the DVC is engaged we’re in ‘freeze’, and might feel numb, helpless, shameful, trapped, or dissociated. It’s designed to conserve energy and protect us in the event where we can’t fight or run away to safety.
We’re constantly oscillating between these systems. We feel safe, connected, and curious in the VVC, then we get activated by something which brings us into the SNS, and if the activation goes on for long enough we might enter the DVC, but eventually we return home to the VVC. This is normal. Getting activated is normal. Indeed, stress can be healthy. Stress isn’t trauma.
Trauma happens when we breach our unique window of tolerance - again, by an event or period of time that is too much, too fast, or too soon for us to handle - and we get stuck in protect-mode, where either the acceleration pedal of the SNS remains pressed, or the brake pedal of the PNS does. If we’re stuck in the SNS (called hyperarousal) we might experience anxiety, hyperactivity, an inability to relax, hyper-vigilance, digestive problems, chronic pain, emotional flooding, insomnia, or hostility/rage. If we’re stuck in the PNS (called hypoarousal) we may experience depression, lethargy, exhaustion, chronic fatigue, disorientation, disconnection, dissociation, also digestive problems, complex syndromes, pain, or low blood pressure. Or we can get stuck in both, which is what Peter Levine calls tonic immobility, a state where we remain consciously or unconsciously activated, while feeling powerless to do anything about it. Frozen.
Below are the first symptoms that begin to show up at the same time or shortly after the trauma occurred:
Hypervigilance (being 'on guard' at all times)
Intrusive imagery or flashbacks
Extreme sensitivity to light and sound
Exaggerated emotional responses and startled responses
Nightmares and night terrors
Abrupt mood swings (rage reactions or temper tantrums, frequent anger, crying)
Shame and lack of self-worth
Reduced ability to deal with stress (easily and frequently stressed-out)
Several of these symptoms can also show up at a later time, even years later. Keep in mind that this list is not for diagnostic purposes. It’s simply a guide to help us get a feel for how trauma symptoms behave.
The next symptoms that may appear are:
Panic attacks, anxiety, and phobias
Mental 'blankness' or spaced-out feelings
Avoidance behaviour (avoiding places, activities, movements, memories, or people)
Attraction to dangerous situations
Addictive behaviours (overeating, drinking, smoking, etc.)
Exaggerated or diminished sexual activity
Amnesia and forgetfulness
Inability to love, nurture, or bond with other individuals
Fear of dying or having a shortened life
Self-mutilation (severe abuse, self-inflicted cutting, etc.)
Loss of sustaining beliefs (spiritual, religious, interpersonal)
The final group of symptoms generally takes longer to develop. In most cases, they may have been preceded by some of the earlier symptoms. However, there is no fixed rule that dictates when and if a symptom will appear. This group includes:
Diminished emotional responses
Inability to make commitments
Chronic fatigue or very low physical energy
Immune system problems and certain endocrine problems, such as thyroid malfunction and environmental sensitivities
Psychosomatic illnesses, particularly headaches, migraines, neck and back problems
Digestive problems (spastic colon)
Severe premenstrual syndrome
Depression and feelings of impending doom
Feelings of detachment, alienation, and isolation
Reduced ability to formulate plans
Any of the above sound familiar? The symptoms of trauma can be stable, meaning ever-present. They can also be unstable, meaning they come and go, and are triggered by stress. Or they can remain hidden for decades and suddenly surface. Usually symptoms do not occur individually, but come in groups. They also often grow increasingly complex over time, becoming less and less connected with the original trauma experience.
When stuck in protect-mode, the amygdala in our limbic system (part of our brain that controls the fear response) can remain switched on, meaning that people, places, situations, or even ideas might feel unsafe, even though rationally there is no threat present. Further, our muscles may remain contracted, where we might habitually raise our shoulders, or mindlessly clench our jaw or grind our teeth, sometimes for years. All of that chronic tension gets stuck in the muscles and tissue. And because the ANS connects to most of our major organs, it can impact these, too, leading to a whole host of diseases. Therefore, we need to reduce arousal in the autonomic nervous system as a much higher order priority than is common in most therapeutic approaches, as this has a direct impact on both our fear-based stories and our physical health.
