5 Questions for Monnica Williams
A growing body of research has shown that psychedelics can help treat mental health issues including post-traumatic stress disorder (PTSD), depression, and addiction. Monnica Williams, a clinical psychologist and associate professor of psychology at the University of Ottawa, believes psychedelic therapy can be used to treat another important and common mental health issue: racial trauma. Existing behavioral treatments, like exposure therapy, require people to repeatedly think and talk about their trauma, which can be painful and even re-traumatizing. Psychedelic therapy, Williams says, provides a potential alternative.
The Microdose spoke with Williams about her research on psychedelic therapies for people of color, and her recent work looking into the history of psychedelic research.
How do you define racial trauma?
Very simply put, it’s symptoms of PTSD caused by racism. That's a little broader than the standard definition of trauma, because we're also looking at cumulative trauma from all the different sources of discrimination and bias people experience, and even community trauma, cultural trauma, and historical trauma as well. All of these things contribute to the overall trauma burden that a person might feel, in addition to very clear and specific instances of racism.
How might psychedelic therapy for racial trauma look different from other types of behavioral therapies?
The person taking psychedelics may revisit the trauma in their mind — but they may not! Their mind may have other ways of healing from the trauma. We know that psychedelics help people have increased perspective and insight around the traumatic experience, which is what you hope to get at the end of good therapy. It seems like it's just almost happening by itself magically. It's not magic, but it kind of looks like magic. And that's cool because it really makes our other approaches look like stone tools by comparison.
There has never been a more exciting – or bewildering – time in the world of psychedelics. Don’t miss a beat.
Do we know what’s behind the magic?
In terms of racial trauma, there hasn't been any research specifically looking at psychedelics. We have a lot of reasons to think that it'll be pretty similar to the way we treat PTSD, but those research studies still have yet to be done.
We have a pretty good idea of what the mechanisms are for PTSD therapy. For example, MDMA releases neurotransmitters that cause people to feel good and motivated and trusting, and it makes it a lot easier to approach the trauma in that way. There are other things, too; we know that we often see parts of the brain that don't usually talk to each other talking to each other during psychedelic experiences. That can give people new insights about their trauma that they may not have had access to before.
And we can't forget the importance of the therapy component: you have a therapist helping people make sense of everything that is coming up.
You’ve been advocating for more therapists of color to enter the psychedelic therapy space, and for training to address racial trauma specifically. Why?
If somebody is getting treated for racial trauma, it's really important that the therapist understand racial trauma and know how to work with it when it comes up. Because honestly, what happens most of the time when issues of race come up is people get really embarrassed and flustered and don't know what to say. You don't want that to happen in therapy, and you definitely don't want that to happen when you're working with somebody who is having a traumatic experience.
Even if a person of color is not specifically getting treated for racial trauma, they've had experiences of racism and those could come up at any time, so the therapist has to be ready to work with that. If they're not, they can end up doing or saying something that’s microaggressive, or a little bit racist, and that's going to be counter-therapeutic; that can contribute to the trauma. There's a vast amount of potential for healing, but also a big risk for harm.
Usually, if you go to a therapist who’s not culturally competent or helpful, it may be very upsetting, but you can get up and leave or decide not to share anymore. But when you're having a psychedelic experience, you might not be able to do that.
Most of the time, when the topic of racism comes up, therapists of color are able to handle that. But not all of them are, and that's why training is so important — all of us need to be trained so that we can work well.
Speaking of studies, you’ve studied the legacy of psychedelic research. What did you find in reviewing earlier work in the field and what should we learn from it?
You hear a lot about all the research that went on in the first wave of psychedelics, and oftentimes, when people talk about it, there’s a little bit of nostalgia about all this wonderful research we were doing. Well, was it all that wonderful? People really need to take an honest look at that research because some of it was actually quite exploitative. From our read of the literature, it seems that Black men were the most exploited with early psychedelic research. (Editor’s note: Williams and colleagues’ work found that in the “first wave” of psychedelic research, between 1950 and 1980, a majority of studies carried out by university researchers used vulnerable populations — people who were incarcerated and/or being treated for mental health issues — as research participants. In one study, Black participants were given twice the LSD doses as white participants and were forced to participate in the study for months longer.)
We have to think about why and how did that happen? What are we going to do to make sure that that doesn't keep happening? And how do we, as a field, respond to this? What does justice look like? How do we elicit trust? How do we take responsibility for what happened? It's not OK to just be like, Oh, well, that was it wasn't my generation — it's on all of us. I think these are really important questions that we have to address if we're going to move forward in an equitable way.
This interview has been edited and condensed for clarity and length.