New Ways Forward Old Ways Back

Long Term Health Effects of Violence and Trauma

Family violence and trauma exists in high volume in our society, although quietly behind doors, under the radar of many. Violence experienced by adults, and children, can resurface in ways throughout a victim’s lifetime, affecting healthy development, quality of life, and abilities to cope with the challenges of everyday life. Alcoholism, treatment resistant depression (TRD) and anxiety, and treatment resistant post-traumatic stress disorder (pTSD) are a few of the mood disorders associated with trauma. Chronic pain, hormone imbalances, adrenal fatigue, and neuro-pathologies such as dementia exist in junction with these health issues. New therapies are needed and are being explored to help provide relief that traditional, allopathic medicine has failed to. Exploring the long term effectiveness of psychedelic compounds is a newly re-emerging area of research that has given hope to the community of doctors and therapist attempting to provide relief to those suffering life long adversities due to the effects of trauma.

According to the article Intimate Partner Violence and incidence of Common Mental Disorder by de Mendonca , a study by WHO aimed to assess the prevalence of intimate partner violence, assess the victim’s outcomes of the violence, their coping mechanisms, and provide risk and prevention. She cites Gracia-Moreno et all 2006 for this information.

The study was conducted in 15 sites in 10 different countries in 2000 to 2003. It involved 24,097 women ages 15-49.

The study determined that 30 – 60 percent of women had experienced some type of intimate partner violence, with physical and sexual being the most prevalent. Of 31 victims, 42% of the victims had between 1-20 health care visits for physical injuries, and 29% for mental health. 64% believed their mental health issues were due to domestic violence. Long term health problems included musculoskeletal issues, pulmonary, dermatological, gastrointestinal, cardiovascular, neurological. Other mood disorders like anxiety, psychosis, substance abuse and depression were equally prevalent .The long term effects of experiencing trauma have been not only ignored, but complicated by ineffective drugs to treat depression, PTSD, addiction, and many psychologic disorders. Treatment resistant depression and post traumatic stress disorder have been the focus for doctors' research in therapy. This research has shed some light on tools such as EMDR, psychedelics, and other self care therapy like yoga and meditation.

In The Biology of Being Frazzled, Arnsten explains the initial functioning of the nervous system in the immediate impact of traumatic, acute, and uncontrollable stress. Arnsten explains that there is a systematic, cascading effect of various parts of the endocrine, and central nervous system that shut down after experiencing this type of unbearable stress. Neurobiology can begin to explain the cognitive changes in response to stress. Our body will protect itself by activating certain parts of the brain, like the amygdala, and deactivating others, the pre-frontal cortex. The amygdala, when activated, inhibits our main functional reasoning and we operate from our "animal brain", unable to self regulate emotions, make quantitative decisions, plan and assess. The prefrontal cortex is our thought processing and language power house. This area of the brain shuts down in periods of stress. This will be explained later with cerebral blood flow and the poly vagal theory.

Need for Alternative Therapies

In the US, the FDA has approved funding for more research of psilocybin with larger groups of subjects f. In 2020, Oregon measure 109/110 passed, making our state the first to decriminalize and legalize mushrooms for therapeutic use. This will make psilocybin accessible; administering it in treatment facilities and decriminalizing mushroom possession. The legalization is not to the extent that marijuana has been, but it is a huge steppingstone in that direction. Tom Eckert, a chief petitioner on the measure, says “psilocybin could help people struggling with issues from depression to anxiety and addiction”, and “We need options. And this is a valid therapeutic option that could help thousands of people”. The bill calls for a 2-year period to conduct more research and develop a plan for regulating and administering therapy.

There is strong evidence that alternative therapies are not only helpful but are needed for treating depression and pTSD, both long-term effects of domestic violence. Lenart in Magic Mushrooms are the Future of Mental Health Care makes claims that psychedelics like psilocybin are showing significant therapeutic potential for all kinds of mental and psychiatric disorders, referencing the extensive research on the subject at Johns Hopkins University (Griffiths) and Imperial College of London (Carhart-Harris).

Lenart recognizes the potential risks and the changes to roles and responsibilities of nurses and doctors as psychedelics are medicalized. The nursing profession needs to respond with training and information to support their staff, preparing for the curiosity from the public on psilocybin as a legitimate form of therapy, as well as training nurses to be the attendees monitoring psychedelic therapy sessions. Lenart recalls the last 20 years of research that has been conducted by Roland Griffiths, Robin Carhart-Harris and others. The Canadian Health Care system is paving the way for psilocybin into psychotherapy, which include psychedelic assisted therapy as alternative treatments for pTSD, anxiety, depression and addiction. Griffiths and Carhart-Harris are two of the most influential and published researchers on psilocybin, with extensive studies involving fMRI scanning. They have made huge progress, making mushrooms a powerful adjunct to traditional therapy.

