Healing Sexual Assault Trauma with Psychedelic Journeys: Potentials and Pitfalls

The path to healing from sexual assault trauma is often complex, deeply personal, and fraught with challenges. In recent years, however, a quiet revolution in mental healthcare has begun to reshape how we approach trauma recovery. Traditional trauma-focused exposure therapy—long considered the gold standard—is increasingly being supplemented or replaced by trauma-informed therapy, a model that prioritizes safety, minimizes re-traumatization, and emphasizes patient agency.

At the nexus of this shift are psychedelic medicines, which hold immense promise as tools for supporting survivors in their recovery journeys. These powerful substances offer the potential for profound emotional breakthroughs, helping survivors process their trauma in compassionate, body-centered, and perspective-shifting ways. Yet, as with any transformative tool, psychedelics come with their own set of risks and considerations.

In this article, Shauna “Doc” Springer dives into the evolving role of psychedelics in treating sexual assault trauma. Through interviews with leaders in the psychedelic space who are also assault survivors, and informed by her clinical expertise, she explores the unique benefits these therapies offer, alongside the crucial safeguards required to ensure patient safety and well-being. From addressing the profound disconnection survivors often feel with their bodies to cultivating forgiveness and empowerment, this piece provides an insightful look at the potentials and pitfalls of this groundbreaking approach to trauma care.

Let’s explore how psychedelic journeys, paired with thoughtful, trauma-informed practices, may redefine the path to healing for survivors.

Healing Sexual Assault Trauma with Psychedelic Journeys: Potentials and Pitfalls

Across the mental healthcare landscape, there is a quiet revolution happening right now in how we address emotional trauma: Trauma-focused exposure therapy is giving way to trauma-informed therapy as the accepted standard of care. 

Until recently, the unquestioned “gold standard” treatment for trauma has been exposure therapy. This treatment involves deliberately exposing trauma sufferers to the sources and triggers of their anxiety to facilitate desensitization and foster habituation. In practice, survivors are urged to recount the details of their trauma, including a sexual assault, leaving no detail, emotion or personal impact unexpressed. 

Conversely, “trauma-informed therapy” aims to support trauma sufferers with treatments designed to minimize the possibility of re-traumatization.  A trauma-informed therapist believes that increasing patients’ sense of helplessness or physiological dysregulation can be harmful, leading patients to avoid starting therapy, to drop out of active therapy, and sometimes, to feel that they will never heal. 

Psychedelic medicines are at the nexus of this shifting approach in favor of trauma-informed therapy. Based on personal clinical reflection and interviews with three leaders within the psychedelic landscape, all assault survivors, this article will explore the unique potentials and pitfalls of psychedelic therapy to treat sexual assault trauma. With any treatment, negative outcomes are possible, so we’ll also look at some guardrails that may mitigate risks related to the use of psychedelics. 

Sexual assault involves a particularly complicated recovery journey. Psychedelic medicines introduce a number of unique potential benefits for supporting survivors. 

A Compassionate Approach. 

For many sexual assault survivors, traditional exposure can be challenging.  After I described the approach and goals of conventional exposure therapies, Coltrane Lord, founder of the Wonderland Project, immediately replied, “That sounds re-traumatizing.” As an alternative, psychedelic medicines can provide a helpful distance from the intensity of trauma symptoms. 

Cristina Pearse, the Founder of the Protea Foundation, said that psychedelics, and specifically MDMA, allowed her to engage in therapy, to revisit her traumatic history and work with the therapist team to process her trauma. The medicine facilitated trauma processing in a more gentle and compassionate way – allowing Pearse to “de-layer the trauma in a calm, non-threatening manner.” 

Coltrane Lord shared, “these medicines allow you to go to a place where you can’t go in your body otherwise.” My patients have shared the same observations during their ketamine integration sessions – that the trauma is not as overwhelming in the altered state of consciousness. As a result, they can move from helplessness and horror to a place of healing more quickly, often without being re-triggered in the process. 

Re-claiming the Body. 

