The archway at the Brattleboro Retreat.
General Assignment Reporter
The archway at the Brattleboro Retreat.
BRATTLEBORO — Kurt White, vice president of community partnerships at the Brattleboro Retreat, is hopeful — even excited — about the prospect of providing psychedelic therapies for mental health.
In the past, he said at a recent seminar at the Retreat, medicine has made small and incremental improvements. Clinical trials for psychedelic therapies, however, have been promising for big returns.
“We are finding that when we use these new treatments,” White said, “is that maybe we’re studying one problem but maybe multiple problems that the person has associated with also get better. “So when we studied PTSD, the depression also gets better. When we study the depression, the trauma centers get better. When we study anxiety, the depression also gets better.”
White is a clinical social worker by training and an adjunct faculty member at the Smith College School for Social work, where he teaches courses about individual and group psychotherapy. His talk, “Breakthrough: A Dive into the Evidence and Research on Psychedelic Psychotherapies” explored the emergence of new and novel treatments that will redefine psychotherapy.
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The Retreat and White have been supportive of a bill in Vermont intended to study psychedelic therapies, which he said “challenge ideas about diagnostic categories” and “what might be possible about the timeframes on which we might intervene on really complicated problems.”
“They challenge our assumptions about how we’re even supposed to do psychotherapy,” he said, “and they definitely are going to challenge business models to adapt and get ready to implement.”
White anticipates new rules as well as different considerations for space and time. He noted the context or therapeutic setting will be important.
MDMA is coming as a treatment for post-traumatic stress disorder or PTSD, White said. He described trials going well.
“They’re passing their initial safety and efficacy tests, moving into larger sample sizes with more robust clinical controls and methods,” he said.
With a “breakthrough” designation from the Food and Drug Administration, the federal agency is required to provide expedited reviews of MDMA for psychotherapy, psilocybin for major depressive disorder and treatment-resistant depression, and an LSD derivative drug for generalized anxiety disorders.
White had never expected to see that designation for anything in the mental health field. Often, he said, it’s reserved for terminal late stage conditions to get patients helpful drugs faster.
Psychedelic therapies also are being studied for smoking cessation, substance use treatment, existential anxiety associated with death and dying, and other things.
“These drugs, as a class, are powerful anti-inflammatories and also do some things that mediate your immune response in lasting ways and so they’re also being studied for medical reasons,” White said.
He suggested checking out a playlist created for psilocybin-assisted therapy for depression studies at Johns Hopkins, which can be found on YouTube. He called music “a very important part of the experience.”
Psilocybin might bring on “perceptual distortion,” White said.
“MDMA does even less of that. It’s really more of an energizing, dissociative, pathogenic drug,” White said. “I think it makes you feel closer to others, more in touch with feelings, more in touch with an understanding of atmosphere.”
His presentation showed a photo of a treatment room for a study on MDMA therapy, where a patient sits reclining on a couch with music in their ears. An eye mask often is worn.
White estimates the experience can last four or five hours, or longer if a patient is provided a booster, followed by sessions to discuss what it was like and how to process it. LSD contains an approximately eight-hour active effect.
Potential harms of psychedelic therapies are still being identified, White said.
“We know that there’s a difference between clinical and non-clinical settings so we shouldn’t necessarily take harms that have occurred in naturalistic settings and immediately simply overlay them on to clinical setting harms,” he said. “We have to think about studying this systematically.”
A study from 2022 concluded “medical risks are often minimal,” White said. “And many risks are often not really supported by the level of evidence that we would actually want to have to call something a significant harm. Research has repeatedly shown that psychedelics did not cause dependence or compulsive use.”
General Assignment Reporter
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