Why do so many victims of cyber fraud remain silent, and what support do they need?

It's a common and unfortunate reality that many victims of cyber fraud remain silent.
This silence creates a significant challenge for law enforcement, perpetuates the stigma, and leaves victims isolated.

The reasons are primarily psychological and societal:

Why Victims Remain Silent:
Shame and Embarrassment: This is by far the biggest factor. Victims often feel incredibly foolish, stupid, or naïve for having "fallen for" a scam, especially when it involves significant financial loss or emotional manipulation (like in romance scams). They fear judgment from family, friends, and society, leading them to hide their experience. Phrases like "You should have known better" only exacerbate these feelings.

Self-Blame and Guilt: Many victims internalize the blame, believing it was their fault for being "too trusting" or "not smart enough" to spot the scam. This self-blame is often compounded in investment scams, where victims might feel they were "greedy" for wanting quick returns.

Fear of Judgment and Stigma: There's a societal stigma attached to being a fraud victim that isn't always present for victims of other crimes (like physical assault or robbery). People tend to associate fraud victims with gullibility, which is a harsh and unfair stereotype.

Emotional Distress and Trauma: The psychological impact of cyber fraud can be immense, leading to severe anxiety, depression, PTSD, isolation, and even suicidal thoughts. This emotional toll can make it incredibly difficult for victims to speak out or even process what happened.

Perceived Futility of Reporting:
Lack of Recovery: Many victims believe that reporting won't lead to the recovery of their lost money, especially with international scams and cryptocurrency.

Lack of Faith in Law Enforcement: Some may feel that law enforcement won't have the resources or expertise to investigate complex cyber fraud cases, or that their case is too small to matter.

Complicated Reporting Processes: The process of reporting can sometimes be perceived as complicated or overwhelming, especially when navigating multiple agencies (e.g., police, bank, platform).

Desire to Forget and Move On: The experience can be so painful and humiliating that victims simply want to put it behind them and avoid reliving the trauma by discussing it.

Fear of Further Victimization: Some victims worry that reporting will make them a target for more scams or expose them to public scrutiny.

Lack of Awareness of Support Systems: Victims may not know who to report to or what support services are available to them.

What Support Do They Need?
Victims of cyber fraud need a holistic approach that addresses not just the financial impact but also the profound emotional and psychological distress.

Empathy and Non-Judgmental Listening:
Crucial First Step: When a victim confides, the most important response is empathy and reassurance that it's not their fault. Avoid any language that implies blame or criticism.

Validation: Acknowledge their pain, shame, and anger. Help them understand that professional scammers are highly skilled manipulators who can deceive anyone.

Accessible and Streamlined Reporting Mechanisms:
Clear Pathways: Provide a central, easy-to-understand point of contact for reporting (e.g., Taiwan's 165 Anti-Fraud Hotline).

User-Friendly Process: Make the reporting process as simple and supportive as possible, minimizing bureaucratic hurdles.

Timely Response: Victims need to feel that their report is being taken seriously and acted upon promptly.

Psychological and Emotional Support:
Counseling and Therapy: Provide access to mental health professionals (psychologists, therapists) specializing in trauma and victim support. Fraud can lead to PTSD-like symptoms, anxiety, depression, and distrust.

Peer Support Groups: Connecting victims with others who have experienced similar fraud can be incredibly validating and therapeutic, reducing feelings of isolation and shame. Organizations like the FINRA Investor Education Foundation offer such groups.

Crisis Hotlines: Accessible hotlines for immediate emotional support.

Financial and Practical Assistance:
Guidance on Fund Recovery: Clear, realistic advice on whether and how lost funds might be recovered (e.g., chargebacks, contacting banks, asset forfeiture in criminal cases).

Identity Theft Resolution: Help with credit freezes, monitoring credit reports, and resolving any identity theft issues that arise from compromised data.

Legal Advice: Guidance on their legal rights and options, including potential civil lawsuits.

Practical Steps: Assistance with changing passwords, securing accounts, and removing malicious software.

Increased Public Awareness and Education:
De-stigmatization Campaigns: Public campaigns that highlight the sophistication of scams and emphasize that anyone can be a victim, thereby reducing shame and encouraging reporting.