Lenart points out that indigenous cultures around the world have used mushrooms and other naturally occurring psychedelics for centuries. The main goals and affects are “profoundly altered consciousness”. In a therapeutic session, patients expressed feeling emotions of love, joy, oneness and of transcending space and time. T

This altered state of consciousness allows the safe and introspective acceptance of past traumatic memories to emerge from the subconscious and be more fully processed. This may assist in a reset of the mind, allowing people experiencing debilitating mental disorders like treatment-resistant depression and pTSD; to process and adapt to reality, heal from past trauma, and avoid self-medicating. This type of advanced in treatment of mental disorders hopefully help avoid a lifetime of anti-depressant medications that don’t always have consistent results.

There are many highly regarded authors on the effects of trauma on the body and mind. In The Body Keeps The Score, Van Der Kolk ties together the intense effects of trauma, PTSD, abuse, and touches on the subject of using psychedelics as therapeutic intervention. Van Der Kolk focuses on stepping beyond traditional psychological therapies and medications, into exploring tools and techniques to help create lasting improvement in behavior and quality of life. He encourages taking back your self awareness and self responsibility to change a traumatic memory into just a memory that happened long ago.

When Van Der Kolk was a medical student, he worked with a doctor that had treated Holocaust survivors with LSD. Although his study was lacking details and support to his claims, it supposedly was highly successful in treating PTSD and traumatic memories. Then, not until 2000, Michael Hoefer, a clinical researcher and psychotherapist, began research with ecstasy (MDMA methlenedioxy-methamphetamine). He mentions a study conducted that used MDMA, with permission from the FDA. Bessel mentions that there are still so many questions and need of research to understand how MDMA works. But it is known to increase the production of oxytocin, vasopressin, cortisol, and prolactin. Regarding treatment for trauma related disorders, MDMA reduces fear, increases feelings of love, and acceptance. It increases a sense of self awareness, curiosity, clarity, confidence and creativity. This is a monumental tool for taking back control and self-awareness.

These new ideas and research are evidence that there is hope for people experiencing trauma, and to the possible alternative therapies and ways to create healing and change.

“When we ignore these quintessential dimensions of humanity, we are depriving people of ways to heal from trauma and restore their autonomy. Being a patient, rather than a participant in one’s healing process, separates suffering people from their community and alienates them from an inner sense of self. Given the limitations of drugs, I started to wonder if we could find more natural ways to help people deal with their post-traumatic responses” (Van der Kolk p.38).

Reports show when a patient has a flashback of a past traumatic incident, the brain activity shifts to the right side, and shuts down on the left. The two halves communicate and coordinate to a certain degree yet having one side completely take over is disabling. The left side of the brain is responsible for language, sequential details and memories, facts, statistics… more logical processes. Without the ability to organize and recall event accurately, we can’t identify cause and effect, grasp long term effects of our actions, or create coherent plans for the future.

The left-brain controls Broca’s area, which is responsible for speech; this area goes completely offline during a traumatic flashback. This is relative to the article “The Biology of Being Frazzled”. Arnsten explains how catecholamines, neuromodulators, are released into the peripheral and central nervous system. This “turns on” our heart and muscles, preparing for fight or flight, and “turns off” stomach and other organs in preparation for an event. Catecholamines are responsible for activation of the amygdala, and impairing function of the prefrontal cortex (PFC). The PFC guides our behavior, permits our working memory, inhibits inappropriate behavior and allows us to plan and organize effectively.

Dorsal Vagal Complex and the Poly Vagal Theory

The scans in Van der Kolk’s research suggest that the stored memories of traumatized people are recalled as if the event is taking place, activating the fight or flight response, and releasing hormones like cortisol, adrenaline and other stress hormones. His studies suggest that people who have been traumatized, from events such as abuse and accidents, take much longer to regulate these hormones, and return to baseline, while disproportionately spike much quicker response to mildly stressful situations. This cascade of stress hormones essentially keeps a person in a state of fight or flight, effecting sleep, memory, attention, irritability and many other long term health issues.

The opposite to fight or flight, yet equally as disabling response to trauma is activation of the dorsal vagal complex. P. 84 of The Body Keeps the Score describes the function of the ventral vagal complex (VVC) as our social engagement, and allows us to signal for help, alarming the body for action. During fight or flight, the sympathetic nervous system (SNS) activates, and we express rage or terror. During collapse, if there is no way out of an inevitably dangerous situation, we collapse and shut down, the dorsal vagal complex nerve is activated (DVC).

Poly Vagal Theory by Stephen W. Porges is a remarkable set of research and ideas on the complexities and branches of the vagus nerve. Darwin was the first to describe the reflexes that involve action, or withdrawal from a threat are controlled by a "pneumogastric nerve" (Van der Kolk p.83) . Darwin describes this nerve as the center of registering heartbreak and gut wrenching feelings. This brings me to a chapter in Heart a History where cardiologist Sandeep Juhar describes this event of dorsal vagal complex activation and its effects on the heart, causing a condition called Takutsubo cardiomyopathy, or broken heart syndrome. In this condition, the heart changes shape, almost weeping into the shape of a Japanese water jug (rounded at the bottom) loosing tone. People can spontaneously recover from Takutsubo syndrome, or it can be fatal.

