Treating PTSD With Cannabis
According to the National Center for PTSD, “approximately 7 or 8 out of every 100 people will experience PTSD at some point in their lives.” That’s a sizeable percentage of the population, and most of those folks will find themselves in relationships at some point in their lives. Studies involving cannabis used to treat PTSD symptoms are still ongoing, and much of the data is anecdotal, but it’s an area that clearly warrants more research. With regards to cannabis use for treatment of PTSD as it relates to sexuality and intimacy, all current data is anecdotal; however, we can offer some hypotheses on how it may help with symptoms. I spoke with Dr. Liz Powell, a San Francisco-based psychologist and trauma-informed practitioner who gave some insight regarding using cannabis as an adjunct to therapeutic PTSD interventions, as well as using it to help with sexuality and intimacy. Dr. Liz also points out some potential pitfalls, and gives plenty of things to consider when thinking about sex, cannabis, and trauma.
She began by explaining how PTSD treatment works, stating, “The balance that’s important to strike when working with PTSD, cannabis and sex, especially if people are looking to get treatment for PTSD, is making sure that the cannabis use is not being done in a way that can interfere with PTSD treatment and actual recovery from PTSD. PTSD is one of the most treatable psychological conditions—the research on it is very strong; we have highly effective therapies for it. The problem is, substances such as benzodiazepines (like Xanax), alcohol and even cannabis—if used to avoid experiencing the emotions related to trauma—can impede the progression of therapy.
“Part of recovery from PTSD is allowing yourself to feel the feelings, so they can run their natural course and you can recover from what’s coming up for you. What I see a lot of people doing is using cannabis to cope in the short term, and it can be highly effective for that, but using it too much to cope in the short term can make it harder to recover in the long term. If you’re going to be using cannabis and you have PTSD or significant trauma symptoms and you’re working in therapy, you’re going to want to check in with your therapist to moderate cannabis use, so it’s not at cross purposes with what you’re doing in therapy.”
I asked about how this might impact sexuality, and Dr. Liz commented: “PTSD tends to lead to a lot issues with sexuality, so we see people going to both ends of the spectrum with it. For some people, any kind of touch or being touched by someone they care about or any type of intimacy can feel too invasive for them, so they will tend to avoid touch and avoid intimacy and avoid that kind of connection and sex, because they feel like if they start to do that they’re just going to break open; everything is going to come rushing out, and they’re not going to be able to control it. On the flip side, we see people who use sex and sexuality as a numbing strategy for the intense emotions they feel related to PTSD, and this is an equally problematic stance. If you are someone who has PTSD and you’re in the process of getting it treated, and you want a way to experience some sexual connection with a partner without that fear of breaking open, especially early on in therapy treatment, cannabis might be helpful to bring the symptoms down a little bit so it feels less dangerous.
“If you’re someone who is using sex as a numbing mechanism, throwing in cannabis with it is just going to amplify that numbing tendency. You want to be very aware of how you’re using cannabis and how you’re using sexuality when it relates to your trauma symptoms. In general, if you’re using something to run away, it’s worth looking at and evaluating how long you want to use that strategy, and when you know that strategy is not the best one for you anymore. If you’re using it as a short-term Band-Aid, and you’re using it with awareness, presence and intention, that is far less likely to be problematic in the long term. There’s an analogy that I share with my clients: PTSD is like a bone you broke that didn’t heal properly. You have to break it again, reset it, and let it heal. The process of re-breaking is painful is going to feel worse, but that’s how healing starts.
“When people have PTSD and develop those symptoms in a long-term way after trauma, what has happened is that something has gotten in the way of their natural healing process from trauma. The symptoms of PTSD are all perfectly natural reactions to a traumatic situation. Symptoms staying past 30-90 days is what makes them problematic—not the symptoms themselves. If something has gotten in the way of your healing, we have to figure out what those things are that are keeping you stuck, and break those apart so you can move back onto that path of healing. That moment of taking patterns that keep you stuck is going to feel like things are getting worse. It feels subjectively more challenging than it was before, so a lot of people will turn to sex or video games or the Internet (or other numbing behaviors) to try to avoid those increased feelings, but that’s going to prolong the healing process even further. The more you’re able to let yourself feel those feelings, in a safe container, and let them run their natural course, the more like it is that you’ll be able to recover.”
I asked if Dr. Liz could share more about cannabis with regards to the sympathetic (fight and flight) and parasympathetic (rest and digest) nervous systems in the body, and the ways in which they interact with sex, and she explained: “Cannabis can help with bringing up more parasympathetic response and with quieting down sympathetic response. Your sympathetic nervous system is your body’s fight/flight/freeze system. It’s designed to be a complete on/off switch; it’s not designed to stay partially on. PTSD is a condition where it’s not able to turn off all the way. When you’re having sex, you need a certain degree of sympathetic activation to achieve orgasm, but in order to begin the sexual excitement process, you have to have parasympathetic activation. When you use cannabis, what it can do is if you have too much sympathetic activation, it can help bring that down a little bit, calm you down, and allow your body to reset itself back to that parasympathetic place, which allows you to begin engaging in sexuality and having a normal response cycle.”
Hopefully this gave you a lot to think about when it comes to PTSD and cannabis as it relates to sexuality and intimacy. If you want to find out more about Dr. Liz and her work, check out her bio below:
Dr. Liz believes that great sex can change the world. She’s a sex educator, coach and licensed psychologist (CA 27871) specializing in non-monogamous and non-traditional relationships. Dr. Liz has helped couples and singles become more confident in who they are and communicate more effectively with their partners. You can learn more about Dr. Liz and her work at sexpositivepsych.com.