Psychedelic therapy is imminent. Within six years, the market for this new wave of therapeutics is predicted to reach nearly $7 billion. With advocates and investors like Tim Ferriss leading the way, protocols for implementing psilocybin, MDMA, LSD, and ibogaine into treatments for depression, PTSD, addiction recovery, and existential distress are being crafted right now.
How will psychiatrists adapt to these new substances?
This is no easy question. Unlike antidepressants currently on the market, you cannot visit a psychiatrist or general practitioner and receive a script within 10 minutes—a longstanding issue in modern psychiatry, especially given that antidepressants don't work better than talk therapy (or as this meta-analysis shows, work better in conjunction with psychotherapy) and carry with them many physical risks. One of the most prominent side effects is weight gain, which has the potential to lead to a whole series of further physical and mental health problems.
Psychedelics are also not without risks. Early results from esketamine—this ketamine variant is not actually a psychedelic but has been generally lumped into the same category and provides a cautionary tale—have not been overly encouraging:
"Through an analysis of adverse events reported to the FDA, the authors found several adverse events related to the use of esketamine nasal spray, such as dissociation, sedation, feeling drunk, completed suicide, and especially suicidal and self-injurious ideation."
This isn't to write off the protocol, which has shown efficacy in trials (though not without issues either). Anecdotal reports have been positive for some depression sufferers. More importantly, the emerging ketamine clinics across North America feature robust protocols that run counter to many current antidepressant-driven psychiatric evaluations. We should continue to explore this line of therapeutics, just more carefully.
The future of psychedelic-assisted psychotherapy | Rick Doblin
The Multidisciplinary Association for Psychedelic Studies (MAPS) foresaw the possibility of psychedelic therapy decades ago. The organization's founder, Rick Doblin, argued against the scheduling of MDMA in the mid-80s. The group's training protocols for MDMA, ayahuasca, ibogaine, and LSD are holistic and include screening sessions, pre-treatment meetings, day-long sessions, and post-treatment integration.
You cannot ingest psychedelics and go about your day. Unlike SSRIs and SNRIs, they don't take weeks for you to feel the effects. This is an entirely different model than current psychiatry protocols. If psychedelic therapy is going to be integrated into psychiatry, mental health professionals need training. They'll have to adapt. Cutting corners will be impossible.
Besides overcoming the hurdle of federal regulations (which is quickly happening), psychedelics should be subject to Risk Evaluation and Mitigation Strategies (REMS), writes Paul Tulls in Nature. This means these novel therapies will be administered according to current FDA guidelines.
"The effect would be to bundle the delivery of the drug with the therapy component, and potentially certify practitioners. A source working on one of the trials says that discussions are under way with the FDA over whether therapists who administer the drugs ought to be trained, what that training might involve and whether therapist certification should be required."
Psilocybin-containing mushroom.
Credit: Microgen / Adobe Stock
This will not be without its challenges. As Tullis writes, some therapists have been skirting federal law by offering psychedelic therapy for 30 years, reminiscent of LSD sessions in the 1950s and MDMA therapy in the 1970s. In fact, LSD was subjected to over 1,000 studies before being criminalized, though it's admittedly hard to offer a placebo. (Niacin has worked in some trials.) The comprehensive protocols being developed now have early pioneers to thank.
Psychedelics are also entering an industry with standard practices. Some therapists are likely to remain skeptical; others might not train properly before administering the drugs, which could create problems for the entire industry should some patients experience adverse effects. Psychotherapy will always be necessary before and after administration. In an industry where many are accustomed to writing scripts, not providing in-depth existential explorations with their patients—and many patients are accustomed to quick visits that result in refills—a giant learning curve is necessary.
While many are hopeful that psychedelic therapy will have broad appeal, the more likely result is a slow integration with specialized clinics (such as with ketamine today). There will undoubtedly be players with no history of psychedelics involved only for economic gain; we're already seeing it with tens of millions of dollars pouring into companies. The competing forces of revenue maximization and psychedelic ritual are likely to create friction.