Sexual assault often leaves survivors with a feeling that they do not own – or control – their own bodies. One of my patients described the loss of control in this way: “After the assault, there was a time when I was too scared to say ‘no’ to anyone. I would continue to freeze and just wait for them to get it over with.” Trauma symptoms can exacerbate this feeling of helplessness. For instance, quite commonly, survivors of sexual assault experience panic attacks, nightmares, and flashbacks. When this happens, survivors often feel out of control as their bodies are flooded with adrenaline. 

These residual shockwaves can stimulate and mimic the original feeling of loss of control in the body, which complicates recovery. If they do not receive trauma treatment that helps them heal, this can leave trauma survivors with the feeling that they can never get past their trauma. Daniela Auñon, who helps manage the efforts of Flourish Trust, adds another layer to this complexity: “for survivors, the body often becomes a site of profound disconnection or even betrayal.”

Different medicines have different effects. As Lord explains, a medicine with dissociative properties like Ketamine may bring deep relief for some survivors because they feel unsafe in their body, while others, like MDMA, may help them reconnect to their bodies. And sometimes reconnection to the body is both difficult and healing at the same time. 

Lord made the analogy of blood flowing back into a foot that has been asleep. As she explains, “sometimes these medicines can help you navigate a painful reawakening after being frozen in the body…it can tingle and feel uncomfortable, but survivors reconnect to themselves after this feeling passes.” In describing this sensation, she made a clear distinction between this kind of tingling feeling and the kind of paralyzing re-triggering that can happen when survivors are re-traumatized. 

Along similar lines, Auñon healed through carefully guided psychedelic experiences which allowed her to rewire her relationship with her body. As a result of this work, she came to this realization: “my body is a sacred and safe space that belongs entirely to me.” 

A New Perspective. 

A third unique benefit of psychedelics is how they can help shift our perspective of a trauma. Psychedelics often facilitate adaptive interpretations of things that may have locked us up, sometimes for years. Auñon explained that her psychedelic experience allowed her to reframe her sexual assault, cultivate compassion for herself, and forgiveness for her attacker. As she put it, “psychedelics acted like windshield wipers for my soul, clearing years of accumulated shame, fear, and numbness so that I could see myself and the world more clearly. They illuminated the possibility of living with light, joy, and safety after an eternity in the dark.” 

Forgiving the attacker was noted as a part of healing for Lord as well as Auñon. During our conversations, we did a deeper dive into what “forgiveness” means in this context.  Forgiveness does not mean letting an attacker off the hook in terms of legal or other consequences of their actions. What it meant to these survivors was freeing themselves from resentment and a continued link to the attacker by reclaiming one’s own body. 

Anything with power has a potential dark side. In addition to discussing the unique benefits of psychedelics for healing assault trauma, we discussed some potential pitfalls associated with the use of these new medicines.

First, all of these survivor-leaders emphasized the need to pair psychedelics with integration. A “psychedelic” is by definition a medicine that “reveals” [delic] what is in the “psyche.” It is critical that survivors are well supported to understand the range of feelings, thoughts, and experiences that emerge. Finding a therapist who is a safe and stable container was repeatedly called out as critical to healing.

Related to this, regardless of an intent to deliver trauma-informed therapy, psychedelic medicines can still surface intense feelings and experiences. While these are generally less intense than revisiting trauma without the support of these medicines, buried thoughts and feelings can come to light. Auñon feels that this can ultimately be transformative but urges thoughtfulness about the readiness of each patient: “there can be a danger of rushing into this work before a patient is ready, which can be destabilizing.”  

Another risk is pairing these medicines with the work of an inexperienced, unskilled, or downright unethical therapist. While this is a risk with any type of talk therapy, psychedelic medicines may lower defenses, and can create a different level of vulnerability.  And supporting sexual trauma recovery often requires specialized expertise. 

To give an example, some of my patients have told me that a previous provider has said things like “surely you said ‘no’ or tried to fight back, right?”  In reality, during a sexual assault, it’s not uncommon to have an instinctive freeze response. In fact, the “freeze” response can be a form of tonic immobility – a natural state of paralysis – controlled by involuntary body systems. (Moller, Sondergaard & Helstrom, 2017). Freezing may also be a life-saving choice in some cases. When a well-meaning therapist asks a survivor if they “fought back,” if they in fact had a freeze response, this may heighten feelings of shame.

