Ceremonial Psychedelic Experiences and Changes in Mental Health Outcomes in Those with Adverse Childhood Experiences

This new study by Mehmood, Bremler, Zeifman, et al. published in Psychedelic Medicine investigates how the severity of Adverse Childhood Experiences (ACEs) influences the mental health benefits of ceremonial psychedelic use.

This new study, published in Psychedelic Medicine investigates how the severity of Adverse Childhood Experiences (ACEs) influences the mental health benefits of ceremonial psychedelic use.

The central premise is that while ACEs typically make traditional mental health interventions less effective, the "disruptive" nature of psychedelics might offer a unique pathway for healing in this high-adversity population.

Key Findings

• Positive Moderation by ACEs: The study found that individuals with higher ACE scores (greater childhood trauma) often experienced greater improvements in mental health outcomes compared to those with lower scores.

• Greater Subjective Intensity: High ACE scores were positively correlated with the intensity of "acute subjective effects." Specifically, survivors of early trauma were more likely to report:

  • Emotional Breakthroughs: A sense of releasing long-held psychological tension or resolving deep-seated trauma.

  • Mystical Experiences: Feelings of unity, transcendence, and awe.

• Predictors of Well-being: For individuals with significant trauma (ACE score ≥ 4), the strength of the emotional breakthrough and mystical experience strongly predicted improvements in well-being and reductions in anxiety at the 2-week and 4-week follow-ups.

• Reduced Experiential Avoidance: The study found a notable link between high ACEs and a reduction in "experiential avoidance." This suggests the ceremony helped trauma survivors become more willing to face difficult emotions rather than instinctively suppressing them.

• Symptom Reduction: Significant improvements were noted across the cohort in PTSD symptoms, complex PTSD (CPTSD), trait shame, and social connectedness,

It is worth noting a few limitations

• Selection Bias: The participants were already choosing to attend a ceremony. This population likely has a higher-than-average "readiness for change," which may skew the results compared to a general population of trauma survivors.

• Self-Report Reliability: The data relies on self-reported survey responses. In a ceremonial context, there is often a "halo effect" or social pressure to report positive breakthroughs.

• The "Safety" Nuance: Although this study highlights the benefits for high-ACE individuals, the authors (and others in the field) maintain that these benefits depend heavily on a supported ceremonial environment. Without that container, the risk of "challenging experiences" or re-traumatization remains a serious consideration.

Abstract

“Background:

Adverse childhood experiences (ACEs) are known to contribute to mental health issues and interfere with response to mental health interventions. Psychedelics have been found to improve mental health outcomes; however, the exploration of the effects of psychedelics on mental health in those with higher ACEs remains limited. The present study aimed to examine mental health outcomes and acute subjective effects of ceremonial psychedelic use across the spectrum of ACE severity.

Method:

Prospective observational survey data were collected from a convenience sample (N = 570) of individuals who participated in psychedelic ceremonies. ACE severity was measured at baseline using the validated ACE-Questionnaire. Acute psychedelic experiences (mystical, emotional breakthrough, and challenging experiences) were assessed 1-day postpsychedelic use. Validated measures of mental well-being, experiential avoidance, and trait anxiety were obtained before, and 2- and 4-weeks postpsychedelic experience.

Results:

A regression analysis found that ACEs significantly moderated the relationship between time and mental health outcomes. Relative to lower ACEs, higher ACEs were associated with greater improvements in mental health across time, corrected for baseline. Spearman’s correlation showed that ACEs were significantly positively correlated with emotional breakthrough (rs = 0.15) and mystical experiences (rs =.12). Among individuals with ACEs ≥4, mystical and emotional breakthrough experiences were positively associated with well-being 2 (adj. r2 = 0.576 and 0.526) and 4 weeks (adj. r2 = 0.438 and 0.463, respectively) postpsychedelic experience (controlling for baseline well-being). Mystical experiences were negatively associated with experiential avoidance (adj. r2 = 0.716), and emotional breakthrough experiences were negatively associated with anxiety, 4 weeks postpsychedelic experience (adj. r2 = 0.401), controlling for baseline. Acute experiences did not significantly moderate the association between ACEs and mental health outcomes.

Discussion:

ACEs were associated with improvements in mental health following psychedelic experiences. ACEs were positively correlated with emotional breakthrough and mystical experiences, which were associated with improved longer term mental health. Study limitations include the use of a convenience sample and noncontrolled design. This study’s findings tentatively inform the development of psychedelic therapy in those reporting ACEs.”

Mehmood, M. K., Bremler, R., Spriggs, M. J., et al. (2025). Ceremonial Psychedelic Experiences and Changes in Mental Health Outcomes in Those with Adverse Childhood Experiences. Psychedelic Medicine. DOI: 10.1177/28314425251392251. Read Paper

For more psychedelic news and research, visit the psychedelic health professional network homepage.