Educational Resources: Easily digestible information about new scam tactics and prevention methods. This needs to be continuously updated and disseminated through various channels.

Focus on Emotional Impact: Educate the public on the psychological toll of fraud, not just the financial loss, to foster greater understanding and empathy.

By focusing on compassion, practical support, and systemic change, societies can help victims of cyber fraud break their silence, heal from their trauma, and contribute to a more effective fight against these pervasive crimes.

A Step-by-Step Breakdown of the EMDR Therapy Process

EMDR therapy is designed to help your brain and body process distressing memories that talking alone can’t resolve. Using simple techniques like tapping or eye movements, EMDR helps shift how trauma is stored in your nervous system—so it no longer triggers the same emotional response. It’s structured, flexible, and effective for issues like PTSD, anxiety, and more. Learn more at https://www.michaelpezzullo.com/emdr

Los Angeles offers diverse mental health treatment options, from outpatient counseling to residential psychiatric programs. Facilities address a wide spectrum of mental health conditions including anxiety, depression, PTSD, and personality disorders, using evidence-based practices and individualized treatment plans.


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Myths, Mischief, and Misconceptions.
Informal misuse of psychiatric diagnoses stigmatizes those who suffer.
Reviewed by Tyler Woods

KEY POINTS-
Informal mischaracterization of psychiatric diagnoses increases stigma.
Just as we should confront racist and misogynist remarks, we should challenge misuse of psychiatric diagnoses.
Let us begin to stand up to those who use psychiatric terms that devalue others.

Medical terminology frequently drains into the non-professional population, which often adopts medical diagnoses inappropriately. Phrases like, “You’re giving me a heart attack,” or, “Don’t get psychotic about it” are usually said flippantly, without harmful intent, but can be offensive. Recognition that open acknowledgment of an illness might produce discomfort causes many people to whisper phrases like, “He has cancer.”

In particular, the invocation of psychiatric diagnoses by the lay public frequently reinforces misinformation that leads to increases in stigmatizing psychiatric patients. The term, schizophrenia, was first used by Swiss psychiatrist Eugen Bleuler over 100 years ago to describe a specific form of psychosis. Bleuler employed the word—schizo, meaning “split”; and phrenia, meaning “mind”—to describe patients’ confusion and fragmented thinking. However, the literal meaning has caused many in the general population to erroneously assume that the illness describes split (or, multiple) personality. In many cases “diagnosis epithets” are used as hurtful accusations. There are common examples:

“He acts strange; is he an Aspy, on the spectrum” implies that nonconforming behavior suggests a diagnosis of autism and devalues individuals with the disorder.

“My first wife was borderline” is code for describing the spouse as difficult to live with and subtly blames her for the failure of the marriage.

“I wish you wouldn’t get all excited and manic about this” suggests the person who may be moderately hyperactive has bipolar disorder, a very serious illness.

“Don’t be anorexic; have dessert with me” invokes the label of a serious illness to challenge the dining behavior of the companion.

“You are so OCD” accuses an individual who may be especially careful or perfectionistic of possessing pathological traits.

“When he gets angry, he goes all schizo” reflects the speaker’s attitude that this expressed anger is unreasonable, suggestive of psychosis, such as schizophrenia.

“She is so ADHD” might be a description of someone who appears disorganized, distracted, or forgetful.

“The horror movie upset him so much, it gave him nightmares and PTSD” conflates a serious and well-defined psychiatric diagnosis that usually persists for long periods with an acute, minor upset.

"Don't be antisocial, come to the party" misidentifies a person who resists socialization as a sociopath.

Examples like these usually are not meant to bestow formal psychiatric diagnoses. Most are not intended to be taken literally or even seriously. But referencing psychiatric terminology by nonprofessionals promotes misinformation and, when used in negative ways, expands stigmatization of individuals who suffer from mental illness.

These mischaracterizations trivialize the suffering endured by those disabled by the disorder. Just as many people will assertively confront others who use racist or misogynistic phrases, now, in May, which is formally designated as “Mental Health Month,” let us begin to stand up to those who use psychiatric terms that devalue others.