Regardless, this emerging industry requires funding to get off the ground. We just need to temper expectations with the real-world consequences of the psychedelic model—a hard sell in a world accustomed to quick returns. And we'll need therapists willing to explore uncharted territory on its own terrain, not the ground they're accustomed to walking on.
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Stay in touch with Derek on Twitter and Facebook. His most recent book is "Hero's Dose: The Case For Psychedelics in Ritual and Therapy."
What is the difference between sexual assault and sexual harassment?
Sexual assault is classified as any type of sexual activity (including rape) that happens without your consent. Sexual harassment is defined as behavior that is characterized by the making of unwelcome and inappropriate sexual remarks or physical advances.
How common is sexual harassment?
A National Study on Sexual Harassment and Assault from 2018 surveyed 2009 adults (18+). This included 996 individuals who identified themselves as female and 1013 who identified themselves as male. The results of this survey showed that 81% of women (and 43% of men) had experienced some form of sexual harassment in their lifetime.
The study conducted a series of 11 multi-method experiments, involving over 4,000 participants.
Credit: Andrey Popov / Adobe Stock
According to a new study published by the American Psychological Association, women who do not fit female stereotypes for beauty are less likely to be seen as victims of sexual harassment, and if they claim they were harassed, they are less likely to be believed.
"Sexual harassment is pervasive and causes significant harm, yet far too many women cannot access fairness, justice, and legal protection, leaving them susceptible to further victimization and harm within the legal system," study co-author Cheryl Kaiser, Ph.D., of the University of Washington said in a statement.
According to Kaiser, sexual harassment claims were deemed less credible (and the harassment was perceived as less psychologically harmful) when it targeted a victim who was less attractive and/or did not act according to the stereotype of a typical woman.
The study conducted a series of 11 multi-method experiments, involving over 4,000 participants. It was designed to investigate the effects a victim's fit to the concept of a typical woman had on participants' view of sexual harassment (and the consequences of that mental association). In five experiments, participants read scenarios in which women either did or did not experience sexual harassment. Participants assessed the extent to which these women fit the idealized image of women, either by drawing what they thought the woman might look like or selecting from a series of photos. Across all experiments, participants perceived the targets of sexual harassment as more stereotypical than those who did not experience harassment.
In the next four experiments, participants were shown ambiguous sexual harassment scenarios which were then paired with descriptions or photos of women who were either stereotypical or not. The participants then rated the likelihood that the incident constituted sexual harassment. According to authors of the study, participants were less likely to label these ambiguous scenarios as sexual harassment when the targets were non-stereotypical women (compared with stereotypical women), despite the fact that, in some cases, the incident was the exact same.
The final two experiments in this study found that sexual harassment claims were often viewed as less credible when the victim adhered less to the typical female stereotype.
Even when a stereotypical woman and non-stereotypical woman submitted the same claim, it was deemed as less credible if the woman was perceived as less feminine. Additionally, the participants found the harassment to be deemed as less psychologically harmful when experienced by a non-stereotypical female.
"Our findings demonstrate that non-stereotypical women who are sexually harassed may be vulnerable to unjust and discriminatory treatment when they seek legal recourse," co-author Bryn Bandt-Law, a doctoral student at the University of Washington, explained in an interview. "If women's nonconformity to feminine stereotypes biases perceptions of their credibility and harm caused by harassment, as our results suggest, it could prevent non-stereotypical women who are sexually harassed from receiving the civil rights protections afforded to them by law."
**If you or someone you know has experienced sexual harassment or assault, contact the National Sexual Assault Telephone Hotline at 800-656-4673. You are not alone.**
BDSM is a kind of sexual expression or practice that refers to three main subcategories:
- Bondage and Discipline (BD)
- Dominance and submission (DS)
- Sadism and Masochism (SM)
It has been widely speculated that many BDSM practitioners or people who enjoy the BDSM lifestyle are more drawn to the kinky lifestyle because of sexual trauma they have experienced in the past.