The Evidence...

Robin Carhart-Harris is an author, researcher and psychiatrist that has designed an extensive study on the cerebral effects of the brain on psilocybin.

Carhart-Harris' research on psilocybin shows support and promise worldwide as a treatment model, but the therapeutic mechanisms are poorly understood. She measured cerebral blood flow (CBF), blood oxygen level dependent, resting-state functional connectivity (BOLD/RSFC) in 19 patients diagnosed with treatment resistant depression (TRD). "Whole brain analyses revealed post-treatment decreases in CBF of the temporal cortex, including the amygdala. Decreased amygdala CBF correlated with reduced depressive symptoms"(Carhart-Harris).

Included in this research is the recognition that psilocybin along with psychological treatment has the potential to be effective long term treatment for a variety of disorders including end-of-life anxiety and depression, alcohol and tobacco addiction, obsessive compulsive disorder, and pTSD. All of these life altering disorders and the long term health effects are directly related to violence and trauma, and most of the subjects studied in this and other studies were those that have had some adverse life events, like intimate partner violence and trauma.

In The Poly Vagal Theory, Poges conducted a study of a group of women that had experienced violence and struggled with pTSD years later. The subjects were healthy, and self reporting (this is a limitation to the study) as experiencing depression and other disorders. The Vagal brake is a mechanism in our brain that helps control the activation/deactivation of the ventral or dorsal vagal complex, and those with a history of trauma showed a slowing to be either excited (increased heart rate during exercise) as well as relaxing (recovering from exercise/ decreased heart rate). His subjects self reporting abuse and trauma all showed decline in the "vagal brake" for the sympathetic nervous system. This provides evidence that mental and physical trauma effects the way we interact to the stresses of everyday challenges, and how efficiently we react. The physiology of our nervous system and brain functioning is altered by trauma, and the level at which we are able to self regulate changes.

Light at the end of the tunnel...

The effects of family and intimate partner violence bear a heavy burden on our society, one that is often and easily overlooked and under considered. In traditional therapy, the cognitive process of analyzing one's position in reality, and being able to distinct that from a feared past reality, dilutes traditional talk therapy's effectiveness.

Parts of the brain are actually not able to process reality, because of mechanisms like the dorsal vagal complex, adrenaline, and subconscious memories ridicule the physiology of awareness, causing a cloudy sense of reality.

Finding new ways to reduce the intense arousal mechanisms that are implanted after adverse child events, intimate partner violence and the effects of violence are highly needed and research has only just re-emerged into science. Credible authors and researchers such as Carhart-Harris and Roland Griffiths are building new platforms, creating hope, and providing some light at the end of a tunnel that so many are trapped inside. Many alternative therapies (EMDR, movement therapy, mind mapping) are in practice, yet psilocybin and other psychedelic therapies show a higher rate of consistent effectiveness in treating long term treatment resistant mental disorders linked to violence and trauma...treatment resistant depression (TRD), pTSD, and addiction.

Reintegration of cerebral blood flow (CBF) and brain functioning, acceptance and ability to process with conscious thought, self awareness on a global level to help find purpose and connectivity. Creating a sense of oneness, love and peace... these are parts of the light to help those suffering from trauma.

Additional Media

In this radio interview, I was shocked to hear a 35 min interview so highly organized and hit every topic of my research. Georgia Public Broadcasting/ On Second Thought, reporter Virginia Prescott interviewed Dr. Broadie Dunlop and Will Stone. Dunlop is the director of Mood and Anxieties Program at Emory University, and Will Stone is an independent health journalist. This interview is clearly focused and creates very close links to treatment resistant depression (TRD) and PTSD, and the developing use of psychedelics as successful treatment. One particular subject had struggled with treatment resistant PTSD, and followed a 3 month/ 1x/month session of MDMA in conjunction with traditional talk therapy. Dunlop correlates his research as MDMA being specifically effective for pTSD, and psilocybin applied to depression as well as pTSD. They describe psilocybin as being a deeper experience, one more complex in length and intensity, and it holding a wider breadth of possible psychological applications.

“I just see so many patients who get stuck," Dunlop explained. "and they do their best in therapy, they do their best with medicines, and we still cant get to where we need to be. So, I think this is very exciting" (Dunlop)

Below is a link to the interview in December 2019.

