How Healing Actually Works: Psychedelics, Compassion, and the Power of Relationship

There's a particular kind of suffering that doesn't always respond to the treatments we have.

The combat veteran with PTSD who has tried multiple medications, several courses of therapy, and is still waking up at three in the morning unable to settle. The first responder whose nervous system hasn't been able to stand down for years. The person whose trauma is so old and so layered that ordinary treatment can reach part of it, but not the part that's actually keeping them locked in.

These are the people who teach us, when we listen, that healing is more complicated than our standard models suggest. And in 2023, a study published in Military Psychology added something important to what we know about what's possible for people in this kind of suffering.

The study followed 86 U.S. Special Operations Forces veterans — Navy SEALs, Special Forces, Special Operators — who traveled to Mexico for a single psychedelic treatment program involving two compounds: ibogaine and 5-MeO-DMT. These were not casually exposed individuals. They were combat veterans with significant trauma exposure, many with co-occurring alcohol misuse and post-traumatic stress symptoms.

What the researchers found was striking. One month after treatment, participants reported substantial reductions in PTSD symptoms, depression, anxiety, and problematic alcohol use. Many described the experience as among the most meaningful of their lives.

But the deeper finding — the one I want to spend time with — wasn't really about the medicines. It was about what the medicines opened, and what made that opening usable.

What This Study Actually Showed

The combination of ibogaine and 5-MeO-DMT, paired with preparation and integration support, appeared to produce something traditional treatment for these veterans had often not been able to reach.

Why this matters: veterans with combat-related PTSD are notoriously difficult to treat. Standard protocols — cognitive processing therapy, prolonged exposure, SSRIs — help some, but a significant percentage of veterans remain symptomatic after years of treatment. For this population, the combination of psychedelics and structured therapeutic support seemed to reach something the other tools couldn't.

The researchers were careful not to overstate what they had found. This was an observational study, not a randomized controlled trial. The veterans self-selected into treatment, which introduces bias. The follow-up period was short. But within those limits, the findings pointed toward something worth taking seriously: a different model of healing might be possible for the people standard treatment has been failing.

That different model is what I want to talk about — because it's not just about veterans, and it's not just about ibogaine. It's about what the research is increasingly suggesting about how change actually happens in people whose suffering has stayed stuck.

Trauma as a System That Stopped Updating

To understand why this kind of treatment may work where others haven't, it helps to look at what trauma actually is at the system level.

Trauma is not, fundamentally, an event. It's a pattern that won't update. Something happens — sometimes once, sometimes many times — that the nervous system can't fully process in the moment. To survive, the system adapts. It learns vigilance. It learns to brace. It learns to suppress what can't be felt. It learns to expect the next threat.

These adaptations are intelligent. They saved your life, or made an unbearable situation bearable. The problem is that they don't shut off. The nervous system that learned to scan for danger in 2007 is still scanning in 2026. The body that braced against grief in childhood is still braced today. The system has become rigid — locked into a configuration that no longer matches the world the person is actually in.

The challenge of healing trauma, then, isn't really about removing the memory or correcting the thought. It's about helping a system that has become rigid become flexible again.

This is where psychedelics enter the picture. Not as cures. As something more interesting: as catalysts that can temporarily soften the structures the trauma is held in, creating an opening for the system to reorganize.

What Psychedelics Actually Do at the System Level

The neuroscience suggests that psychedelic medicines like psilocybin, ibogaine, MDMA, and 5-MeO-DMT share a common effect, though they work through different mechanisms: they temporarily increase the brain's flexibility, sometimes called neural plasticity or cognitive flexibility.

What this looks like, in lived terms:

Rigid thought patterns soften. Defenses ease. The grip of old narratives loosens. Material that has been carefully kept at a distance can come into view. Emotions that have been frozen can move. Memories can be revisited with something other than the original terror.

This is the opening. And for many people, including the veterans in the study, the opening itself is meaningful. The sense of being released, even briefly, from a pattern that has felt like a permanent feature of one's life can be one of the most significant experiences a person ever has.

But here's the part the research keeps confirming, and the part most marketing of these medicines glosses over:

The opening, by itself, is not the healing.

If the system opens and there is no structure around it, no relationship to hold what surfaces, no support to integrate what emerges — the opening tends to close again. The pattern reasserts itself. The relief proves temporary. People often describe this as the worst version: glimpsing freedom and then losing it.

What turns the opening into actual healing is what surrounds it.