Now, mammals have evolved over millions of years to know how to instinctively discharge survival energy soon after a traumatising event in order to return home to a Ventral Vagal Complex state, and to a felt sense of safety. Their very survival depends on their ability to do this; if they’re stuck in protect-mode then they won’t be able to return out to look for food, or socialise and play. And how do they do this? Well, first they need to complete the fight or flight response. If they can’t fight their way out to safety, they’ll flee. And if they can’t do that, then their systems will shut down and they’ll enter freeze, or the Dorsal Vagal Complex, where they’ll disconnect from the event because it’s too overwhelming. As long as they don’t get eaten or mauled to death, they’ll leg it as soon as the opportunity presents itself, thus discharging the fight/flight survival energy that was generated when the Sympathetic Nervous System was activated. Once safe, they’ll then shake or tremor, further discharging any excess survival energy. Or they’ll shake first and then leg it. This is how mammals heal. They don’t think about it, they just do it.
The above videos show two animals - an impala and a polar bear - automatically discharging the survival energy that was generated when they were overwhelmed.
It was only once I started to understand trauma and work somatically that my unwanted symptoms, including my insomnia, went away
Sometimes we forget that we’re mammals. But we are, so this is how we heal, too. And by healing I mean releasing the unwanted symptoms that I mentioned earlier. I’ll use myself as an example. I had several years of conventional talk therapy, and although one could argue that it helped me to understand some things, it didn’t help me to heal. For example, my chronic insomnia, something that I suffered through for 17 years, remained because I was stuck in a state of hyperarousal without realising it. It was only once I started to understand trauma and work somatically that my unwanted symptoms, including my insomnia, went away. I can’t begin to tell you how life-changing this has been for me. Further, as I released the trauma from my body, my mental and emotional states changed dramatically; I softened, I could be intimate in a way that previously felt overwhelming, things became clearer for me, my narratives changed, and I felt much more resourced to meet challenges.
Keep in mind that most of our physiological systems are designed very similarly to those of other mammals, and we too have evolved over millions of years to know how to instinctively heal. Often, our need is also to complete the fight/flight response and discharge the survival energy that was generated when we were overwhelmed. For example, if our boundaries were crossed - physically, mentally, or emotionally - we will have generated survival energy needed to fight off the aggressor. Or if we grew up in an environment (both personal or societal) that was oppressive, exhaustive, confusing, hurtful, shaming, neglectful, or overwhelming in any way, our organisms will have generated survival energy necessary to flee. This is simply how we’re wired as mammals.
The above videos show me automatically discharging the survival energy that had been frozen in my body since childhood. The first video demonstrates the shakes/tremors, and the second video demonstrates me completing the flight response. Both were completely painless, non-rational, automatic, and instinctual processes. I didn’t need to think about it, and there was no story attached to the release.
Which begs the question: if our organisms have evolved over millions of years to know how to instinctively heal, then why don’t we do it? In short, often the rational mind gets in the way. Most of us don’t understand trauma, so if we start discharging the energy then we might stop it. We may consider it being out of control (and boy do we hate that). Perhaps we connect shaking to cowardice, again thwarting the automatic process from completing. Or we might be fearful of feeling into the activation that lies beneath the frozen state.
Healing is primarily a physiological process, where the story of what happened is secondary to the release of the stuck survival energy and resulting nervous system regulation
The deeper I went into my training and work, and the more I directly experienced the healing effects of working somatically, the more I realised that healing mostly happens beyond the rational mind. Beyond the stories and the narratives. And don’t get me wrong, telling ourselves better stories and updating our life scripts is an essential part of any healing process, but it won’t help us to overcome our unwanted symptoms alone. It’s also important to point out that our stories are influenced by the state of our nervous system. Indeed, Peter Levine says that healing is primarily a physiological process, where the story of what happened is secondary to the release of the stuck survival energy and resulting nervous system regulation, which in turn updates our stories about ourselves, others, and the world. That’s a full-bodied yes from me, Peter. For an example of this, see this client testimonial I received from Jason:
“I remain awestruck by how much somatic trauma was released. I feel like a new person. I can breathe fluidly and the anxious stories have diminished substantially.”
We also exalt the rational mind in our culture. We mostly incentivise and reward a certain type of intelligence - logical-mathematical intelligence - which is of course immensely useful, yet also highly disembodied. But there are many types of intelligence, all worthy, and which includes somatic intelligence (also known as bodily-kinesthetic intelligence). And although trauma can disconnect us from our bodies, many of us are already disconnected, relating to our bodies merely as a way of getting our minds to meetings.