GRB Interview onPTSD/Depression and Psilocybin

Annotated Bibliography and Citations

Emily Moore

Professor Chazlett

WR 122

June 1, 2021

Annotated Bibliography:

Psilocybin and Alternative Therapies for long term affects of Domestic Violence, TBI and PTSD

Acker, Lizzy (2020). Oregon Becomes First State to Legalize Mushrooms. The Oregonian/

OregonLive. https://www.oregonlive.com/politics/2020/11/oregon-becomes-first-state-to-legalize-psychedelic-mushrooms.html

In the US, the FDA has approved funding for more research with larger groups of subjects. In 2020, Oregon measure 109/110 passed, making our state the first to decriminalize and legalize mushrooms for therapeutic use. This would make psilocybin accessible, administering in treatment facilities and decriminalizes mushroom possession. The legalization is not to the extent that marijuana has been, but it is a huge steppingstone in that direction. Tom Eckert, a chief petitioner on the matter, says “psilocybin could help people struggling with issues from depression to anxiety and addiction”, and “We need options. And this is a valid therapeutic option that could help thousands of people”. The bill calls for a 2-year period to conduct more research and develop a plan for regulating and administering therapy.

Alejo, Kavita (2014). Long- Term Physical and Mental Health Effects of Domestic

Violence. Themis: Research Journal of Justice Studies and Forensic Science: Vol. 2, Article 5. https://doi.org/10.31979/THEMIS.2014.0205

This article is peer reviewed, and the sole author Kavita Alejo is highly regarded, experienced scholar. She won Paper of the Year with Semantic Scholar in 2018 for another publication. This article is represented by San Jose State University.

Alejo describes domestic violence as an issue affecting all genders, races, and ages. She compares the long term effects of domestic violence between all combination of partners, and whether the effects are more serious for men or women. She brings to light those homosexual relationships and woman as perpetrators are often under represented in statistical studies on domestic violence. Alejo provides an extensive list of the injuries and short and long term health effects. In my research I’d like to focus on the long term effects such as hypertension, heart disease (Takotsubo syndrome in “Heart a History”), depression and anxiety, alcohol and other substance abuse, sleeping and eating disorders, social dysfunction and suicide. Most easily correlated to my other research is PTSD, and its effects on the central nervous system as described by Arnsten in “The Biology of being Frazzled”. This article also mentions the WHO world wide study on domestic violence, which correlates to the research cited- Intimate Partner Violence and incidence of Common Mental Disorder by de Mendonca et all. This study by WHO aimed to assess the prevenance of intimate partner violence, assess the victim’s outcomes of the violence, coping mechanisms, and provide risk and prevention. She cites Gracia-Moreno et all 2006 for this information. The study was conducted in 15sites in 10 different countries in 2000 to 2003. It involved 24,097 women ages 15-49. The study determined that 30 – 60 percent of women had experienced some type of intimate partner violence, with physical and sexual being the most prevalent. Alejo continues the conversation with providing statistic for women to women, women to men violence being just as prevalent as violence against women in heterosexual relationships. She states that data compared to the National Violence Against Women Survey determined that “domestic violence poses a bigger threat against men in homosexual relationships than those in heterosexual relationships but is equally as serious for lesbians and heterosexual relationships” (Owen and Burke, 2004). A. A. Gerlock conducted a study in 1999, taking information from women that had received abuse, either physically or psychologically, to determine the health consequences. They interviewed both the perpetrator and the victims, but I will only focus on the victims. Of 31 victims, 42% of the victims had between 1-20 health care visits for physical injuries, and 29% for mental health. 64% believed their mental health issues were due to domestic violence. Long term health problems included musculoskeletal issues, pulmonary, dermatological, gastrointestinal, cardiovascular, neurological, mood disorders like anxiety, psychosis, substance abuse and depression.

She reported on the correlation between Cervical cancer from HPV and the prevalence of domestic violence due to them more likely to be smokers… I thought that was very interesting, but for another paper.

Arnsten, A.F. The Biology of Being Frazzled. Science. 12 June 1998. Vol 280, Issue 5270.

P 1711-1712. DOI: 10.1126/Science. 280.5370.1711

In this article in Science, Arnsten explains and argues the initial functioning of the nervous system in the immediate impact of a traumatic, acute, and uncontrollable stress. Arnsten explains that there is a systematic and cascade effect of various parts of the endocrine, and central nervous system that shut down after experiencing this type of unbearable stress. Neurobiology can begin to explain the cognitive changes in response to stress. Our body will protect itself by activating certain parts of the brain, the amygdala, and deactivating others, the pre-frontal cortex. Memory is affected by worsening and then a person having experienced a traumatic event would rely on patterns and habits. Arnsten describes a scenario of having witnessed a traumatic and gruesome vehicle accident. Passing by the accident, emotions and hormones begin to affect the physiology of the on-looker. In hesitation and slight mental shifting, there is an overreaction to stopping the vehicle, as if the body is in hyper reactivity mode. After the incident, life goes on… yet the ability to continue the days responsibilities and professional tasks seem difficult; feelings of disassociation and distracted thoughts, lack of concentration, due to the hormones that cause the flight or fight response to stress.

