Rachel Yehuda, Ph.D, Professor of Psychiatry and Neuroscience, is the Director of the Center for Psychedelic Psychotherapy and Trauma Research. She is also Director of the Traumatic Stress Studies Division at the Mount Sinai School of Medicine which includes the PTSD clinical research program and the Neurochemistry and Neuroendocrinology laboratory at the James J. Peters Veterans Affairs Medical Center. Dr. Yehuda is a recognized leader in the field of traumatic stress studies. She has authored more than 450 published papers, chapters, and books in the field of traumatic stress and the neurobiology of PTSD. Her current interests include the study of risk and resilience factors, psychological and biological predictors of treatment response in PTSD, genetic and epigenetic studies of PTSD and the intergenerational transmission of trauma and PTSD. She has an active federally-funded clinical and research program that welcomes local and international students and clinicians.
PsyTech: How did you get into psychedelic research?
Dr. Yehuda: Reluctantly. I was skeptical when I first heard about the findings from the Phase 2 MDMA trials in PTSD. But I kept an open mind because it was hard to dismiss a treatment that claimed such high effect sizes, particularly because there are so few really efficacious treatments for PTSD. After participating in the MDMA-assisted psychotherapy training held in Neve Shalom, Israel in 2019, at the invitation of Dr. Rick Doblin, it became clear to me that this was an approach worth pursuing with full force. And that’s what I am now trying to do.
PsyTech: How would you describe your area of research focus?
Dr. Yehuda: Most of my work to date has focused on developing biomarkers in order to describe molecular and other neurobiological mechanisms associated with trauma and resilience. In the last decade, we have been interested in the question of whether we can predict treatment response in persons with PTSD, and understand the neurobiological mechanisms of recovery by comparing psychotherapy treatment responders to non-responders. We have also studied epigenetic changes associated with trauma exposure, and even effects observed in offspring of trauma survivors. My lab is therefore in a position to pursue clinical trials of psychedelic-assisted psychotherapy, and to evaluate the biological mechanisms of action of psychedelic-assisted integration. Our first study will be to compare the efficacy of 3 vs 2 experimental MDMA sessions in combat veterans with PTSD. We also seek to perform studies with psilocybin, and in connection with intergenerational and racial trauma.
PsyTech: Looking back on your career, can you describe a profound moment or experience that stands out to you?
Dr. Yehuda: There have been many such moments because I have been working in the field of psychiatry since 1987. In relation to psychedelics, I would say that participating in the MT1 study sponsored my MAPS, in which I was able to experience MDMA and placebo-assisted psychotherapy under the masterful guidance of Dr. Michael and Annie Mithoefer, was pivotal and profoundly meaningful, because it enabled me to understand both how to guide a psychedelic-assisted therapeutic process as well as what it means to experience its healing effects.
PsyTech: What’s it like being a female leader in this field? Are there any particular challenges or advantages?
Dr. Yehuda: This is a difficult question to answer while standing on one foot. I couldn’t possibly say it better than Grace Kelly did when asked what it was like to dance alongside Fred Astaire and she responded that she just did everything Fred did but backwards and in high heels. It is certainly more challenging to dance backwards in high heels, but if you are actually able to do it… the accomplishment can be very satisfying.
PsyTech: What do you feel are the unique qualities that a woman can bring to psychedelic research?
Dr. Yehuda: I thought we were getting away from these kinds of binary gendered conversations! It is clear now that what any field of research needs is diversity – diversity in gender, race, ethnicity, culture, geography, religion and perspective. This is particularly true in the case of psychedelic medicine where so many important traditions and methods are embedded in indigenous, non-White cultures. In diversity, we will find our common humanity and the things that unite us.
PsyTech: What’s the next big step medicinal/therapeutic psychedelics needs to take to bring it to the next level?
Dr. Yehuda: I would say there are at least three important things that will bring the field to the next level. First, in pace with the investment in developing newer psychedelic compounds, there must be investment in the kind of science that provides the scaffolding for understanding the mechanisms of action of these treatments. Second, we have to acknowledge that while psychedelic approaches may be game-changing for many, they may not be for everyone. We should be learning more about the characteristics of responders vs. non-responders and applying neuroscience approaches to see if responders could be identified in advance. Third, we should be thoughtful and strategic about the implications or potential consequences of legalizing psychedelics before they are FDA approved as therapeutic agents for psychiatric disease.
PsyTech: What would you like to see happen to help increase the number of women in the psychedelic research field?
Dr. Yehuda: I hope that conferences and other educational forums about psychedelics will ensure representation of the many women who are making substantial contributions to psychedelic research. There are a growing number of psychedelic centers opening up in academic centers around the globe, and I would like to see women assume leadership roles as center directors.
PsyTech: What advice would you give to a woman who is considering entering this field?
Dr. Yehuda: Concentrate on the contribution you wish to make, and push forward.