Dee Dee Goldpaugh, LCSW

Cases in which psychedelics reveal lost “memories” or feeling states related to sexual abuse have been some of the most challenging for both clients and myself as an integration therapist.

A client arrives for a first appointment at my office. She shares that, during an intentional MDMA experience with a sitter, she recovered memories of sexual abuse by her uncle at age 4. She’s been flooded, disoriented, and overwhelmed since. The next week, a phone call from a young man recalling a “felt state” of abuse by his father. He now cannot have sex and feels confusion and distress. And the next week, a young woman returned from Peru after experiencing night after night of images of being abused by a babysitter in early childhood. None of these people had any clear or specific memory of childhood sexual abuse prior to these psychedelic ceremonies and arrive in therapy with feelings of confusion, shame, disgust, somatic complaints, or flashbacks. Cases in which psychedelics reveal lost “memories” or feeling states related to sexual abuse have been some of the most challenging for both clients and myself as an integration therapist. This article will explore the phenomenon of “psychedelic-recovered memories” and their implication for both psychedelic journeyers and therapists.

The Truth of Memory

Perhaps one of the most controversial topics to rock the psychological establishment since the ‘90s has been the phenomenon of recovered memories. One faction of researchers believes there is no concrete evidence that the psyche can repress and later recover information about severe trauma, mainly because psychologists have been unable to reproduce it in laboratory conditions. In fact, the American Psychological Association states occurrences of recovered memory are quite rare (https://www.apa.org/topics/trauma/memories). This belief is countered by a robust community of trauma therapists who routinely observe that people can uncover memories of abuse that occurred in childhood that have been dormant in our minds for decades. This controversy becomes even more thorny when psychedelic medicines are involved.

It would seem reasonable to believe the worst experiences of our lives would be indelibly marked in our memory in vivid detail. Psychiatrist Lenore Terr argues that, although this may be true of a single event trauma, such as an accident, children who experience recurring trauma employ “defensive mechanisms such as dissociation, splitting, and denial… to lessen the impact of the trauma. When trauma occurs over time, the defensive strategies interfere with the memory process.” But, she remarks that, “inaccurate details can also be added to true memories due to the reconstructive nature of memory” (Corelli, 1997, p. 35). Trauma theorist Bessel Van Der Kolk notes that, “memory loss is most common in childhood sexual abuse, with incidents ranging from 19 to 38 percent” (2014, p. 192). Trauma therapist Wendy Maltz further explains that memory loss can also protect us from the psychological distress associated with not having been protected by our parents (2012).

When a memory is uncovered in a psychedelic state, survivors may feel the additional fear that therapists will be suspicious of them, not take them seriously, or feel they have no recourse or support if it’s unsafe to reveal their psychedelic use to family or friends.

When a memory is uncovered in a psychedelic state, survivors may feel the additional fear that therapists will be suspicious of them, not take them seriously, or feel they have no recourse or support if it’s unsafe to reveal their psychedelic use to family or friends. Therapists unfamiliar with psychedelics can be at a loss to understand how this information emerged, or the experience of psychedelic ceremony in general.

Medicine Revelations

What is it about psychedelics that unearth memories distant from the conscious mind, yet alive in the body? How can psychedelics hold the potential to treat PTSD and also overwhelm us with traumatic memories when we aren’t necessarily pursuing them? Jeffrey Guss, a psychiatrist who has collaborated in numerous research projects involving psychedelic-assisted therapy, shared with me: “information in the form of memories gets put to rest in our mind, and under the influence of a psychedelic these memories can get highly activated. This can be extremely intense and startlingly real.” He emphasized that psychedelics “help people to more directly experience affective states like love, connection, sadness or terror. These medicines can help people shift away from their familiar narrative story and plunge directly to emotions that are more deeply felt than ordinary conscious states will allow” (J. Guss, personal communication, 2020.)

By positively confirming recovered memories as factually true in the form in which the survivor remembers them, therapists potentially cause great harm to survivors themselves, families, and communities impacted by these revelations.

But a troubling question remains for both psychedelic users and integration therapists: Are these “memories” true? For some clients with whom I’ve worked in my integration therapy practice, the memories they access in psychedelic work are like a lightbulb going on. “I have always had a stomachache any time this uncle entered the room and the impulse to run away. This makes sense to me now.” And for others, they are left with more questions: “memories” of abuse by family members with whom they remember only positive interactions and no distressing feelings; images of abuse so ritualized and fantastical they seem outlandish even to the survivor. What are we to make of this? Integration therapists bear an enormous responsibility to both support survivors of sexual abuse and violence, and also to do no harm. By positively confirming recovered memories as factually true in the form in which the survivor remembers them, therapists potentially cause great harm to survivors themselves, families, and communities impacted by these revelations.