The article sets a powerful engagement, while tending towards highly detailed science to explain the author’s position. “During stress, the amygdala also induces increased catecholamine release int the prefrontal cortex. However, in contrast to the facilitative actions in subcortical structures, high levels of catecholamine release in prefrontal cortex result(s) in cognitive dysfunction.” (Arnsten). Arnsten relates this neurochemical functioning to the development of mental illness, attention deficit hyperactivity disorder, in children experiencing stress in a home due to divorce. Other mental illnesses may develop like affective disorder, and schizophrenia.

Arnsten is a published author, with a related long term research article (cited in this bibliography) on the same subject with multiple authors. Arnsten is with the Section of Neurobiology at Yale University School of Medicine. The research in this, and her other articles, are relevant and viable for my research; she maintains a foundation of medicine and science while reaching the public issue with tone and intension around change. I will correlate this article with Arnstens other cited article.

This article is relevant to my research due to its scienced based citations of studies done, linking neurobiology and trauma.

Lenart, Kristen (2020). Magic Mushrooms are the Future of Mental Health Care. Canadian

Nurse. https://www.canadian-nurse.com/en/articles/issues/2020/july-2020/magic-mushrooms-are-the-future-of-mental-health-care

Lenart is a practicing RN. He is passionate and supportive to the research of psilocybin as a therapy to provide relief for those suffering from mental health disorders and substance abuse. In his article, he cites works by Griffiths and Carhart-Harris. These researchers are involved with John Hopkins University and the Imperial College of London, respectively.

The article makes claims that psychedelics like psilocybin are showing significant therapeutic potential for all kinds of mental and psychiatric disorders, referencing the extensive research on the subject. He recognizes the potential risks and the changes to roles and responsibilities of nurses and doctors as psychedelics are medicalized. The nursing profession will need to respond with training and information to support their staff for the curiosity from the public on psilocybin as a legitimate form of therapy, as well as training nurses to be the attendees monitoring psychedelic therapy sessions. Lenart recalls the last 20 years of research that has been conducted by Roland Griffiths, Robin Carhart-Harris and others. The Canadian Health Care system is paving the way for psilocybin into psychotherapy, which include psychedelic assisted therapy as alternative treatments for PTSD, anxiety, depression and addiction. Griffiths and Carhart-Harris are two of the most influential and published researchers on psilocybin, with extensive studies involving fMRI scanning. They have made huge progress, making mushrooms a powerful adjunct to traditional therapy.

In the US, the FDA has approved funding for more research with larger groups of subjects. In 2020, in Oregon, measure 109 passed, making our state the first to decriminalize and legalize mushrooms for therapeutic use. The bill calls for a 2-year period to conduct more research and develop a plan for regulating and administering therapy. The prohibition and criminalization of psychedelic substances in the 1960s put a stop to research that had already started in the 1950s.

He mentions that indigenous cultures around the world have used mushrooms and other naturally occurring psychedelics for centuries. The main goals and affects are “profoundly altered consciousness”. In a therapeutic session, patients expressed feeling emotions of love, joy, oneness and of transcending space and time. This altered state of consciousness provides the safe and introspective acceptance of past traumatic memories to emerge from the subconscious and be more fully processed. This may assist in a reset of the mind, allowing people experiencing debilitating mental disorders like treatment-resistant depression and PTSD to process and adapt to reality, heal from past trauma, and avoid self-medicating and a lifetime of anti-depressant medications that don’t always have consistent results. Lenart’s article relates to several of my research sources. It has become the nugget to bring all of my ideas to reality and made my research viable and confirming.

“The outcomes of phase 1 and phase 2 trials, though preliminary, have thus far been promising, especially at a time when there has been little advancement in therapies and drugs for treating mental disorders in over 30 years” (Carhart-Harris et all., 20116)

This article also mentions safety and risks. Researchers are highly focused on approaching psychedelics with care and safety. “The safety risk is low- psychedelics show no addictive properties and there is no known legal dose (Solon, 2017)”

Psychedelic therapies are bringing a sense of hope and compassion to a wide variety of conditions; treatment of Alzheimer’s disease, anorexia, OCD, and addictions.

“During a time when there has been little improvement in the effectiveness of medication targeting anxiety and depression- despite the billions invested in research- psychedelics could be the answer psychiatry has been looking for” (Lenart)

Lobue, C.M. Cullum. 2020. Point/ Counter point- Beyond the headlines: the actual evidence

that traumatic brain injury is a risk factor for later in life dementia. Oxford University Press/ Archive of Clinical Neuropsychology. Issue 35. P 123-127

This point/ counter point addresses some of the issues of traumatic brain injuries being associated with developing dementia later in life, and the debate and controversy associated with public opinion and limited research. The authors are highly credible, published and closely associated with several schools and journals. C. Lobue is with the Dept of Psychology, University of Texas Southwestern Medical Center in Dallas Texas. Lobue is also with the Dept of Neurological Surgery, University of Texas Southwestern Medical Center. C.M. Cullum is associated with the previous two aforementioned departments, as well as the Dept of Neurology and Neuropathology at the University of Texas Southwestern Medical Center. This project was funded by the University of Texas Alzheimer Disease Research Center, Texas Alzheimer’s Research and Care Consortium, and the Texas Institute for Brain Injury and Repair.