What the Veterans' Experience Reveals

The Special Operations Forces veterans in the Armstrong study didn't just take ibogaine and 5-MeO-DMT and go home. They were in a structured program with preparation, supervision, and integration support. The researchers identified specific elements of the experience that participants associated with their improvement.

Three things kept showing up:

The experience itself. The altered state, the encounters with memories and emotions and material that had been stored away, the felt sense of being released from rigid patterns. The medicine produced something that traditional therapy hadn't been able to deliver: a direct, embodied experience of being outside the trauma pattern, even temporarily.

The relational container. The veterans were not alone. They were in a setting with people who knew what to do, who had presence and skill, who created the safety required for the opening to be workable rather than overwhelming. The participants consistently named the importance of feeling supported and held.

Integration. What happened after the experience mattered as much as what happened during it. The work of metabolizing what came up, of bringing insights into ordinary life, of letting the system reorganize around what had been revealed.

The medicines were one of three legs of the stool. Without the other two — the relationship and the integration — the medicines alone would not have produced what they produced.

The Inner Layer: Self-Compassion

There's a fourth piece that the research, and my clinical experience, keep pointing toward.

It's not enough to soften the trauma pattern, provide a safe container, and integrate the experience. For lasting change, the internal relationship — the one between the person and their own suffering — has to shift too.

For people with long trauma histories, the inner relationship is often punishing. Harsh self-criticism. Persistent shame. The conviction that something is wrong with them at a fundamental level. These patterns survive even profound psychedelic experiences. They reassert themselves in the weeks and months after, often quietly undoing what the experience opened.

Self-compassion, by contrast, creates a different kind of inner ground. Instead of meeting the difficult material with judgment, the person learns to meet it with care. The research is now clear that this isn't soft thinking — it's a measurable shift in nervous system regulation, in emotional resilience, and in capacity to integrate difficult experience. It changes how pain is held, even when pain remains.

Many of the veterans in studies like this one have described, in their own words, something like this: they discovered they could meet their own history with something other than the harshness they had been carrying for years. That shift in inner relationship, more than any single insight, was what allowed the changes to take root.

A Unified Picture

Looking across the trauma research, the psychedelic research, the work on therapeutic relationship, and the work on self-compassion, a unified picture emerges that I find clinically and personally meaningful.

Healing isn't really one thing. It's the interaction of several things, all of which have to be present for real change to happen:

Opening — through medicine, through movement, through experience, through any of the practices that temporarily loosen the structures that suffering has been held in.

Holding — through relationships of real safety and skill, both with practitioners and with people who can witness what's emerging without flinching.

Integration — through the slow work of letting what was opened become woven into ordinary life, the patterns of behavior, the body, the choices, the way time gets spent.

Inner softening — through the slow change in how a person relates to themselves, from criticism toward care.

When all four are present, lasting change becomes possible. When any of them is missing, the work tends to stall.

What This Means Beyond Veterans

The Armstrong study focused on veterans, but the model it points to applies more broadly. Anyone whose suffering has stayed stuck despite their best efforts — through trauma, through chronic depression, through anxiety that hasn't responded to standard treatment, through addiction patterns that won't release — may benefit from understanding healing this way.

Not as a single intervention to find.

But as a system of openings, holdings, integrations, and inner shifts, all of which have to come into alignment.

Psilocybin therapy, when it becomes legally available, will offer one path. Ketamine-assisted psychotherapy is already offering another. Plant medicines in legal jurisdictions offer others. Even without medicines, the same model applies: openings can come from breathwork, from somatic practice, from deep contemplative work, from moments of grace. What matters is that the rest of the structure be in place to hold and integrate what opens.

A Closing Reflection

What I find most moving about the Armstrong study, and about the broader research it joins, is what it implies about the nature of suffering.

The suffering of these veterans was not a personal failing. It was not a moral weakness. It was a nervous system that had organized itself around survival under conditions most of us will never face — and then could not, on its own, find its way back to flexibility.

What helped them wasn't a single intervention. It was a coordinated process: the medicine that softened the structure, the relationship that held the opening, the integration that let the change take root, the slow shift in how they met themselves afterward.

This is, I believe, how healing actually works. For veterans, for survivors of childhood trauma, for anyone whose suffering has stayed locked in a system that stopped updating.

Healing happens when rigid systems become flexible again — through openness, safety, integration, and the slow turning of compassion inward. None of these alone is enough. Together, they make change possible that none of them could produce on its own.

If you're sitting with what feels like a pattern that won't update, and you'd like to explore what this kind of integrative work could look like for you, you're welcome to book a consultation.