Caitlin's Ayahuasca Practice
Integrating PMDD through Ceremony and Psychotherapy
*Before we get into Caitlin’s story, this article references suicidal thoughts and suicide attempts. Please proceed with caution if you are having thoughts of self-harm or wish to avoid this type of content. BIG hugs.
Please see our HARM REDUCTION GUIDE for female biology as well.
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Growing up with a mother who worked in OB / GYN meant Caitlin’s intermittent mood symptoms didn’t go unrecognized for long. By age 16, following chronic suicidal ideation and suicide attempts in the weeks preceding her period, Caitlin was diagnosed with late luteal phase dysphoric disorder, now known as PMDD.
Tucked away in the back of the Diagnostic Manual for Mental Health (DSM) at the time, late luteal phase dysphoric disorder was added to the appendix in 1987, under the section titled “more research required”. It wasn’t until 2013 when the condition was renamed to premenstrual dysphoric disorder, or PMDD, and was included with full diagnostic criteria under depressive disorders.
PMDD affects an estimated 4.2 million women in the United States and is categorized by severe mood disruptions and / or physical symptoms in the one to two weeks preceding menstruation, otherwise known as the luteal phase of the menstrual cycle.
Now 34, Caitlin has been battling with PMDD for most of her life. Living with chronic suicidal ideation, depression and anxiety from such a young age and struggling to find equilibrium, Caitlin has tried numerous treatment options to help ease symptoms.
“It’s something I’ve known forever, since a young age. In my twenties it got progressively worse - due to toxic relationships, stress in the environment, different jobs I was working, and my overall lack of awareness on how to work with this, even though I had been diagnosed. I’ve always told my gynecologists I have this, and most of them go straight to the SSRIs which I never really wanted to be on. So then we tried birth control - I’ve been on almost every type of birth control at this point, and most have made it worse. For about a year I tried a low dose, intermittent SSRI but I can’t really say whether or not the medication helped, there were so many factors in my life at the time - working fulltime, relationships and starting my PhD program. What I can say, is that the SSRI made me feel numb, so after about a year, I decided to stop taking it.”
A PMDD Half Life
Women with PMDD sometimes describe living a half life. For one to two weeks every month, symptoms can be debilitating in nature and can lead to severe disruptions in interpersonal relationships and career progression. When the dust settles from luteal phase symptoms, the PMDD trail of destruction persists, leaving women with PMDD only a few short weeks to clean up the mess before the cycle repeats. The work that didn’t get done and the relationships in shambles demand attention, particularly after intense, debilitating PMDD episodes.
“I think having my life turned upside down every month was worse than the suicidal ideation. Every month I wanted to end my relationship - it’s the temporal desire to leave an experience, whether it’s a job, a relationship, or my life in general. Suicidal ideation might be an end all to life, but I actually think it’s worse to feel a complete disruption every two weeks, to feel like my life is in shambles every two weeks is excruciating. By 2018, my symptoms of both PMDD and PTSD - that I live with everyday - became so disruptive to my life and I just couldn’t take it anymore.”
In Caitlin’s case, the overwhelming instability that developed as a result of PMDD was like running on a never ending hamster wheel, and after trying countless other options, psychedelic medicines provided a glimmer of hope when nothing else seemed to work. After a few psilocybin mushroom journeys, the desire to go deeper led her to work with Ayahuasca, a traditional Amazonian plant medicine integral to South and Central American Shamanism and indigenous cultures in the regions.
“I’d worked with psilocybin mushrooms a few times before, but knew that I needed a more guided experience. I would say that my psilocybin experiences were therapeutic but I didn’t have any therapeutic sense to work with them. I’d already been traveling at that point in my life, so my first Ayahuasca experience was in Guatemala at a retreat center.”
For more detailed information about Ayahuasca, including case studies, harm reduction, and a theory on the biological mechanisms that may be involved in ayahuasca’s healing potential, I recommend The Fellowship of the River, by Dr. Joe Tafur. Dr. Tafur is a Western Medical Doctor who traveled to the Amazon, trained with Indigenous Shipibo Shamans and documented his healing work with Ayahuasca.
When The Student Becomes the Teacher
After participating in countless Ayahuasca ceremonies over the years and becoming deeply immersed in the culture, Caitlin was called to become a Trauma-Informed Plant Medicine Facilitator. Working closely with teachers in Central America, Caitlin has embarked on a journey of self-discovery and healing through service and a personal commitment to working with the traditional Amazonian brew and other plant medicines.
Working with her teachers, she has learned how to hold space for others during ceremony. Holding space in a psychedelic ceremony can be taxing and exhausting, but Caitlin has found a silver lining, and discovered that working as a facilitator has helped her integrate some of the extreme sensitivities that can come with PMDD.
“I’ve been learning more about myself working with the medicines in ceremonial settings, both as a participant and as a facilitator. I’ve learned that when I ask for help, people show up, and that alone really helps to reduce PMDD symptoms. It’s helped me become aware of my needs so that I can speak them. I facilitated a medicine ceremony at the end of April and I was literally in my peak PMDD and I was like shit, I can feel it. I feel so sensitive, kind of tired, out of my body a little bit, like I know I’m here. And what is so beautiful about working with psychedelics in community spaces is that I have learned so much more compassion for the difficulty that we all experience. Specifically a lot of my fears around being in a ceremonial setting have been about how I might be triggered. Especially when I’m in PMDD, I’m more sensitive, I get irritated, smells really bother me, so many things, but every time I’ve entered a ceremonial space when I’m in PMDD, I have been taught by the medicine and by the people that I am welcomed. That my sensitivities are not too much.”
Integration & Psychotherapy
Integration, put simply, is the process of bringing parts together to make a whole. So often, we tend to push parts of ourselves away and reject them rather than integrate them into our lives. For many of us, after working with psychedelic medicines, the PMDD sensitivities don’t go away, rather we are presented with an opportunity to learn how to integrate who we are, and put the pieces of ourselves back together. In Caitlin’s case, rather than shying away from the world because of PMDD, she began walking towards it and learned how to address her unique needs.
“I would say that Ayahuasca actually rewired some of the ways that I process, but in order for that to stick, I’ve been in psychotherapy for three years. Really what it is - is unpacking all the little things that can come to light, so it’s working with the subtleties as they come up, and integrating them, even six months to a year after the journey through psychotherapy.”
As a Trauma-Informed Plant Medicine Facilitator, Caitlin suggests to anyone working with Ayahuasca to pair it with some form of therapy. Her recommendation is an important one, because altered states of consciousness are novel and unique, and it’s vital to have an outlet to properly integrate the experience for maximum therapeutic benefit. Psychedelics are consumed around the world in many ways - including recreationally. Psychedelic research for mental health, however, focuses on psychedelic assisted therapy. Combining psychedelic experiences with psychotherapy has been shown to enhance the therapeutic potential.
As psychedelic research continues to unfold, I’m optimistic that PMDD will be included so we can better understand the therapeutic potential of psychedelic assisted therapy, specifically for PMDD. In the meantime, I’m grateful for the countless women that are willing to share openly and authentically about their PMDD experiences and psychedelics. BIG shout out to Caitlin for sharing her story with us so we can learn from her valuable insights - both as a participant and facilitator in this space.
For more on Ayahuasca and PMDD, check out A Path for Polly: PMDD vs. Shamanism. Have a story you’d like to share? Send an email to info@dysphoricproject.org, we’d love to connect with you!