This disconnect between mind and body goes way back. In his book Intelligence in the Flesh: Why Your Mind Needs Your Body Much More Than it Thinks, Guy Claxton, a cognitive scientist, suggests that the misguided split between body and mind originated in ancient Greece and was made worse when early Christians started framing the body as a source of distraction, in need of taming. This separation continued into the scientific age, and was concretised by the work of 17th-century philosopher René Descartes and his theory of mind-body dualism.
However, this view, still widely believed today, and which continues to underpin many of our therapeutic models, is wrong. The fact we call it ‘mental health’ rather than ‘organism health’ is indicative of this. We simply can’t resolve everything in the head. Claxton explains how, instead, our organisms are a “massive, seething, streaming collection of interconnected communication systems that bind the muscles, the stomach, the heart, the senses and the brain so tightly together that no part - especially the brain - can be seen as functionally separate from, or senior to, any other part”.
It’s all connected: the body doesn’t just have a brain, it is a brain
Indeed, research into embodied cognition has shown that memory, language comprehension, problem-solving, and decision-making all depend on the quality of the relationship that mind and body have. As such, the cardiovascular system, the digestive system, the somatosensory system, the immune system, the endocrine system, and the nervous system (including the brain) is an information exchange, constantly talking to, and being informed and modified by, all of the others. Because the whole person has to act as one unit, each of these is a sub-system, and is responsive to the wider context of the whole. It’s all connected: the body doesn’t just have a brain, it is a brain.
Now, because trauma mostly impacts the autonomic nervous system and the deeper reaches of our brain in the limbic system, we often can’t actually access it via the rational mind. This has implications for conventional talking therapies, because often we’re trying to access and process the trauma via the rational mind through narrativising and story-telling techniques. This is a bit like trying to see into the basement by turning on the lights at the top floor. No matter how hard we try, the trauma remains inaccessible.
What has become clear to me over the years is that the best way to access and discharge trauma is to create a deeply felt sense of safety, tuning down the rational mind by becoming present and embodied, breathing deeply into the belly, and then letting our organism do what it has evolved over millions of years to know how to instinctively do. The story of what happened to us is secondary to this process, and quite often we can get stuck in obsessively trying to uncover all the details (which can in itself be a trauma-response, especially if people were hurtful and confusing for us growing up. Raising my hand here). Not to mention that every time we recall a memory we change the memory. Meaning that it’s pretty much impossible to know exactly what happened anyway. The most important thing is to unfreeze ourselves from the past, and feel safe in the here and now.
Somatic Experiencing offers us a way to actually release our unwanted symptoms, and return to a regulated Ventral Vagal nervous system state. A nervous system reset, if you will
Trauma-informed, body-based modalities like Somatic Experiencing offer a revolutionary way for us to access the trauma, and importantly, discharge it. Most talking therapies largely involve ‘moving beyond’ rather than removing our issues. This still stands. However, Somatic Experiencing offers us a way to actually release our unwanted symptoms, and return to a regulated Ventral Vagal nervous system state. A nervous system reset, if you will.
Somatic Experiencing also shows us that the root of many of our unwanted symptoms lies in the nervous system. Indeed, the chemical imbalance of the brain theory of certain mental disorders like depression (i.e. viewing the cause of depression as a lack of serotonin in the brain) is at last “dead”. As I mentioned at the start, this has been a narrative pushed by Big Pharma to sell drugs that require daily intake. In short, although conventional talking therapies and psychopharmacology might help to a point - indeed, they can be a lifeline in some cases - they won’t resolve trauma.
The current research on MDMA for trauma is also really exciting, and I see a huge opportunity to combine trauma release with this substance. But more on that later.
So that’s how the body keeps the score of trauma. What do I mean by the mind hiding the score?
The Mind Hides the Score
As well as Somatic Experiencing, my training also includes Internal Family Systems (IFS), which is an increasingly popular, non-pathologising, evidence-based, and trauma-informed therapeutic model. Often confused with family constellations therapy, rather than being about our actual family (although that can of course come into play), IFS relates to our inner family. Allow me to explain. Central to IFS is the idea that we’re not a singular entity, but rather, we consist of multiple parts, a bit like an inner family of sub-personalities. Multiplicity of mind (although our parts live in the body too of course, and indeed can control our physiology). These parts have their own roles, needs, and fears. The parts that we work with in IFS are grouped into 2 categories: Exiles and Protectors.
