Cannabis-Assisted Psychotherapy for Complex PTSD with Dissociation: A Groundbreaking Case Report
A 28-year-old woman with treatment-resistant dissociative PTSD showed dramatic improvement after 10 sessions of cannabis-assisted psychotherapy — drawing parallels to psychedelic-assisted therapy.
Quick Facts
What This Study Found
Dissociative PTSD (D-PTSD) is a particularly severe form of PTSD where patients experience detachment from their own body and surroundings — depersonalization and derealization — on top of standard PTSD symptoms. Standard treatments often fail for this population, and targeted interventions are essentially nonexistent.
This case report describes a novel approach: cannabis-assisted psychotherapy (CAP). A 28-year-old woman with complex D-PTSD underwent 10 sessions over 5 months, each combining cannabis administration with a specific psychotherapy framework — psychedelic somatic interactional psychotherapy, an approach borrowed from the psychedelic therapy world.
The parallels to psychedelic therapy are intentional. At sufficient doses, cannabis can produce experiences similar to classic psychedelics: oceanic boundlessness (a sense of unity and expansiveness), ego dissolution, and emotional breakthrough. The therapists used these cannabis-induced states as a therapeutic window, much as psilocybin or MDMA therapists use the altered state to facilitate processing of traumatic memories.
The results were striking. From baseline to post-treatment, the patient showed large improvements across PTSD symptoms, dissociation, depression, anxiety, sleep quality, and overall functioning. The treatment also incorporated integrative cognitive behavioral therapy between cannabis sessions.
This is a single case report, not a clinical trial — it can't prove cannabis-assisted psychotherapy works for D-PTSD. But it introduces a conceptual framework for using cannabis therapeutically in psychotherapy that hasn't been formally described before, and the patient's response was clinically meaningful.
Key Numbers
1 patient, 28 years old, female. 10 sessions over 5 months (twice monthly). Treatment combined cannabis administration with psychedelic somatic interactional psychotherapy and integrative CBT. Large improvements reported across PTSD severity, dissociation, depression, anxiety, sleep, and functioning from baseline to post-treatment.
How They Did This
Case report of a single 28-year-old female patient with complex D-PTSD. Treatment: 10 sessions of cannabis-assisted psychotherapy (CAP) scheduled twice monthly over 5 months, using psychedelic somatic interactional psychotherapy combined with integrative cognitive behavioral therapy. Outcomes measured included PTSD symptoms, dissociation severity, depression, anxiety, sleep quality, and functioning.
Why This Research Matters
This case report sits at the intersection of two growing fields: medical cannabis and psychedelic-assisted therapy. While psychedelic therapy with psilocybin and MDMA has gained significant research momentum for PTSD, cannabis-assisted psychotherapy is virtually unexplored. If cannabis can facilitate similar therapeutic states at a fraction of the regulatory and logistical complexity of Schedule I psychedelics, it could open a more accessible pathway for treatment-resistant PTSD patients.
The Bigger Picture
This case report introduces cannabis-assisted psychotherapy as a distinct treatment concept, positioning it alongside the growing psychedelic therapy literature. For the RethinkTHC database, it connects to the broader mental health cluster — anxiety (RTHC-00009, RTHC-00077), sleep (RTHC-00083, RTHC-00095), and the endocannabinoid system's role in emotional regulation. The deliberate use of cannabis's psychedelic-like properties at higher doses is a fundamentally different therapeutic model from the low-dose symptom management that most medical cannabis research examines.
What This Study Doesn't Tell Us
Single case report — the lowest level of clinical evidence. No control condition; improvements could reflect natural recovery, placebo effects, the psychotherapy itself (independent of cannabis), or the therapeutic relationship. The patient's demographics (young, female, engaged enough to commit to 10 sessions) limit generalizability. The psychedelic-like effects of cannabis are dose-dependent and unpredictable, raising safety concerns for broader application. No long-term follow-up reported.
Questions This Raises
- ?Could cannabis-assisted psychotherapy be tested in a controlled trial for D-PTSD?
- ?What cannabis dose and administration route optimally produces therapeutic psychedelic-like states without adverse effects?
- ?How does cannabis-assisted psychotherapy compare to psilocybin or MDMA-assisted therapy for PTSD?
- ?Is the cannabis essential, or would the psychotherapy framework alone produce similar results?
Trust & Context
- Key Stat:
- Evidence Grade:
- Single case report — the most preliminary level of clinical evidence. While the patient's improvement is notable, a single uncontrolled case cannot establish treatment efficacy. This is best understood as a proof-of-concept introducing a new therapeutic model.
- Study Age:
- Published in 2023. Cannabis-assisted psychotherapy is a very new concept; clinical trials may not yet exist.
- Original Title:
- Cannabis-assisted psychotherapy for complex dissociative posttraumatic stress disorder: A case report.
- Published In:
- Frontiers in psychiatry, 14, 1051542 (2023) — Frontiers in Psychiatry is a reputable journal focusing on various aspects of mental health and psychiatric research.
- Authors:
- Ragnhildstveit, Anya, Kaiyo, Miriam, Snyder, Matthew Brian, Jackson, Laura Kate, Lopez, Alex, Mayo, Chasity, Miranda, Alyssa Claire, August, River Jude, Seli, Paul, Robison, Reid, Averill, Lynnette Astrid
- Database ID:
- RTHC-04862
Evidence Hierarchy
Describes what happened to one person or a small group.
What do these levels mean? →Read More on RethinkTHC
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Cite This Study
https://rethinkthc.com/research/RTHC-04862APA
Ragnhildstveit, Anya; Kaiyo, Miriam; Snyder, Matthew Brian; Jackson, Laura Kate; Lopez, Alex; Mayo, Chasity; Miranda, Alyssa Claire; August, River Jude; Seli, Paul; Robison, Reid; Averill, Lynnette Astrid. (2023). Cannabis-assisted psychotherapy for complex dissociative posttraumatic stress disorder: A case report.. Frontiers in psychiatry, 14, 1051542. https://doi.org/10.3389/fpsyt.2023.1051542
MLA
Ragnhildstveit, Anya, et al. "Cannabis-assisted psychotherapy for complex dissociative posttraumatic stress disorder: A case report.." Frontiers in psychiatry, 2023. https://doi.org/10.3389/fpsyt.2023.1051542
RethinkTHC
RethinkTHC Research Database. "Cannabis-assisted psychotherapy for complex dissociative pos..." RTHC-04862. Retrieved from https://rethinkthc.com/research/ragnhildstveit-2023-cannabisassisted-psychotherapy-for-complex
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.