ADDICTION-
Believe It or Not, You Can Overdose on Weed.
If you think cannabis is basically harmless, you may need to think again.
Reviewed by Ekua Hagan

KEY POINTS-
As more states legalize it, the overuse and abuse of cannabis products will inevitably increase, resulting in more cases of cannabis toxicity.
Although eating cannabis, or edibles, doesn’t affect the lungs compared with smoking, accidental overdoses are more likely to happen.
While most legal cannabis products list the amount of THC they contain, understanding what this means in terms of potency can be a challenge.

You may have some familiarity with the term “blacking out” due to alcohol consumption. The phenomenon refers to gaps in a person’s memory for events that occurred while they were intoxicated and involves memory loss even while they are awake and conscious (they can be moving around, interacting with others, and may seem okay to those around them). A fragmentary blackout, also known as a “grayout” or “brownout” combines gaps in memory with some recollection of events, rather than no recollection as is the case with a total blackout.[1]

If this is your first encounter with the term “greening out” it’s unlikely to be your last, as cannabis use becomes ever more accessible and mainstream. It refers to an acute anxiety- or panic-inducing high, more frequently involving edibles (cannabis-containing food products that you can buy or make yourself) than smoking weed. Greening out is actually a form of overdose or toxic reaction caused by consuming too much of a cannabis product, and can include symptoms such as confusion, dizziness, disorientation, visual impairments, weakness, anxiety, panic, paranoia, increased pulse rate and blood pressure, nausea, or vomiting.

The psychoactive ingredient in cannabis is tetrahydrocannabinol (THC), which causes a euphoric high but can also cause psychological reactions that include anxiety, fear, panic, or depression. The way it enters the body, whether by smoking weed or eating or drinking cannabis products in the form of gummies, chocolate bars, or baked goods, affects how much THC is absorbed. The amount of THC, or its concentration in edibles can be difficult to measure and is often unknown. Consequently, people who use edibles are sometimes unpleasantly surprised by their strength and long-lasting effects.

According to the World Health Organization, around 2.5 percent of the world’s population, or 147 million people, consume weed. As more and more states legalize it, the overuse and abuse of cannabis products will inevitably increase, resulting in more cases of cannabis toxicity, and in turn more emergency room visits and hospitalizations.[2]

A 2022 study that looked at more than 35,000 people in Canada found that people who reported using cannabis in the past year were more likely to have an ER visit or hospitalization than those who didn’t use it.[3]

How much is too much?
While most cannabis products that you can buy legally list the amount of THC they contain, understanding what this means in terms of potency can be a challenge. Moreover, if you’re consuming an edible that isn’t packaged commercially, it’s almost impossible to tell how much THC is in it, or in cannabis that is smoked. Generally, the likelihood of experiencing uncomfortable and potentially problematic effects is higher for first-time or infrequent users. However, even regular and veteran cannabis users sometimes experience anxiety, panic, and/or paranoia, with some (including professional clients as well as personal friends) reporting the sudden onset of these and other adverse effects, even after years of use.

A 2023 study in the journal Molecules at the Institute of Nutrition at Mahidol University in Thailand suggested that smoking 2 to 3 mg of THC can impair attention, focus, short-term memory, and executive functions including memory, thinking, and self-control.

More severe symptoms affect people who smoke more than 7.5 mg of THC, such as low blood pressure, panic, anxiety, delirium, jerking movements, and difficulties with balance and speech. The same study suggested that an oral dose of 5 to 20 mg of THC can impair short-term memory and executive functioning.[4]

Although eating cannabis, or edibles, doesn’t affect the lungs compared with smoking, accidental overdoses are more likely to happen. Also, it generally takes considerably longer for the mind- and mood-altering effects of edibles to begin to manifest—usually 30 minutes to two hours. As a result, people may take more, thinking they haven’t consumed enough, sometimes precipitating taking too much and greening out. Moreover, the high also lasts longer when eating cannabis relative to smoking it; depending on dosage the effects can last 6-12 hours before they subside. The duration of effects depends on several factors, such as body size, amount ingested, when food was last eaten, and interactions with medications or alcohol.