Exiles are often, although not always, young parts of us that carry the memories, sensations, and emotions from times when we’ve been shamed, hurt, abused, humiliated, scared, neglected, abandoned, or overwhelmed in any way. Because they are too painful to face, they are exiled from conscious awareness. These parts are often young because when we’re young we’re more likely to be overwhelmed - we haven’t fully developed or built many resources yet, and often we have nowhere to go.
And then we have the Protectors - which include the roles of Managers and Firefighters - ensuring we don’t ever access the Exiles because it was so overwhelming at the time. Their motto is ‘do and say whatever it takes’, and can sometimes be quite extreme in their roles.
Managers are proactive parts of us that try to keep us safe and functional. If we’ve been overwhelmed in the past, Managers can keep us from getting too close or dependent on others. They might deflect the pain by being overly critical or judgemental of others, or they may focus on others’ needs before their own. They can also present as an inner critic, ensuring that we remain small and safe.
And if Managers let anything slip through the net (because life happens), our Firefighters kick in. These are reactive parts that spring into action whenever an Exile part becomes so activated that the person risks being hurt again. Their role is to distract or numb the Exile’s feelings. Addictions to, or excessive consumption of, drugs, alcohol, food, sex, internet, social media, porn, comics or books, exercise, and work are all common firefighter behaviours.
Another central concept of IFS is that, beyond our wounded and protective parts, at the core of our Being is the unwavering Self. In IFS, the Self embodies several characteristics known as the 8 Cs - calmness, curiosity, clarity, compassion, confidence, creativity, courage, and connectedness. In wisdom traditions the Self might be called Buddha Nature, Christ Consciousness, or Atman. It’s the infinite space in which all our parts can be held without judgement or agenda. Our essential Self.
Although the relationship between the IFS practitioner and client is crucial, the most important relationship to build in IFS is between the client and their Self. Because it’s the Self that heals, and is what is always with them. Once they’ve accessed their Self, they can then turn their ‘Self-energy’ (the qualities of the aforementioned 8 Cs) towards the protective parts, who now trust that the client is open, curious, and able to hold their experience. Once the Protectors’ roles, needs, and fears are witnessed, they learn to lower their weapons and grant access to the Exiles they’re protecting, who can then be healed.
Taking a trauma-informed approach shows us that there is nothing wrong with us. We’re simply stuck in protect-mode
As you can see, there are parts of us that we may feel are getting in the way of our happiness. But these parts are on our side - they’re trying to protect us from being overwhelmed again. IFS is a wonderful shortcut to self-compassion in this sense. Indeed, taking a trauma-informed approach shows us that there is nothing wrong with us. We’re simply stuck in protect-mode.
Often we need to update our Protectors about our actual age. As is the case with trauma, these parts can be frozen in time to the event or period when we were overwhelmed. Such parts are usually surprised to know that we’re adults now, with resources we didn’t have back then. The things that overwhelm us as children are manageable for us to face as adults, especially with support and if we’re coming from a place of Self. According to Richard Schwartz, creator of IFS, only our parts get overwhelmed, whereas the Self can never be overwhelmed.
As with Somatic Experiencing, IFS also isn’t a rational ‘talking it through’ process. It’s more like a shamanic guided inner voyage, one that works directly with our parts, as opposed to around them, or even past them (think CBT, which can entirely bypass our parts with 'just think better thoughts' strategies).
For me, one of the most powerful aspects of IFS, and Somatic Experiencing for that matter, is that 100 percent of the healing, potential, and wisdom comes from within the client. In IFS sessions, I simply have the client ask their parts what they need, and then they tell the client. It's a symmetrical power dynamic that invokes the Ram Dass quote, "We're just walking each other home". The therapist/practitioner is never the expert of the client at all, and doesn’t need to be too clever - rather, they simply create a space for the process to happen. Being a non-pathologising model, there is no need to diagnose the client, whether directly, as in labelling them with a ‘disorder’, or indirectly, by using theoretical frameworks to know how to approach the client. Because what if the psychiatrist or therapist gets it wrong? Which is common. What if the client can’t fit neatly into a diagnostic box? Also common. Not to mention that this approach often doesn’t work. Increasingly, we’re waking up to the idea that certain disorders might not be disorders at all, and instead are protective responses to overwhelm and adversity.