A 2020 study smashed this myth by surveying 771 BDSM practitioners and 518 non-practitioners from the general population. These participants all completed a survey assessing BDSM interests as well as the Brief Trauma Questionnaire that is used to gauge traumatic events, and the Relationships Questionnaire that is used to assess a person's attachment style.
What is the Brief Trauma Questionnaire?
The BTQ, as it's referred to by the National Center for PTSD, is a self-report questionnaire derived from the Brief Trauma Interview. This questionnaire is used to assess whether an individual has had an event that meets the criteria for traumatic events.
What is the Relationships Questionnaire?
The RQ, as it's referred to by the Fetzer Institute, is a four-item survey designed to measure adult attachment styles. There are four main attachment styles: secure, dismissive-avoidant, anxious-preoccupied, and fearful-avoidant. This article does a wonderful job summarizing the various attachment styles by comparing them to relationships on the television show "How I Met Your Mother."
No, being interested in BDSM doesn’t mean you had a traumatic childhood
While many may assume being interested in BDSM may mean you've experienced unhealthy or violent relationships/situations in your formative years, this study explains why that myth should be put to rest.
BDSM practitioners across the study scored higher levels of physical abuse in adulthood. However, no significant differences emerged for other traumatic experiences (including childhood physical abuse or unwanted sexual trauma).
There have been many accounts (such as this) from BDSM practitioners that have claimed there is a certain "healing process" involved in finding a trustworthy BDSM relationship after escaping from a toxic relationship. This could account for why people who have experienced physically abusive relationships as adults then turn to the BDSM community and BDSM-related sexual interests.
When it came to the Relationship Questionnaire, people who engaged in the BDSM lifestyle more often scored in the "secure" attachment style than people who were not BDSM practitioners. While many BDSM practitioners had secure attachment styles, there was also a significant spike in anxious-preoccupied attachment styles when it came to people who practiced BDSM. In particular, the "secure" attachment style was associated with BDSM practitioners who identified as "Dominant" and the "anxious-preoccupied" attachment style was associated with people who identified as "submissive."
There are no findings to support the hypothesis of BDSM being a coping mechanism for early life dynamics or trauma.
This authors of the study claim that BDSM practitioners deserve perception as normal sexual practice free from stigmatization rather than deviant behavior—and the final results of the study support this idea.
Are people involved in BDSM practices more aware of their attachment styles?
Could people who engage in BDSM be more mindful in their relationships?
Photo by Tiko on Adobe Stock
While many people insist engaging in BDSM practices means you've had significant traumatic experienced that led you to do so, there are some experts that argue BDSM practitioners are actually more in tune with their own psychopathology than people who do not engage in BDSM activities.
BDSM involves a diverse range of practices which can involve role-playing games in which one person assumes a dominant role and the other assumes a submissive role. These activities are often intense and can involve activities such as physical restraint, power plays, humiliation, and sometimes (but not always) pain.
According to a study published in the Journal of Sexual Medicine, people involved in BDSM may actually be more mentally healthy. The study suggests people who engage in BDSM activities often show more extroverted qualities and tend to be more open to experiences and more conscientious. They also tend to be less neurotic and less sensitive to rejection. The study also showed BDSM practitioners had a more secure attachment style, which is supported in the more recent study listed above.
Additionally, it's been hypothesized that people involved in BDSM are more mindful during sex than those who do not engage in BDSM practices.
The question "does pornography lead to sexual assault?" has been asked by many researchers and outlets over the years—from previous studies done on the topic, to Huffington Post think pieces. Whether pornography contributes to sexual aggression has been a subject of research for decades, with scholars not being able to come to a consensus over whether or not the two are in any way linked.
Does pornography cause sexual violence?
Is there any truth to the notion that pornography causes sexual violence?
Credit: ninefotostudio on Adobe Stock
The anti-pornography group, Fight the New Drug, is dedicated to confirming this theory, with mass-spread articles that heavily suggest consuming porn can (and will) lead to sexual violence.
We have seen a similar question being posed across all spectrums of the entertainment world:
- "Do violent video games lead to violence in kids?"