If cannabis use results in out-of-control behaviors, injury, or suicidal thoughts, people should seek medical help by calling 911 or going to the hospital. Those with underlying medical conditions or chronic illness, such as heart or lung disease, or diabetes, need to be especially aware of any symptoms of overdose, especially if these include shortness of breath or chest pain. Since THC intoxication can amplify symptoms of psychiatric disorders like depression, anxiety, PTSD, ADHD, bipolar disorder, and schizophrenia, it’s important for people with those conditions important to get emergency care in cases of overconsumption.

While psychotic episodes and serious medical problems are rare, cannabis-related reports to the U.S. National Poison Control increased from 2,951 cases in 2016 to 11,569 cases in 2020. From January to July 2021, 18 percent of exposures (119 of 661 cases) required hospitalization and 39 percent of the cases involved people under 18 (258 of 661 cases).[5]

What to do in the event of a "greenout"
Generally, cannabis toxicity improves on its own over time without medical intervention as cannabis is gradually and progressively metabolized and its effects subside. Unlike certain other substances, notably opioids—in the absence of other medical complications related to co-occurring conditions—an overdose of cannabis is highly unlikely to be fatal and most people do not need hospitalization. As long as someone can remain in a calm and safe environment, they will get through the greenout and be fine. When in doubt, it’s always advisable to seek medical assistance, and in more extreme cases of anxiety, panic, or paranoia, going to a hospital for observation with or without the administration of anti-anxiety drugs may be indicated.

When young children inadvertently consume cannabis products, rather than becoming agitated or paranoid, they tend to get lethargic, sleepy, and sometimes comatose. For them, observation in an urgent care or hospital setting is advisable for monitoring and to make sure their airways are not compromised. To prevent overdose and medical emergencies related to pets and children, the best practice is to keep cannabis secured and with its original packaging.

For those experiencing a greenout in the absence of a medical emergency, the following actions that create a calming environment can be beneficial:

Decrease the overall amount of stimulation by dimming lighting, reducing the volume of music or other sounds, and turning off the TV. That said, soothing/relaxing music or calming sounds at low volumes may be helpful.
Breathe intentionally by making your breathing slower and deeper, and breathing through your diaphragm/stomach.
If you're familiar with them, practice meditation, utilizing a guided meditation app if necessary.
If you can, call or text someone whom you are comfortable talking to about what you’re going through. If they can be with you in person, even better. Connecting with someone you trust and feel safe with can help to reassure you and decrease your symptoms of anxiety.
Keep in mind, and remind yourself as necessary, that this experience is temporary—even if it lasts longer than you would like, it will pass.

TRAUMA-
Are You Experiencing a Trauma Bond?
Recognizing the signs so you can heal from this type of relationship.
Reviewed by Jessica Schrader

KEY POINTS-
All traumatic bonds share a common pattern: they have cycles of both intermittent positive and negative reinforcement.
Traumatic bonds are introduced in childhood where traumatic experiences increase the risk of a child developing an insecure attachment style.
A person with a history of depression or low self-esteem is at an increased risk of falling victim to a narcissistic partner and a trauma bond.

A traumatic bond in a romantic relationship is defined as having a foundation based on coercive control, manipulation, codependency, and sabotage and is mixed with intermittent moments of calm. This pattern of highs and lows increases an unhealthy “attaching” between partners where the bond is strengthened.

Traumatic bonds are typically introduced in childhood between a child and their primary caregivers where traumatic experiences (neglect, abuse, invalidation, abandonment) increase the risk of a child developing an insecure attachment style, specifically an anxious, or fearful-avoidant (“disorganized”) attachment. Common environmental patterns seen in developing an anxious or fearful-avoidant attachment include: high levels of unpredictability with caregivers, inconsistent caregiving (vacillating between nurturance and dismissiveness), a lack of safety and security, narcissistic and abusive parenting, and where the child’s basic needs to feel comforted and protected are unmet.

Children reared in environments where unrealistic expectations, image, or achievements are upheld over the child’s inherent value can additionally foster traumatic bonds where the child may learn their worth as conditional for appeasing their caregivers. Similarly, this dynamic can breed a pattern of approval-seeking, perfectionism, increased risks of mental health issues including depression, anxiety, complex post-traumatic stress disorder (cPTSD), and the risk for further victimization in their adult relationships.