Any person who seeks therapy for sexual abuse or assault should be respected and believed by their therapist without question. The only ethically defensible position for therapists and society at large is to believe survivors. But, when images of abuse arise in psychedelic work and the client themself is unsure of what to believe, how do we proceed ethically when affirming that a fuzzy recollection of abuse has dramatic implications for both the client and the client’s family and community? The hard truth is, in most cases, absent a parent or caregiver to affirm details the client might remember, we can’t know what “really” happened. What we can know is what the body and mind are telling us right now that can direct our healing journey.

Psychedelic medicines, broadly speaking, teach us and heal us through symbols, images, and feelings. These can be elaborate visions, seizure-like “shaking” of trauma from the nervous system, or simply felt sense in the body of experiences from long ago. They may show us depictions of “true” experiences (experiences that are close to how they actually happened) or they may be concretizations of feeling states. In other words, it is possible to see a sexual abuse scenario in a psychedelic ceremony when, in fact, what was actually experienced was neglect, disrespect of bodily autonomy, or an emotionally-invasive caregiver: a different kind of trauma all together.

My approach with clients is to say, “we may never know for sure what exactly happened to you, but I will do my best to help your body to heal from the trauma it’s holding.”

Clients often look to their therapist to affirm and believe them, and rightly so. This should be the universal experience of any person who comes to therapy after being sexually assaulted as an adult or with the knowledge of being abused as a child. But, for survivors who are unsure, competent integration work is more aligned with helping clients to tolerate the ambiguity of not knowing “truth,” and helping clients to accept that psychedelics are trying to help us unearth material helpful to our healing, though it may be in the form of symbolic expressions of feeling states from childhood. The primary focus of integration work is helping the body to process the somatic implications of trauma. My approach with clients is to say, “we may never know for sure what exactly happened to you, but I will do my best to help your body to heal from the trauma it’s holding.” And that’s exactly where we start: the body.

Body Healing

One form of therapy I have found particularly helpful in dealing with psychedelic-recovered memories is EMDR (eye movement desensitization and reprocessing). Pioneered by Francine Shapiro in the 1980s, EMDR uses bilateral stimulation paired with connection to a somatic and affective feeling state to reprocess traumatic material. EMDR is most concerned with what the body and mind are experiencing now, and how we can bring the mind-body back to balance by transforming emotional memory—memory that feels emotionally charged, alive in the present, and self-referential—into objective memory, a more functional form of memory that reminds us a trauma is over and we are not to blame (Parnell, 2007). In EMDR, we don’t need to know what “really” happened; we need to know what your body is feeling right now and the beliefs you hold about yourself as a result of the information you received in a psychedelic state. “It’s my fault”; “I can’t trust anyone”; and “I’m not safe,” are a few that plague survivors of trauma.

In integration EMDR work, I help clients to identify images or feeling states from their ceremony experience paired with somatic responses. Clients may then desensitize emotional reactivity and reprocess or reframe their experience. Sometimes, survivors have more clarity about the material uncovered in psychedelic work, and sometimes they do not. Hopefully, they emerge with a sense of being safe in their bodies in this moment. The most important outcome is when a survivor feels, both in therapy and in their life, a sense of control, respect, and knowledge that their body holds the key to their own healing. 

Psychedelics offer us potential for healing trauma that is nearly unparalleled by other therapies. Current research on psychedelic medicines such as psilocybin mushrooms and ayahuasca are only beginning to uncover what Indigenous healers have known for centuries: that these medicines are our allies and create experiences that allow the mind and body to heal (Kreidiet, et al., 2020). Psychedelics are also complex medicines and can produce perplexing experiences that, to some, may be repressed psychological material; to others, the collective unconscious, or messages from plant spirits connecting with us for healing. The most important lesson these medicines have to offer may be that we are not our trauma. We are whole and capable of healing through our own natural resilience, with our body wisdom and hearts leading the way.

References

Corelli, T., Hoag, M., & Howell, R. (1997). Memory, repression, and child sexual abuse: Forensic implications for the mental health professional. Journal of the American Academy Psychiatry Law, 25(1), 31–47.

Krediet, E., Bostoen,  T., Breeksema, J., van Schagen, A.,  Passie, T.,  & Vermetten, E. (2020). Reviewing the potential of psychedelics for the treatment of PTSD.

International Journal of Neuropsychopharmacology, 23(6), 385–400. https://academic.oup.com/ijnp/article/23/6/385/5805249

Maltz, W. (2012). The sexual healing journey. New York City, NY: William Morrow.

Parnell, L. (2007). A therapist’s guide to EMDR. New York City, NY: Norton.

Van Der Kolk, B. (2014). The body keeps the score: Brain, mind and body in the healing of trauma. Westminster, UK: Penguin Books.

Note:

The case examples mentioned here are composites and do not reflect confidential client information. The author does not provide either psychedelic sessions or refer clients to “underground” facilitators. Clients in their practice are strictly integration clients.



A Conversation with Ismail Ali, Adele Getty, Mariavittoria Mangini and Tessa Vita Wednesday, September 30th from 12-1:30pm  REGISTER FOR THIS EVENT HERE The modern psychedelic community...

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