- "Do graphic violence scenes in movies promote and encourage violence?"
How does what we consume, whether it be pornography, video games, or movies, impact our actions in the real world?
Many studies in the past have attempted to draw a line (or erase the link entirely) between violence and pornography with no success on either side. This 2000 study by Raquel Kennedy Bergen and Kathleen A. Bogle collected data from 100 survivors of sexual abuse. Twenty-eight percent of respondents reported that their abuser used pornography and 12 percent of female respondents explained that pornography was imitated during their abusive incident.
More recently, a separate 2019 study of almost 600 male Croatian secondary school students (between the ages of 15-17) explored the link between sexually aggressive students and pornography. While teenagers who showed signs of sexually aggressive behavior were more likely to use pornography, the researchers were unable to find any apparent link showing pornography had caused the behavior. In fact, it was found that people who were sexually aggressive were those who were already predisposed to aggressive acts.
The consensus with many of these studies is that while porn can be particularly enticing to individuals who are prone to becoming or have in the past become sexually aggressive, there is no concrete evidence that porn has caused or worsened their sexual aggression.
A new study hopes to disprove this notion once and for all.
The most recent research on this topic is a 2020 meta-analysis study published in the Journal of Trauma, Violence, and Abuse. The current meta-analysis examined experimental, correlational, and population studies of the pornography/sexual aggression link dating from the 1970s until 2020. Several notable things were discovered in this meta-analysis that ultimately weakens the connection between pornography consumption and sexual aggression.
This meta-analysis examined decades of work, some of which suggested there is a link between pornography and sexual violence in real life and some of which suggested there is not. In the cases where the studies were conducted over a longer period of time, the link was weakened.
Violent pornography was correlated with sexual aggression, but the evidence was unable to distinguish between selection effect compared to socialization effect.
"Selection effect" is defined as the bias that's introduced when a methodology or analysis is biased towards a specific subset of a target population.
"Socialization effect" is defined as the process of learning throughout a larger process of learning. For example, as we begin to study more about the link between sexual violence and porn, we learn more about both of those things which can then impact how we view the results of these studies.
Studies that employed higher levels of best practices tended to provide less evidence of a potential link.
"Best practices" can be defined as a systematic process used to identify, describe, combine, and disseminate effective and efficient clinical strategies. Some of the "best practices for conducting research" include things like observing regulations during your research, reviewing protocol with all team members regularly, ensuring that each team member has the most current information, creating and using proper tools to assist in research, etc.
The studies that employed higher levels of best practices for research tended to also be the studies that provided less evidence of any potential link between pornography and sexual aggression.
Sexual violence is not caused by one specific factor, suggests the CDC
Credit: Iryna on Adobe Stock
Does pornography cause sexual violence? The evidence suggests not. The CDC has put together a list of "risk factors" that can be linked to a greater likelihood of sexual violence perpetration.
While "exposure to sexually explicit media" is on this list, there are also many other factors that can contribute, such as:
- Alcohol and/or drug use
- Lack of empathy
- Delinquency
- General aggressiveness and acceptance of violence
- Hyper-masculinity
- Suicidal behavior
- Prior sexual victimization or perpetration
- Hostility towards women
- Early sexual initiation
- Preference for impersonal sex and/or sexual risk-taking
Additionally, there are several "community" (or environmental) factors that can also contribute, such as:
- Poverty
- Lack of employment opportunities
- Lack of institutional support
- General tolerance of sexual violence within the community
- Societal norms that support sexual violence
- Weak laws and policies relating to sexual violence
- High levels of crime
"During the past few years many states have declared that pornography is a public health crisis," said Chris Ferguson, a professor of psychology at Stetson University, to The University of Texas at San Antonio.
"Dr. Hartley and I were curious to see if evidence could support such claims—at least in regard to sexual aggression—or whether politicians were mistaking moral stances for science. Our evidence suggests that policymakers should examine other causes of sexual aggression and that beliefs about pornography may be driven more by methodological mistakes than sound science."