Traumatic Bonds and Intermittent Reinforcement
All traumatic bonds share a common pattern: they have cycles of both intermittent positive and negative reinforcement that strengthen the bond, making it difficult to walk away. Traumatic bonds are compared to having similar symptoms as “Stockholm syndrome” where there is a compulsion to seek comfort from the same person who is also a source of fear. This is especially true in cases of childhood traumatic bonds and in romantic relationships.

Risk factors for traumatic bonds include:
Family history of mental health problems.
Poor socioeconomic status.
Limited social support.
Insecure attachment style.
Poor or insufficient coping strategies.
History of being bullied or harassed.
Prior history of trauma.
Substance abuse or addiction.
Absentee or negligent parenting/caregiving.
Identity disturbances.
Narcissistic parenting/caregiving.
Existing mental health issues (depression, PTSD, borderline personality disorder, anxiety).

Aside from the above risk factors, there are several red flags that contribute to the possibility of being traumatically bonded in a romantic relationship, which include:

Behavioral Reenactment. Children raised in an unpredictable or inconsistent environment may try to make themselves feel safe by ignoring their needs for love, attention, or connection in exchange for meeting their caregivers’ expectations as a way of keeping the peace. Many learn to ignore their own needs for what their caregivers expect. Narcissistic parenting in childhood places a person at an increased risk for narcissistic romantic relationships based on early conditioning. Thus, what is learned in childhood as “normal” can be unconsciously sought out as “familiar” in our adult romantic relationships.

History of Unmet Basic Needs. A history of unmet basic needs in childhood predisposes a person to further traumatic bonding in their adult lives where their needs for safety, consistency, predictability, and belonging continue going unmet. For example, a person with a history of depression or low self-esteem from childhood trauma is at an increased risk of falling victim to a narcissistic partner where the person comes in as a “hero” and taps into their unmet needs for love or safety with “fairy-tale” promises—only to pull the rug out from under them, thus risking re-traumatization.

Obsessions/Ruminations on "Good Times." Because traumatic bonds are based on intermittent reinforcement, there is an increased risk of feeling “stuck” in the good times while downplaying the bad times. This is especially true in relationships identified with covert narcissistic abuse where manipulation can fly under the radar or may come across as concern. In healthy relationships, each person retains their autonomy. In traumatic bonds, enmeshment can negatively reinforce the bond, and further enmesh the “good times” and the toxicity.

Healing From Traumatic Bonds
If you notice similar patterns in your relationships, it’s important to recognize whether you may be experiencing a traumatic bond as it can cause significant damage to your mental, emotional, and physical health. The reason traumatic bonds are so difficult to walk away from is because of the cycles of intermittent positive reinforcement (the “good times”), mixed with cycles of intermittent negative reinforcement that tap into a desperate need for safety, belonging, and a secure attachment.

Healing from a traumatic bond requires a comprehensive approach to intervention from a trauma-informed clinician that specializes in attachment and relational trauma. It is important that a clinician help educate you on how traumatic bonds are formed and maintained, as well as provide you with behavioral goals that help you establish a sense of safety, build self-reliance, establish firm boundaries, and increase your autonomy, so you can empower yourself and your healing.

ANGER-
Bitterness: What Is Its Function?
We focus on its effects but not its neural basis or its function.
Reviewed by Gary Drevitch

When I enter “bitterness” into Google or PubMed, I receive a long list of articles and research into the taste sensation not the emotional or psychological state. I have to specifically enter the not command for sweet and taste to find a few articles on the destructive state of bitterness. On PubMed, articles refer more to the basic science of aversive states on emotional memory than specifically on bitterness; for example, Likhtik and Johansen’s abstract in Nature Neuroscience:

“While the role of excitatory and inhibitory neural circuits mediating emotional learning and its control have been the focus of much research, we are only now beginning to understand the more diffuse role of neuromodulation in these processes. Recent experimental studies of the acetylcholine, noradrenaline and dopamine systems in fear learning and extinction of fear responding provide surprising answers to key questions in neuromodulation.”

Although researchers have not focused on brain injury anger — that specific type of anger that arises out of neurophysiological injury — they have studied the brain areas involved in anger, yet without differentiating between its many forms. I suspect that each anger type would light up different pathways, one for the sense of outrage at injustice, another from one’s life being threatened, another at seeing a person being assaulted.

