Underground small-group therapy of treatment-resistant depression and complex post-traumatic stress disorder (C-PTSD) with psilocybin—A retrospective case study

Abstract

While a relatively large body of research exists on many aspects of psychedelic therapy, articles describing a complete, successful treatment process are rarely found. This article therefore presents a case of a woman in her early forties with early complex trauma due to domestic violence, sexual abuse and poverty in her childhood, resulting in approximately three decades of treatment resistant depression. Antidepressive medications did not alleviate her depression but resulted in adverse effects and an eventual discontinuation of the medications. Eventually the woman resorted to 'mixed-method' underground small-group sessions that utilized breathing exercises, cold exposure, physical exercises, music, and psilocybin mushrooms. Psilocybin appeared to interrupt trauma-related dissociation, producing an 'anti-dissociative' effect, allowing the woman to re-experience, in a controlled setting, dissociated physical sensations produced by earlier overwhelming events. After a period of approximately 1.5 years, during which time she had six psilocybin sessions, either individually, in the small group, or with friends, she achieved a remission of her depression. A follow-up interview 2.5 years later indicated permanence of the result. Information was acquired from semi-structured retrospective interviews with a total duration of approximately eight hours. This case study may facilitate an improved understanding of the requirements for and the process of alleviating or resolving treatment-resistant depression with psychedelics. Recent clinical trials have utilized one or two doses of psilocybin. This case illustrates the need for adopting a multi-dose strategy over an extended period of time in order to achieve remission.

Ketamine in severe, highly treatment-resistant depression—a retrospective case study and a perspective

“…Compared to this esketamine pilot implementation, an implementation resembling the Oxford model should be approximately 90% cheaper and thus scalable and sustainable on a population level, as the cost of no treatment or treatment with the current practices is the same or higher. Instead of a clinical setting, ketamine group sessions could be organized along the lines of psychedelic group session practices (Turkia, 2022d). One potential extra-medical context for such groups could be the church.…”

“…Due to these reasons, classical psychedelics have mostly been applied in self-treatment (Turkia, 2022b,c), often in psycholytic (i.e., low or 'half') doses. Alternatively, they have been successfully used in one-day or multi-day nonclinical group contexts (Turkia, 2022d). An effective healthcare system should not adopt tasks that can be handled elsewhere.…”