SEXUAL HEALTH: psychedelics and sex therapy

In recent years, medical research into the therapeutic use of psychedelic drugs has cautiously re-emerged after decades of being shut down by War on Drugs rhetoric. Major medical centers are now participating in multi-stage trials of MDMA (ecstasy) for treatment of post-traumatic stress disorder (PTSD) and psilocybin (the active ingredient in magic mushrooms) for treating depression, cancer anxiety, and alcoholism. In South America, the Amazonian plant medicine ayahuasca has been used to manage a variety of ailments, especially alcohol and drug addiction.

Like a lot of people, I caught wind of this renewed research into psychedelics from reading an article by Michael Pollan called “The Trip Treatment” that was published in the New Yorker two years ago. Pollan noted:

Beginning in the nineteen-fifties, psychedelics had been used to treat a wide variety of conditions, including alcoholism and end-of-life anxiety…Between 1953 and 1973, the federal government spent four million dollars to fund a hundred and sixteen studies of LSD, involving more than seventeen hundred subjects…Psychedelics were tested on alcoholics, people struggling with obsessive-compulsive disorder, depressives, autistic children, schizophrenics, terminal cancer patients, and convicts, as well as on perfectly healthy artists and scientists (to study creativity) and divinity students (to study spirituality)…

By the mid-nineteen-sixties, LSD had escaped from the laboratory and swept through the counterculture. In 1970, Richard Nixon signed the Controlled Substances Act and put most psychedelics on Schedule 1, prohibiting their use for any purpose. Research soon came to a halt, and what had been learned was all but erased from the field of psychiatry.

It’s taken decades for conditions to shift so that research into the therapeutic use of pyschedelics can pick up where it left off in 1970. The bulk of Pollan’s article focused on participants in clinical trials at several universities, including N.Y.U., in which psilocybin was being administered to cancer patients in an effort to relieve their anxiety and “existential distress.”

One of the researchers was quoted as saying that, under the influence of the hallucinogen, “individuals transcend their primary identification with their bodies and experience ego-free states . . . and return with a new perspective and profound acceptance.”

Naturally, as a sex therapist, I was intrigued to attend a presentation last December called “Reclaiming Ecstasy: An Exploration of the Therapeutic Use of Psychedelics and Sacred Plant Medicines in the Treatment of Sexual Trauma and Dysfunction” given by my friend and colleague Dee Dee Goldpaugh. The presentation took place as part of the Sexuality Speakers Series, hosted by Dulcinea Pitagora and Michael Aaron, creators of the AltSex NYC Conference.

reclaiming ecstasy

image by Alex Grey

In her talk, Goldpaugh laid out some basic pharmacological information about the two classes of psychedelics (the hallucinogens such as psilocybin, LSD, and ayahuasca/DMT and the empathogens such as mescaline, 2cb, and MDMA) and the difference between therapeutic use (pure substances in measured doses) and self-administration. She shared the distinction that clinicians make between big-T trauma (rape, incest, assault, molestation) and little-T trauma (being catcalled, medical exams, being belittled, punished for masturbation, boundaries not respected by caregivers). And she explained the numerous ways in which sexual abuse has lasting effects on those have been sexually abused: PTSD, depression, dissociation, substance abuse, distrust, dysfunction, shame, self-blame, body image issues, sexually transmitted infections.

Citing the work of Friedericke Meckel Fisher (Therapy With Substances) and Bessel van der Kolk (The Body Knows the Score), Goldpaugh then laid out some of the explorations researchers are conducting to use psychedelics to treat trauma, especially in the area of sexuality, intimacy, and relationships. MDMA, for instance, was first patented in 1914 and until it was outlawed in 1985 was used for couples therapy, among other things, because of its effectiveness in treating symptoms of PTSD and because it seemed to activate long-term memory and allow subjects to reprocess traumatic material safely. Because it induces pleasurable sensations, MDMA allows users to feel fully embodied, increases empathy, and reduces shame.

Psilocybin studies suggest that it increases openness and facilitates mystical experiences by helping the brain bypass habitual thinking. Goldpaugh proposed that psilocybin could be useful in sex therapy to reduce body anxiety and to be present with pleasure. Similarly, ayahuasca enables users to override old responses and write new stories of their own experience. Goldpaugh suggested that these substances have potential to enhance a spirituality often neglected in sex therapy. She gave examples of using guided visualizations with trauma survivors who experience intrusive images during sex, helping them identify non-sexual images they can connect to in an embodied way during sexual activity (including masturbation).

Goldpaugh was very upfront in saying that she doesn’t give psychedelics to her clients or refer them to “underground” practitioners who do. At the same time, she does advocate working to legalize the use of these medicines and to support further research through organizations such as MAPS (Multidisciplinary Association for Psychedelic Studies). Her website introduced me to the term “psychedelic integration therapy,” indicating that she helps clients process their experiences with psychedelics, as I have begun to do in my own work.

I consider Goldpaugh a kindred spirit in many ways, including how she describes a “psychedelic” approach to working with clients. This approach, she said, is based on strengths, not pathology; engages spirituality, “whatever that means for the client,” as an aspect of identity; embraces radical sex-positivity; sees all people as capable of change and growth; and views sexual pleasure as a sacred human right.

 

 

 

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