Clinicians who work with people who’ve suffered brain injury know that neurostimulation and/or neuromodulation release the person from brain injury anger and eradicate the constant irritation that’s like nails on chalkboard from any kind of sensory stimuli from a passing car to a person’s voice. When rebooting, repairing, and rewiring the brain through neurostimulation eliminates the type of anger that flashes on and flashes off and exists without any ability to control it, then you know it’s neurophysiologically based.

In The Brain's Way of Healing, Norman Doidge defined neuromodulation as an “internal method by which the brain contributes to its own healing. It quickly restores the balance between excitation and inhibition in the neural networks and quiets the noisy brain.”

Neurostimulation can trigger neuromodulation. Since neurostimulation includes using our sensory inputs, our environment and relationships are also a form of neurostimulation. And while Doidge talks about the healing effects, the brain’s same internal neuromodulating mechanism can also harm. Bruce Perry wrote in What Happened to You that, among “those three ‘components’ of trauma, the three E’s — the event, the experience, and the effects — PTSD is about the effects.”

We see trauma effects, including bitterness, even when we’ve missed seeing the precipitating event or the changes in the brain’s wiring. We see bitterness as an emotional state and attribute it to attitude or mental illness. UK-based Harley Therapy echoes other therapists on their blog: “the emotional reaction and mood of bitterness is referred to as ’embitterment’. It is an emotional state of feeling let down and unable to do anything about it.” They cite Michael Linden’s theory of it being a mental disorder, calling it "post-traumatic embitterment disorder," and stating “bitterness can lead to long term psychological distress.”

But isn’t bitterness inherently distressing? As Christopher Lane wrote, “bitterness strikes the person feeling it as a justified response to a social ill or personal wrong.”

Does bitterness emerge after damage to particular neurons or neural networks? Does the damaging event need to be physical, or is emotional or psychological trauma the kind of event that precipitates bitterness? Does it arise more easily in those with learned helplessness than in those whose brains have rewired to act in the face of seeming lack of control? Are there different forms of bitterness like there are of anger?

Most importantly, what is bitterness’s function?
Anger allows us to express ourself when facing injustice or oppression; it initiates action to protect another; it’s a safer way to express our distress than deep sadness or grief as the latter makes us feel vulnerable whereas anger feels protective.

Thinking about the latter, what does bitterness do for us? Perhaps it protects us from feeling the deep psychic pain from betrayal, abandonment, or intentional harm because to feel that pain would render us immobile and unable to eat, sleep, look after ourselves, engage with others.

I've written that “I became bitter when it finally penetrated my brain that doctors…who treat brain injury are simply not interested in thinking outside the box, in learning from non-MDs, in working alongside their patients.” In other words, the medical profession abandoned me to a catastrophic injury and I stopped believing I could escape that shock.

Maier and Seligman have updated their understanding of learned helplessness, as I wrote: “Prolonged exposure to trauma keeps [default neural] pathways, and thus passivity and fear or anxiety, active. For a person with brain injury, already overwhelmed by the injury and fatigue, this could add to or look like no motivation and continual anxiety…discovering one can escape shock creates the learned state.”

What happens, though, if a person has not learned, or has unlearned, that one can escape shock and experiences abandonment, betrayal, or trauma so profound that the psychic pain is unendurable? What if that person’s brain remains in the default passive state, which manifests as not believing one has any control while believing that another has full control over them and has abandoned them? Bitterness may function then as a protective mechanism against the resulting intense lacerating psychic pain.

These are the questions researchers have yet to delve into. While psychologist, pastors, and self-help experts impose guilt or labels for feeling bitter, researchers are barely studying the neural correlates of bitterness or its function. When we understand these, clinical researchers could develop effective therapies that combine neuromodulation with training the brain to learn it can escape shock and with talk therapy based on the principle of establishing a stable relationship between professional and client that counters abandonment. For ultimately, bitterness arises out of damage to one or many relationships.