The long term consequences of traumatic brain injuries (TBI) are a highly significant interest of the medical, scientific and general public. The article points to the research and studies on the subject have only been since the last decade. (This article was published in 2019, and appeared in the Oxford University Press in 2020, therefore very recently relevant). The assumption and concern of the general public that repetitive TBI, or severe TBI, will cause dementia and cognitive decline later in life is partially due to some scientist’s reports claiming TBI leads to depression, suicidality, aggression and progressive cognitive deterioration in middle to late adult hood, and suspected to relate to the neuropathological condition known as chronic traumatic encephalopathy (CTE). There are points in the article leading to evidence that some people may already be susceptible to the aftereffects of TBI neurologically, and cognitive decline. For instance, one example of how TBI involve alterations of the central nervous system is through the tau protein., which stabilizes microtubules and serves to build/ rebuild axonal and neuro structures. Tau levels increase immediately following TBI, building up in cerebral spinal fluid, then return to normal. Tau levels increase in healthy aging people as well as Alzheimer disease (AD) later in life, therefore the possible correlation of TBI in the presence of tau protein causing neuropathology. This may be caused by the issue that some people tau levels may not return to normal.

The authors point out that the growing public concern and confusion may be linked to a lack of scientific research and literature. Although moderate to severe TBI have been linked to later in life dementia or AD, there are very few studies that link mild TBI injuries to neuropathology. The limitations of the correlation to TBI and pathological brain changes in athletes with mild to moderate injuries are due to sample ascertain bias, lack of representative samples, lack of control group, and confounding TBI factors like alcohol and opioid abuse. The Conclusion of the article is that there is an association between the earlier onset of dementia, but no evidence of the triggering of progressive decline. The article has no conflict of interest from peer review. This article is very useful in providing a counter point to my question of TBI being an independent cause of dementia, while providing more specific details on the matter. This article can be associated with “Belson article Study Bolsters Link Between Routine Hits and Brain Disease”.

McMains, Vanessa and Tong, Karen (2016). Researchers Urge Caution around Psilocybin Use. John Hopkins University/ News and Publications.

The article is not clearly authored, but there are 2 references for contacts for media pertaining to the article. I’m assuming they are the authors. There is a list of included authors at the end of the article but it’s unclear whether the authors are for a study and publication with Griffiths, of this particular article. I believe this article is not credible, or viable, based on the mostly positive correlation to the study and the researchers. This is a counter point to psilocybin use, yet it clearly states some of the benefits of the experience from medicinal mushroom use, even after a “bad trip”. The article includes original research and their main scholar cited for additional confirming evidence is from Roland Griffiths, PhD, whom I will cite for his research and studies. The 2 points of the article are that people stated their worst experience on mushrooms was seen as a meaningful life experience, even after a negative experience. The other is that bad trips on mushrooms could lead to potentially risky and life-threatening behavior. They surveyed from an online social media platform 2000 people who had had a negative experience. 10 percent of the respondents reported their bad trip as being “their worst bad trip and having put themselves or others in harm’s way”. Regardless of the difficulties explained later in the article, most people surveyed reported the experience as meaningful or worthwhile, and half of those claiming the bad trip as “one of the topmost valuable experiences in their life”.

The results were lacking specifics, like species and amount of mushroom ingested, environment or setting, and behavioral circumstances prior to the trip. Griffiths, the main research contributor, mentions that the evidence from the survey concludes that psilocybin use by users and researchers should not be taken lightly. There are obvious risks to having an existential life altering substance ingested that caused hallucinations and physical symptoms. (Griffiths has conducted more than a dozen studies over 15 years with the clinical application of psilocybin, confirming benefits and this particular study was to only focus on the negative affects).

“The counterintuitive finding that extremely difficult experiences can sometimes also be very meaningful experiences is consistent with what we see in our studies with psilocybin – that resolution of a difficult experience, sometimes described as catharsis, often results in positive personal meaning or spiritual experience” Griffiths says. With all of Griffith’s studies, patients are giving a highly supportive and safe environment or setting, monitored by professionals, and the patients are screened and people who may not be suited for the experience are ruled out. Essentially, they won’t give just anyone a dose of mushrooms, without skillful supportive monitoring. There is a very low risk in these situations for risky behavior or lasting negative psychological effects. The article ends with psilocybin not being addictive mentally or physically, and there have not been any reports of damage to the brain, liver or other organs.