In this way, our protective parts hide the score of the trauma. Which, alongside Somatic Experiencing, also has implications for conventional talking therapies. In hindsight, when I was in talk therapy myself, I spent most of my time obsessively trying to understand what the hell happened. Although I believe it’s important to broadly understand our issues and traumas - the hows and whys we are the way that we are - as I’ve mentioned, attempting to uncover all the details is at best of limited value, and at worst impossible. Further, I now realise that I spent much of my time in therapy selling and buying my own BS, which is to say that I was caught up in the stories of my Protectors. And wow did they sound convincing! Which is what they’re designed to do - they will say and do whatever it takes to block access to the wounded parts that were overwhelmed. It was only once I started to work with my Protectors directly that they learned to soften their defences and grant access to the parts of me that needed healing. And I’m not saying that it’s impossible to access these parts in traditional talk therapy. But in my view, IFS offers us a more reliable and direct way in that doesn’t take as long. Plus it’s a natural ally to an intentional psychedelic process, which I’ll explain later.
What Causes Trauma?
Hopefully I’ve made it clear how and why trauma can be framed as the protective response to overwhelm, in which our unique window of tolerance is breached, locking us into protect-mode, and where the body keeps the score, and the mind hides the score of trauma.
So what causes trauma? Well, lots of things, potentially. As Peter Levine says, “trauma is a fact of life. But it doesn’t need to be a life sentence”. Remember, we’re especially prone to being overwhelmed when we’re young.
Obvious causes of trauma include:
Emotional, physical, or sexual abuse during childhood
Neglect, betrayal, or abandonment during childhood
Experiencing or witnessing violence
Catastrophic injuries and illnesses
Less obvious causes of trauma include a wide variety of seemingly ordinary events. Many of these events prove traumatising far more often than we might expect, and include overwhelm to both the mind and body - it’s all connected.
These can include:
Minor automobile accidents, especially those that result in whiplash
Invasive medical and dental procedures, particularly when performed on children who are restrained or anaesthetised. (The use of ether increases the chance of trauma. For adults, many medical procedures, such as a pelvic exam, can be experienced as an attack, even if rationally we know they are necessary and helpful)
Falls and other so-called minor injuries, especially when children or elderly people are involved (for example, a child falling off a bicycle)
Natural disasters, including earthquakes, hurricanes, tornadoes, fires, and floods
Illness, especially when a high fever or accidental poisoning is involved
Being left alone, especially for young children and babies
Children having their reality denied consistently
Children whose parents live vicariously through them
A consistently confusing and turbulent home environment growing up, especially where parents don’t regulate their emotions
Prolonged immobilisation, especially in children (casting or splinting for long periods, such as for scoliosis or turned-in feet)
Exposure to extreme heat or cold, especially in children and babies
Sudden loud noises, especially in children and babies
Birth stress, for both mother and infant
Many things can push us outside our unique window of tolerance. This is especially true if we’ve experienced many cumulative unresolved stresses over our lives. The final straw could be a divorce, losing a loved one, being fired. The list is endless.
And although it’s beyond the scope of this essay, with the emerging science of epigenetics we’re discovering that we might inherit trauma through generations as a modification to our gene expression (and in case that sounds alarming, as this is a modification to the gene expression as opposed to the DNA itself, it can be undone).
Just as our organisms contain interconnected and interdependent systems, so too does everything else. We can never be well if the planet, people, and systems around us are sick
It’s also important to point out that the scope of what might break our window of tolerance extends to socio-economic-cultural factors, too (sometimes the narratives around trauma can be overly focused on the individual). For example, intergenerational structural racism can be overwhelming. Our Neoliberal cultural model that normalises individualism, greed, inequality, exhaustion, depletion, extraction, disconnection, hoarding, lack, and infinite growth on finite resources (both personal and planetary) can lead to overwhelm. And although we can acknowledge the global average is on the whole healthier, more democratic, less violent, and more educated than it’s ever been, this can create a false confidence. For we are also lonely, depressed, anxious, medicated, and addicted. It is not unreasonable to assume that this could be a response to an overwhelming environment. Indeed, our nervous systems are millions of years old and haven’t evolved much in a very long time, whereas the environments in which we live have developed extraordinarily rapidly, and our technologies exponentially. It’s perhaps no surprise that many of us are struggling. Healing trauma therefore needs to address several levels: individual, cultural/societal, and environmental. Just as our organisms contain interconnected and interdependent systems, so too does everything else. We can never be well if the planet, people, and systems around us are sick.
