Clinical conceptualisation of PTSD in psilocybin treatment: disrupting a pre-determined and over-determined maladaptive interpretive framework
Nadav Liam Modlin, Victoria Williamson, Carolina Maggio, Joanne Stubley, James Rucker, Namik Kirlic, Anthony J. Cleare
Therapeutic Advances in Psychopharmacology June 8, 2025 DOI: 10.1177/20451253251342319 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Intervention | Psilocybin |
| Topics | Anxiety Psilocybin PTSD |
| Keywords | Psychotherapist Cognition Clinical psychology Stressor Hallucinogen |
| Citations | 1 |
| Key findings | Psilocybin may disrupt the rigid, maladaptive interpretive framework underlying PTSD, facilitating therapeutic progress. |
Abstract
Post-traumatic stress disorder (PTSD) and associated trauma and stressor-related disorders are common and debilitating, presenting significant treatment challenges due to their complex interplay of biological, cognitive, affective, somatic and social factors. Current treatments, while advancing and effective, yield limited efficacy for many individuals, underscoring the need for novel therapeutic approaches. This review explores the multifaceted nature of PTSD, emphasising its intricate predisposing and maintaining factors and explores the potential of psilocybin, a classical psychedelic, as a therapeutic agent. This review synthesises recent literature on the safety, efficacy and proposed mechanisms of action and change of psychedelic therapies for psychiatric conditions associated with traumatic stress, including treatment-resistant depression, end-of-life anxiety and anorexia nervosa. Correspondingly, it proposes a conceptual framework for psilocybin treatment in PTSD, framing the condition as a complex, maladaptive interpretive framework that is both predetermined and over-determined. A clinical narrative illustrates how psilocybin’s unique psychopharmacological properties and catalysed subjective effects may facilitate therapeutic progress by disrupting this rigid and restricting framework. Finally, we offer recommendations for the safe administration of psilocybin for traumatised patients in medical research settings, emphasising the importance of rigorous and trauma-informed protocols and comprehensive patient care.
Comparable studies
Other narrative reviews on psilocybin for PTSD, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Novel psychopharmacological therapies for psychiatric disorders: psilocybin and MDMA. | 2016 | Review | |
| Registered clinical studies investigating psychedelic drugs for psychiatric disorders. Registered clinical trials on clinicaltrials.gov evaluating psychedelics for... | 2021 | Review | n = 70 |
| The Psychedelic Future of Post-Traumatic Stress Disorder Treatment | 2024 | Comprehensive review | |
| Diverse therapeutic developments for post-traumatic stress disorder (PTSD) indicate common mechanisms of memory modulation. | 2022 | Review | |
| Is it now time to prepare psychiatry for a psychedelic future? | 2024 | Review |
Citations in the library
Cited by 3
- Retreat from Racism: A Psychedelic Group Experience for Racial Stress and Trauma Psychedelics July 1, 2026
- PHENOMENOLOGICAL EXPLICATION OF INTEROCEPTIVE EXPERIENCE IN TRAUMA-FOCUSED ACCEPTANCE AND COMMITMENT THERAPY: CONCEPTS, PRINCIPLES, AND RESEARCH METHODOLOGY Bulletin of Taras Shevchenko National University of Kyiv Philosophy May 29, 2026
- Level of Preparedness to Use Psilocybin Among Individuals Seeking Psychedelic Risk Reduction: A retrospective study of a pilot psychiatric consultation service medRxiv August 19, 2026
Cites 58
- Single-Dose Psilocybin for a Treatment-Resistant Episode of Major Depression. New England Journal of Medicine November 3, 2022
- Safety and Efficacy of Lysergic Acid Diethylamide-Assisted Psychotherapy for Anxiety Associated With Life-threatening Diseases The Journal of Nervous and Mental Disease March 4, 2014
- Psychedelics and the essential importance of context. Journal of Psychopharmacology February 15, 2018
- Validation of the revised Mystical Experience Questionnaire in experimental sessions with psilocybin Journal of Psychopharmacology October 6, 2015
- Psilocybin-occasioned mystical-type experience in combination with meditation and other spiritual practices produces enduring positive changes in psychological functioning and in trait measures of prosocial attitudes and behaviors Journal of Psychopharmacology October 11, 2017
and 53 more in the library