Salvador de Mendonca, Marcela and Ludermir (2017). Intimate partner violence and the

incidence of common mental disorder. Revest de Saude Publica. Vol 51, issue 32

This article has 2 authors and provides extensive details on their original research study conducted. It is peer reviewed and well written, and it provides a counter point. It also explains the limitations. Salvador de Mendonca is involved with a post graduate program at the University Federal de Pernambuco in Brazil. Ludermir is with the Department of Social Medicine at the same University. This article mentions the World Health Organizations Multi-Country study on women’s health and domestic violence. The study was originally done in done in 2003 and mentions the updated study as of 2014. It states that still 30% remains the percentage of women who have suffered from intimate partner violence. The common metal disorders (CMD) listed in this article are insomnia, fatigue, irritability, depression and anxiety, forgetfulness, difficulty concentrating, and somatic complaints (body aches). Women who have experienced intimate partner violence are more likely to suffer from psychological disorders, like PTSD, depression and anxiety. A study conducted by the authors of the article mentioned that the increase of physical domestic violence increased depending on socioeconomic and sociocultural status in which gender hierarchy is more present; this was in countries that are conservative and patriarchal that reinforce gender inequality. This is somewhat of a counter point to statistics on domestic violence in the United States, where these statuses are less indicative to the group of women experiencing violence. I’d like to maybe link this with the theory of Honor Culture by Ryan Brown, who does link many social statuses and gender inequality with violence but may not in this paper. This correlates to my research and by providing yet another viable resource listing the long term mental and physical effects of domestic violence. Eventually connecting these issues to the treatment of therapeutic mushrooms. The limitation to the authors study is the information bias: there tends to be under reporting of domestic abuse, not depending on the country. Stigma and shame are mentioned here, and how sensitive the matter is to the lives of women and children who may not be able to seek protective services. The under reporting by women can also can be from post-traumatic stress, and it may be very scary and painful to remember incidences. In Brazil, it is public health concern though because of the number of reported cases, and the link between intimate partner violence and common health disorders. The conclusion is that there needs to be a release of stigma, education and public services available immediately to reduce the severity of chronic CMDs.

Van Der Kolk, Bessel, M.D (2014). The Body Keeps the Score. Penguin Random House, LLC.

This book in The Body Keeps The Score, Van Der Kolk ties together essentially every other perspective on trauma, PTSD, abuse, and touches on the subject of using psychedelics as therapeutic intervention. Van Der Kolk focuses on stepping beyond traditional psychological therapies and medications, into exploring tools and techniques, self-guided care to create lasting improvement in behavior and quality of life. He encourages taking back your self awareness and self responsibility to change a traumatic memory into just a memory that happened long ago. When the author was a medical student, he worked with a doctor that had treated Holocaust survivors with LSD, although his study was lacking details and support to his claims. It supposedly was highly successful in treating PTSD and trauma memories. Then, not until 2000 Michael Hoefer, a clinical researcher and psychotherapist, began research with ecstasy (MDMA methlenedioxy-methamphetamine). He mentions a study conducted that used MDMA, with permission from the FDA. Bessel mentions that there are still so many questions and need of research to understand how MDMA works. But it is known to increase the production of oxytocin, vasopressin, cortisol, and prolactin. Regarding treatment for trauma related disorders, MDMA reduces fear, increases feelings of love, and acceptance. It increases their sense of self awareness, curiosity, clarity, confidence, creativity and confidence.

These new ideas and research are evidence that there is hope for people experiencing trauma, and to the possible alternative therapies and ways to create healing and change.

“When we ignore these quintessential dimensions of humanity, we are depriving people of ways to heal from trauma and restore their autonomy. Being a patient, rather than a participant in one’s healing process, separates suffering people from their community and alienates them from an inner sense of self. Given the limitations of drugs, I started to wonder if we could find more natural ways to help people deal with their post-traumatic responses” (Van der Kolk p.38). The author reports scans that show when a patient has a flashback of a past traumatic incident, the brain activity shifts to the right side, and shuts down on the left. The two halves communicate and coordinate to a certain degree yet having one side completely take over is disabling. The left side of the brain is responsible for language, sequential details and memories, facts, statistics… more logical processes. Without the ability to organize and recall event accurately, we can’t identify cause and effect, grasp long term effects of our actions, or create coherent plans for the future. The left-brain controls Broca’s area, which is responsible for speech; this area goes completely offline during a traumatic flashback. This is relative to the article “The Biology of Being Frazzled”. Arnsten explains how catecholamines, neuromodulators, are released into the peripheral and central nervous system. This “turns on” our heart and muscles, preparing for fight or flight, and “turns off” stomach and other organs in preparation for an event. Catecholamines are responsible for activation of the amygdala, and impairing function of the prefrontal cortex (PFC). The PFC guides our behavior, permits our working memory, inhibits inappropriate behavior and allows us to plan and organize effectively.