The Psychedelic Renaissance
In case you missed it, there’s a psychedelic renaissance happening at the moment. Some of the world’s leading research institutions in the US, UK, and elsewhere have been studying the therapeutic benefits of classic and non-classic psychedelics such as psilocybin (the active compound in magic mushrooms), ketamine, and MDMA, among others, as part of a wider therapeutic process. Psilocybin has so far dominated this new wave of exciting research, showing promising preliminary results in helping with the alleviation of alcohol and nicotine addictions, depression, end-of-life anxiety, cluster headaches, and obsessive-compulsive disorder.
The main healing mechanism for psilocybin, or what many of the research teams have been focusing on, is the so-called mystical experience, which is said to include a sense of unity (i.e. loss of internal boundaries within the self, or external boundaries between self and environment); transcendence of time and/or space; ineffability and paradoxicality (i.e. that the experience is difficult to describe or conceptualise); a sense of sacredness or awe; a noetic quality (i.e. sense of direct knowledge of ultimate or higher reality); and a deeply felt positive mood (e.g. joy, peace, love). Such an experience can quite radically shift the lens through which one views the world. Pretty much instantly, too. It should be noted that the positive clinical outcomes appear to be tied to the extent to which a mystical experience was had, suggesting that the therapeutic effects of psilocybin are dependent on the experience rather than the pharmacological action.
Now, if you have a mystical experience then that’s great. It quite literally has the potential to open up the entire universe for you. The only thing is that not everyone has one, which has the potential to lead to disappointment, especially if the noted benefits are so dependent on one having it. It’s also important to note that most, if not all, of all of the current protocols involve lying down with an eye mask on and headphones playing a curated playlist. Participants are encouraged to stay with the experience, and let their inner healing intelligence lead the way, which often involves remaining lying down in stillness. Much of the research has also been focused on the neurological effects of the experience, exploring changes to neuroplasticity, psychological flexibility, cognitive reappraisal, 5-HT2A receptors, the Default Mode Network and the like. The focus is mostly neck-up, basically.
So my question is… where is the body in all of this? Don’t get me wrong, much of the research so far, as well as the teams behind it, has been truly stellar (not to mention courageous). Exploring the neurological changes to the brain in the psychedelic state is perhaps especially exciting given its implications in understanding the nature of consciousness (Johns Hopkins’ research facility is named the Centre for Psychedelic & Consciousness Research). And hopefully I’ve made it clear that trauma is a protective response largely in the body, and trauma is a much broader term than many appreciate. It is arguably responsible for many of our unwanted symptoms, including depression, where we get stuck in the Dorsal Vagal Complex, or anxiety, where we get stuck in the Sympathetic Nervous System.
Of course, not everyone will be seeking a psychedelic process for healing. Some people will merely be curious, or might want to creatively explore a life issue in a new way, or have a mystical experience, or whatever else the reason may be. There may also be use cases for which one or two high-dose psilocybin experiences might be better indicated—smoking cessation, end-of-life anxiety, and others. Beyond these, on behalf of all the many people who are seeking such experiences to feel better (which includes those with depression and anxiety), I reiterate: we can’t resolve everything in the mind alone.
My hunch is that this might be one of the reasons behind why some research shows depression returning within a few weeks to months in the psilocybin for depression trials, if it goes at all. Although participants may adopt a new story about themselves and existence, because the trauma hasn’t been physiologically discharged and the participant’s parts haven’t been worked with directly, eventually the new story will unravel enough so that participants return to their unwanted symptoms. Parts and stuck survival energy don’t go anywhere. And although there are many factors implicated in our wellbeing - diet, exercise, a sense of community, connection to nature, the quality of our relationships, our environment, our socio-economic standing, and so on - the impact of undischarged overwhelm plays a major role, as do our parts, who will continue to run the show if bypassed.
Which brings me to MDMA. Already MDMA has been shown to be a remarkably effective treatment for PTSD. Researchers found that 67 percent of PTSD sufferers who had MDMA supported with therapy no longer qualified for a PTSD diagnosis following the trial, compared with 32 percent of those who received a placebo with therapy. And 88 percent of subjects in the MDMA group experienced a “clinically significant improvement” in symptoms. Pretty impressive.
