People who have experienced severe childhood trauma may experience a marked improvement in their mental health after using psychedelic drugs in a ritual setting. New observational study published in psychedelic medicine They found that people who reported more adverse events in childhood had greater reductions in anxiety and greater improvements in overall well-being after attending a psychedelic retreat compared to those with fewer childhood traumas. These results suggest that guided psychedelic experiences may offer a new approach to helping people with deep psychological scars.
Adverse childhood experiences include a variety of stressful life events that occur before the age of 18 years. These events generally fall into two broad categories. The first is direct child abuse, such as physical abuse, emotional abuse, and extreme neglect. The second category includes household dysfunction. This includes growing up with a family that struggles with severe mental illness, substance abuse, domestic violence, or criminal activity.
The effects of these early adverse experiences often persist into adulthood, leading to poor physical and mental health. People who carry the burden of childhood trauma often exhibit increased levels of general anxiety and decreased overall mental health. They also tend to exhibit a psychological trait known as experiential avoidance. This is a defense mechanism in which a person tries to suppress, ignore, or avoid difficult thoughts, painful memories, or unpleasant physical sensations.
Treating the psychological effects of childhood trauma is notoriously difficult. Standard interventions such as traditional talk therapy and common psychiatric medications are often less effective for people with a history of childhood abuse. People who have experienced severe childhood trauma are often less likely to engage deeply with treatment or find the interventions offered helpful. Because of these challenges, mental health professionals are actively seeking alternative interventions to help this particular population.
Psychoactive substances have recently received worldwide attention for their potential to alleviate stubborn mental health conditions. Classic psychedelics, such as psilocybin, a chemical found in magic mushrooms, interact with specific serotonin receptors in the human brain. In high doses, these substances reliably change a person’s mood, thoughts, and perception of reality. Recent clinical studies have shown that these drugs may reduce symptoms of depression, anxiety, and eating disorders.
Beyond formal clinics, psychedelic use is becoming increasingly popular in naturalistic settings and ceremonial settings. Retreats often last several days and consist of guided group sessions supervised by a facilitator who provides ongoing emotional support. Taking psychedelics in a supportive communal environment has been shown to have positive effects on mental health, but the specific benefits and risks for people with a history of severe trauma are still poorly understood.
Mariam K. Mehmood, a researcher at Imperial College London, led a study examining the mental health effects of ritual psychedelic use across the spectrum of childhood trauma severity. The research team used data from a large-scale online survey conducted between 2018 and 2019. The project recruited individuals planning to consume psychedelic drugs at established retreat centers.
The final analysis included 570 participants who attended various retreats, mainly in the Netherlands and the Caribbean. Most of the participants took psilocybin, but some took ayahuasca, a traditional South American psychoactive beer. This group tended to be highly educated, predominantly white, and primarily from the United States and United Kingdom.
To track changes over time, researchers collected data at four different time points. Two weeks before the psychedelic ritual, participants completed a questionnaire measuring their history of adverse childhood experiences. During this baseline assessment, they also answered questions designed to assess their current level of generalized anxiety, experiential avoidance, and overall mental health.
The day after the psychedelic ritual ended, participants were surveyed again to measure the acute subjective intensity of the experience. The researchers focused on measuring three specific types of psychedelic phenomena. First, they focused on mystical experiences that involved a deep sense of spiritual oneness, transcendence of time and space, and a sense of the sacred.
Next, the team evaluated emotional breakthrough experiences. It refers to the process of confronting painful emotions that a person would normally push aside, ultimately leading to emotional release and a sense of catharsis. Finally, the researchers measured difficult experiences during the active action of the drug, including symptoms of acute distress such as fear, paranoia, feelings of isolation, and sadness.
After the retreat, the research team contacted participants to measure psychological changes over time. Participants completed follow-up surveys two and four weeks after the psychedelic experience. These studies reassessed anxiety levels, avoidance behaviors, and general psychological well-being.
The researchers found that participants in all groups tended to report improved mental health after the retreat. When considering how individuals felt before the ceremony, the data showed that those who had more adverse childhood experiences reported greater psychological benefits compared to those who had fewer traumatic events in their childhood. After the retreat, higher levels of childhood trauma were associated with higher subsequent well-being.
Participants who had been burdened by severe childhood events also reported reduced overall anxiety in the weeks following the trip. The study showed a link between extensive childhood trauma and decreased experiential avoidance four weeks after the ceremony. This suggests that participants became willing to sit with their unpleasant emotions, rather than actively suppressing them.
The study also found a link between childhood trauma and the specific nature of drug-induced experiences. Researchers found a positive correlation between adverse childhood experiences and mystical and emotional breakthrough experiences. Participants with more traumatic backgrounds were generally more likely to feel a strong sense of spiritual togetherness and deep emotional release during psychedelic sessions.
Researchers found no correlation between childhood trauma and difficult experiences. People with a traumatic past did not report facing more paranoia, fear, or severe psychological distress than other participants during psychedelic sessions. Severe travel experiences did not alter the general relationship between childhood trauma and observed mental health improvements.
The team conducted additional analyzes focusing entirely on the subgroup of participants who reported four or more different types of childhood adverse events. This trauma threshold is known to be strongly associated with particularly poor outcomes in both mental and physical health. The researchers wanted to see if the subjective nature of psychedelic trips predicted specific psychological benefits for this severely traumatized group.
For people with severe childhood trauma, emotional breakthrough during the ceremony predicted greater well-being both two and four weeks after the ceremony. Emotional breakthrough in this group was also negatively correlated with anxiety at 4 weeks, meaning that stronger emotional release was associated with lower subsequent anxiety levels. This delayed reduction in anxiety may suggest that participants needed time to process the repressed memories they encountered during the ceremony.
Similarly, for the severely traumatized subgroup, experiencing a strong mystical state was associated with increased well-being in the weeks following the ceremony. Deep mystical experiences also predicted decreased experiential avoidance 1 month later. In contrast, having a highly challenging or frightening psychedelic experience was neither positively nor negatively associated with changes in mental health outcomes.
The authors noted several limitations to their study. Because this study utilized a prospective observational design, it cannot prove that psychedelic substances directly caused improvements in mental health. Because participants actively sought out and paid for these retreats, it is likely that their personal expectations influenced their psychological outcomes.
The convenience sample used in the study limits the applicability of the study results. Participants were primarily Caucasian from high socio-economic backgrounds and do not reflect the broader population that suffers most from severe childhood trauma. Many of those who completed the initial survey also failed to complete the final follow-up questionnaire, which could skew the results if those who dropped out had poor outcomes.
The findings of this study provide preliminary guidance for developing structured psychedelic treatments for people deeply affected by early life adversity. The authors suggest that future research should include clinical trials specifically targeting individuals with mental health disorders and confirmed histories of childhood trauma. Conducting controlled longitudinal studies will determine the safety, efficacy, and appropriate administration of psychedelics for this vulnerable population.
The study, “Ritual Psychedelic Experiences and Changes in Mental Health Outcomes in People with Adverse Childhood Experiences,” was authored by Mariam K. Mehmood, Rebecca Bremler, Meg J. Spriggs, Hannes Kettner, Leor Roseman, Lasse Damgaard, Robin Carhart-Harris, David Elizzo, and Richard J. Zeifman.