The scans in Van der Kolk’s research suggest that the stored memories of traumatized people are recalled as if the event is taking place, activating the fight or flight response, and releasing hormones like cortisol, adrenaline and other stress hormones. His studies suggest that people who have been traumatized, from events such as abuse and accidents, take much longer to regulate this=ese hormones, and return to baseline, while disproportionately spike much quicker response to mildly stressful situations. This cascade of stress hormones essentially keeps a person in a state of fight or flight, effecting sleep, memory, attention, irritability and many other long term health issues. Van der Kolk’s research and therapy recommend helping find stability through desensitization through various methods such as EMDR, yoga, meditation and alternative drugs. He refers to the brain as a cultural organ, one that is shaped by our experiences.

The opposite to fight or flight, yet equally as disabling response to trauma is activation of the dorsal vagal complex. P. 84 describes the function of the ventral vagal complex (VVC) as our social engagement, and allows us to signal for help, alarming the body for action. During fight or flight, the sympathetic nervous system (SNS) activates, and we express rage or terror. During collapse, if there is no way out of an inevitably dangerous situation, we collapse and shut down, the dorsal vagal complex nerve is activated (DVC). I will relate this topic on the opposing function of the Vagus nerve branches in the book “Poly Vagal Theory” by Stephen W. Porges, as well as Sandeep Juahar’s book “Heart a History”. Juhar describes this event of dorsal vagal complex activation and its effects on the hear, causing a condition Takutsubo cardiomyopathy, or broken heart syndrome.

Van Der Kolk is a doctor of psychiatry, scientist and scholar highly regarded by peers as innovative and authoritative in his writing, teaching and research around the world. He is the founder and director of The Trauma Center in Brookline, Mass. This book is reviewed by Porges, PhD.; “…a courageous journey into the parallel, dissociative world of trauma victims and the medical and psychological disciplines that are meant to provide relief” (Porges).

Carhart-Harris et all (2017). Psilocybin for treatment-resistant depression: fMRI-measured brain mechanisms. Scientific Reports/ www.nature.com/scientificreports . doi:10.1038/s41598-017-13282-7

This paper is written by Carhart-Harris and many others. The study goes into depth about the way the brain works, how a fMRI measures cerebral blood flows, and blood oxygen level dependent resting state functional connectivity. The 19 subjects were scanned before, after and in placebo of psilocybin treatments. Their goal was to measure the perceived levels of depressive states over a period of time, and in subsequent sessions of mushrooms. The studies were consistent with a professional setting, safe environment, and the subjects were highly monitored to meet criteria for participating in the study. Decreased depressive symptoms were observed in all 19 patients one week post ingestion. Whole brain analyses showed post-treatment decreases in cerebral blood flow CBF in the temporal cortex, as well as the amygdala. Decreased CBF to the amygdala has a high correlation to decreased depression. This study was limited by a small sample study and absence of a control condition.

Citations-

Zieman, Glynnis, Bridwell, Ashley, Carderes, Javier F. Journal of Neurotrauma. “Traumatic Brain Injury in Domestic Violence Victims: A Retrospective Study at the Barrow Neurological Institute”. Journal of Neurotrauma. Feb2017, Vol. 34 Issue 4, p876-880.

· “Traumatic brain injury is a frequent sequela of domestic violence, from which many victims sustain multiple injuries without seeking medical care. Brain injuries are often sustained over many years and lead to lasting physical, behavioral, and cognitive consequences. Better understanding of these injuries will lead to improved care for this population”.

McIntosh, Jennifer. “Children Living With Domestic Violence: Research Foundations for Early Intervention”. https://childrenbeyonddispute.com/publications/

· [Of] particular power has been definitive evidence about the potential for interspousal trauma to disrupt neurological and biochemical pathways in the developing child. From their respective vantage points, clinicians and researchers name the imperative for the early identification of children traumatized by domestic violence, in the service of preventing acute trauma symptoms from becoming embedded in development, at all levels of the child's functioning.

LoBue, C., & Cullum, C. M. (2020). POINT/COUNTER-POINT-Beyond the headlines: the actual evidence that traumatic brain injury is a risk factor for later-in-life dementia. Archives of clinical neuropsychology: the official journal of the National Academy of Neuropsychologists, 35(2), 123–127. https://doi.org/10.1093/arclin/acz074

Daniel, J., & Haberman, M. (2018). Clinical potential of psilocybin as a treatment for mental health conditions. The mental health clinician, 7(1), 24–28. https://doi.org/10.9740/mhc.2017.01.024

Van Der Kolk, M.D., Bessel (2014). The Body Keeps The Score. Penguin Books.

Aye, W. T., Lien, L., Stigum, H., Schei, B., Sundby, J., & Bjertness, E. (2020). Domestic violence victimization and its association with mental distress: a cross-sectional study of the Yangon Region, Myanmar. BMJ open, 10(9), e037936. https://doi.org/10.1136/bmjopen-2020-037936

Arnsten A. F. (2009). Stress signaling pathways that impair prefrontal cortex structure and

function. Nature reviews. Neuroscience, 10(6), 410–422. https://doi.org/10.1038/nrn2648