The wisdom of lived experience adds a critical dimension to this revolution in care. Coltrane Lord of the Wonderland Project recalled an interaction with a therapist who used what she thought was a gentle, dis-arming voice, along with reassurances that “shhh, it’s OK, you’re safe,” during a critical emotional and embodied release. Lord was triggered and recoiled from this, explaining that the use of a “saccharine sweet voice” whispering these kinds of assurances while trying to minimize her process, is exactly what many perpetrators (who are known to the victims) say and do during an assault. It is really important for therapists to take the time to understand and discover the unique nuances of trauma for each client in order to co-create a safe space. Similar trauma events can affect people in different ways.

We also talked through the power dynamics in many therapy relationships. With the lowering of a patient’s defenses, attention to power can become very important for protecting patient safety. Survivors stressed the importance of patients “finding a therapist that feels safe to [their] nervous system.” However, what can complicate this is that some survivors may not have a strong radar for unsafe people. In fact, before their trauma has been addressed, some survivors may even gravitate to the kinds of people who are not trustworthy. These people may feel familiar. As Lord put it, “someone who has not healed her body may still be responding from her internal trauma patterns, which can lead to unsafe choices.”

Based on these risks, guardrails can be put into place to promote a safer healing journey. First, a thoughtful assessment of readiness might include questions like: 

Can this patient describe their expectations, hopes and any concerns up front?

Does this patient have a solid, positive, dependable support system?

Does this patient demonstrate an ability to ground him or herself?

Based on this patient’s history, how does this patient cope with novel physiological responses and emotions? 

What makes this patient feel safe? 

How does this patient feel about authority figures? 

What are this patient’s triggers? (Is this patient aware of them?) 

How can we give this patient agency during this process? 

How does this patient feel about having a therapist of either gender? (Sometimes female patients who have survived assault from a male perpetrator may prefer to work with a female, and for others, working with a safe and ethical male therapist can be intensely healing). 

 

Patients should also be directed to ask questions like: 

Does the therapist have specific experience with supporting psychedelic medicine healing (or is the therapist supervised by a licensed provider with this specific expertise?)  

How will this therapist empower me during this journey?

Who will respond if I am distressed? 

Will the therapist ever touch me in any way? If so, what boundaries are clear about the use of touch?  

Auñon suggested that some patients who have never had psychedelic medicine may benefit from exploring altered states of consciousness through holotropic breathing or the use of Ketamine as a “more gentle medicine.” As she explains, “Ketamine is shorter-acting and allows individuals to feel more in control of their body and experience, which is particularly important for survivors of sexual assault.” 

And finally, because this work requires a special kind of trust, it is critical that therapists are accountable for their actions. Cristina Pearse of the Protea Foundation emphasized that individuals need to work with licensed therapists, since licensing boards can oversee these practitioners. Unlicensed providers have limited to no accountability. Pearse also recommends layers of oversight, medical monitoring, informed consent, clearly written disclosures, and policies designed to keep patients physically and emotionally safe during all aspects of an intervention. Finally, she recommends that reporting of any concerns needs to be encouraged and made available. As part of standard informed consent for psychedelic work, patients should have clear steps on who to contact to rectify the situation if there is an ethical transgression on the part of a therapist. 

To wrap up, a foundational principle of healing work is to do no harm. When paired with trauma-informed therapy, psychedelic medicine has created a new pathway for healing trauma. With thoughtful guardrails to protect patient safety, psychedelic-assisted work may allow us all to align with a trauma-informed, more compassionate way of supporting those who suffer.

 

Shauna ‘Doc’ Springer is a licensed psychologist, award-winning Military Times podcast host, and one of the world’s leading experts on psychological trauma, suicide prevention, and close relationships. A Harvard graduate who has become a trusted advisor to our nation’s military warfighters and first responders, she is the author of three best-selling books, including RELENTLESS COURAGE which has been described by Lt. Col. David Grossman, best-selling author of On Killing as “one of the most important books of our time.” As the Chief Psychologist for Stella, she is responsible for developing Stella’s trauma informed approach to care across its international network of clinics.