Because nothing can overwhelm the Self, it means that we can courageously explore, be with, and heal the most wounded parts of ourselves without risk of being overwhelmed again
MDMA works by enhancing the release of monoamines such as serotonin, norepinephrine, and dopamine, and hormones including oxytocin. It also reduces activation in brain regions implicated in the expression of fear, namely the amygdala and insula. Essentially, what this means is that it creates psychological and physiological safety, granting access to Self-energy in IFS language. With this in place, the experience can soften the defences of the Protectors so that we gain access to the Exiles underneath that require healing. And although Somatic Experiencing teaches us to move very slowly so as not to overwhelm the client, because nothing can overwhelm the Self, it means that we can courageously explore, be with, and heal the most wounded parts of ourselves without risk of being overwhelmed again. MDMA has also been said to unlock deep abdominal breathing, a profound healing tool in itself (we’re pretty bad breathers on the whole). With the volume of the rational mind turned down, bodily awareness can increase, enabling the participant to remain present with the unfolding somatic experience in the here and now.
Therefore, in my view MDMA could be the perfect tool to release trauma, and many of the aforementioned symptoms associated with it, including depression and anxiety. Indeed, I believe the healing potential for MDMA reaches far beyond PTSD. I also believe it could be especially powerful when used in conjunction with Somatic Experiencing and IFS approaches. Somatic tools could be utilised to teach the language and vocabulary of sensations, where the participant will know how to track sensations in real-time. Combined with a felt sense of safety and plenty of Self-energy, this has the ability to give the participant's organism the opportunity to do what it has evolved over millions of years to know how to instinctively do: discharge the survival energy that remains frozen within them. IFS can be used in the preparation period, to give the Protectors a heads up that an MDMA experience is about to take place, working through any of their fears or concerns (another way of framing Protectors is ego defences, which can create resistance. Working directly with the parts that might resist the experience upfront has the potential to allow for a deeper experience to take place).
I also think that more than one psychedelic experience is required, ideally three. We’re talking about a lifetime’s worth of parts and built-up survival energy here. Therefore, IFS can be used in between the MDMA sessions to work with any parts that emerge throughout the process. I believe IFS could also be used in the MDMA sessions themselves, in the event that the trauma release, which I would prioritise in the MDMA sessions, doesn’t occur. And I understand why so far the non-directive, inner healing intelligence model has been used in the MDMA research. The argument is that an overly active therapist could inadvertently undermine the participant’s own self-healing capacity. There are ethical concerns, too; taking a directive approach using conventional therapeutic models puts far too much power with the therapist. I completely agree with this. But IFS and Somatic Experiencing are new, different, and innately inner-healing models. In IFS, the participant can only ever heal themselves, by connecting with their Self, and then directing their Self-energy towards their parts that need healing. Everything emerges from within the client and their parts, and never the therapist/practitioner. The model simply doesn’t allow it. With a participant’s protective parts relaxed, and with Self-energy generated due to the MDMA effect, this has the potential to allow for some deep work to take place. Indeed, in a recent conversation on the Psychedelics Today podcast, IFS creator Richard Schwartz said using IFS in MDMA sessions has a lot of potential. And by using Somatic Experiencing embodiment tools, the participant would simply track sensations and discharge the stuck energy, without needing to go into the narratives. So although this is a very different proposal to the ‘lie back with eye mask and headphones on’ model that we’ve mostly seen so far, it would remain entirely led by the participant’s organism - mind and body - and would also serve to build helpful tools that the participant can use after the process has completed.
I suggest an ideal protocol could include three psychedelic sessions supported with nine preparation/integration sessions: three preparation sessions before the first psychedelic session, two integration sessions in between the three psychedelic sessions, and finally two integration sessions after the third psychedelic session, with community support being offered after the entire process completes, and tools for regulating the nervous system, practising mindfulness, embodiment, connecting with Self, and working with parts are embedded throughout the process.
The first preparation session could focus on drawing a broad map of the participant’s history and, importantly, the current issues they want to work with. The next preparation session could include embodiment tools to help the participant learn what embodiment feels like, and how to track sensations, which would support the entire process. (The therapist/practitioner wouldn’t necessarily need to have done the full three-year Somatic Experiencing training to be able to do this, although some training would be required). Embodiment awareness could be further supported with embodiment meditations and a trauma-informed educational written guide, thus offloading some of the ‘work’ from the therapist/practitioner. As mentioned, IFS could be used in the remaining preparation session to prepare the Protectors and support the work with the parts throughout the process (this would need to be facilitated by a trained IFS practitioner/therapist, but thankfully there are more and more people being trained in this model due to its increasing popularity).
