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

A woman in her early forties with a three-decade history of treatment-resistant depression stemming from childhood trauma (domestic violence, sexual abuse, poverty) achieved remission after approximately 1.5 years of underground small-group sessions. These sessions combined breathing exercises, cold exposure, physical exercise, music, and psilocybin mushrooms. Psilocybin appeared to interrupt trauma-related dissociation, allowing her to re-experience dissociated physical sensations in a controlled setting. She had six psilocybin sessions individually, in the small group, or with friends. A follow-up interview 2.5 years later indicated the remission was sustained. This case suggests that a multi-dose strategy over an extended period may be necessary for remission, contrasting with recent clinical trials using one or two doses.

Study at a glance

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.