And although I believe MDMA should be used for at least two of the psychedelic sessions, perhaps there could be the option to work with psilocybin for the third psychedelic session, once much of the ‘groundwork’ has been done, i.e., once the participant has a more regulated nervous system and connection with Self. This is beneficial because psilocybin has the potential to surface potentially hurtful or even shameful material from the unconscious. If a person doesn’t have a strong, or any, connection with Self, it has the potential to be quite destabilising. IFS, MDMA, and Ventral Vagal access through trauma release all serve to build the Self connection, meaning that if difficult material does surface in a psilocybin experience, the participant is better equipped to meet it with self-compassion and curiosity, and would of course be supported by the therapist/practitioner throughout the process.
It should be noted that psilocybin works very differently to MDMA. Whereas MDMA can be relational and allows the participant to be calmly present with, and safely explore, the unfolding process, a high-dose psilocybin experience is one arguably necessitated by the need to surrender to it without external influence. Therefore, I believe a psilocybin session would need to follow an entirely non-interventional approach, where the psilocybin and the participant’s psyche does the majority of the work within the session, and the therapist/practitioner is there to provide safety, comfort, and reassurance, helping the participant to move through any resistance that might emerge.
The state of our nervous system greatly influences our mental and emotional states, and the narratives we hold about ourselves, others, and the world
To summarise, trauma exists on a continuum, and can be defined as the protective response to overwhelm/adversity (an event or period of time that is too much, too fast, or too soon for us to handle), in which the unique window of tolerance in our autonomic nervous system is breached, and we get stuck in protect-mode. When we are overwhelmed, there is a physiological consequence: we generate survival energy (adrenaline, noradrenaline, cortisol) which can then get frozen within us, locking our nervous system into dysregulation, causing chronic muscle tension, and sometimes somatic diseases. And there is a psychological and spiritual consequence: we can disconnect from Self, and our protective parts, developed as an adaptive response, work hard to protect us from being overwhelmed again. Trauma can be generational, and it can be a result of both our personal histories as well as the environments in which we live. Trauma also relates to a threat, or the perception of a threat.
I hope I have explained that trauma is a much broader term than many people realise - it is not limited to PTSD that requires ‘actual or threatened death, serious injury, or sexual violence’. Lots of things could lead to us breaching our unique window of tolerance. We are increasingly waking up to the idea that trauma’s protective response to overwhelm and adversity could very well explain many of our unwanted symptoms, and the tools we’re currently commonly using might not be the optimal ones for the important task of helping people get well.
Indeed, overcoming trauma is largely a physiological process - we can’t talk, think, medicate, or meditate our way through it. Further, I believe it’s of crucial importance that we acknowledge how the state of our nervous system greatly influences our mental and emotional states, and the narratives we hold about ourselves, others, and the world. Rather than solely working at the narrative level, which is a later stage process, we must address the root at the somatic and nervous system levels, while working directly with the parts of ourselves that came into being as a response to overwhelm and adversity, so as not to either disregard them or get too caught up in their protective stories.
We’re constantly evolving and adapting, and the therapeutic tools, methods, and approaches we’ve used thus far have paved the way for others to emerge. For example, there would be no IFS without psychosynthesis, gestalt, Jungian psychology, systems thinking, humanistic psychology, and indeed many shamanic and spiritual traditions.
I’m deeply grateful to all the teachers, guides, healers, therapists, clinicians, and researchers who have taken us this far. And although there are other great approaches out there for trauma (EMDR, yoga, etc.) I believe that Somatic Experiencing, Internal Family Systems, and psychedelics present us with new, increasingly popular, and most importantly, very effective alternatives to some of the approaches we’ve used to date. Perhaps especially when combined. Therefore, I believe there is a great research and/or investment opportunity here to combine these models in a transdiagnostic, trauma-informed MDMA (or MDMA + psilocybin) protocol that connects to Self, processes parts, and importantly, prioritises the release of stuck survival energy and nervous system regulation.
If you’d like to reach out regarding such an opportunity, please feel free to contact me.
Thank you, and may you, your parts, and your nervous system be well.
Founder of Brighter Pathways