Ready or Not, Psychedelic-Assisted Therapy Is Happening.
How do we make sure we don’t cause greater harm?
Reviewed by Kaja Perina

KEY POINTS-
There is still much ground to cover in ensuring proper regulation around psychedelic-assisted therapy.
Human trials for these new substances typically involve testing people who are already vulnerable; therefore, trauma-informed care is pivotal.
Identifying harms and focusing on new and safe solutions should be our goal, clearing a path for the true healing potential of psychedelics.
The world isn’t ready for psychedelic-assisted therapy.

Don’t get me wrong: If you know me, you’re aware my life has been devoted to finding and developing cures for undertreated health problems, focusing on innovations in cannabinoid and psychedelic compounds. The message of hope that psychedelics might be the healing the world has been waiting for is not lost on me: I’m a believer in it, and I’ve seen enough to keep the fire lit—in my own research as well as the studies and progress of my peers.

As a scientist, I can see a great horizon ahead, one of powerful solutions discovered, changed lives, and the potential eradication of certain diseases.

A Dark Side
But there is a well-reported dark side to the work of those advancing psychedelic research, and it is one that is very challenging to resolve. We are not only dealing with progress and possibility but also with human psychology, with the mind: the most unchartered territory left for humanity.

There is still so much we do not understand about trauma and mental illness, and—when it comes to psychedelic-assisted therapy—still too many cracks in the floorboards for abuses to slip by unnoticed and fester.

One can note the human trials for these new substances typically involve testing people who are already vulnerable: whether suffering from posttraumatic stress disorder (PTSD), sexual-assault victimization, or depression. They hope psychedelics can help them heal, and they’ve tried everything else. If retraumatization is to be avoided, there has to be as much attention paid to the regulation of therapies as there is to the development of the drugs themselves.

And, I would add, here’s where we run into an unfortunate issue: We’re not there yet. The therapeutic component of psychedelic-assisted therapy is still in nascent form when it comes to testing and instituting proper regulations.

Let’s look at Oregon, for example. Just this year, the state became the pioneering first to legalize both the manufacture and administration of psilocybin, with the caveat that the drug must be administered under the supervision of a facilitator.

The Oregon Health Authority began accepting applications for Psilocybin Service Facilitator licenses on January 2, 2023, and the requirements were simple: You have to be an Oregon resident of 21 years of age or older with a high-school diploma or equivalent and a criminal background check, then you have to complete 160 hours of training and 40 hours of hands-on experience in their psilocybin facilitator training program, finalized by an exam that determines your eligibility. Once you pass, you’re in. No other mental health treatment experience or trauma-informed care is required.

Trauma-Informed Care
And there are plenty of reasons why trauma-informed care is pivotal. Whether it comes to inappropriate touch between therapist and client in the gray space of consent in drug-induced therapies, the variety of therapeutic approaches permitted but not necessarily tested, or insufficient care and follow-through after the trials themselves, there is still much ground to cover in ensuring proper regulation around psychedelic-assisted therapy.

And time is running out.


Come July of this year, Australia will recognize and allow the prescription of psilocybin and MDMA for the treatment of certain mental health conditions. The Multidisciplinary Association of Psychedelic Studies (MAPS) announced pending U.S. Food and Drug Administration approval for MDMA as a treatment for PTSD as early as 2024. Ready or not, psychedelic-assisted therapy will happen. And our actions now will determine whether it will be the force of healing it's anticipated to be or yet another avenue of harm.

Now, I wouldn’t be true to my roots as a scientist if I didn’t highlight one further possibility, and a question that has motivated my own research: Can we create a truly safe psychedelic medicine, not dependent on a therapeutic setting? I ask this because, among the many reports of ethical and sexual misconduct related to psychedelic-assisted therapy, the abuses hinge on the actual therapy rather than the psychedelic itself.

I first heard about the novel compound MEAI (5-methoxy-2-aminoindane) in 2020. At that point in time, the evidence from use of the drug was anecdotal but powerful. I heard stories of countless individuals and families who were drinking MEAI along with alcohol, and finding that, after taking MEAI, their desire for alcohol simply…stopped. There was no therapeutic component. There was no talking about it. They just didn’t want to drink anymore.

In preclinical trials, we tested the molecule on rodents that were addicted to alcohol and cocaine. Not only were the MEAI-treated mice able to stop their addictive behavior, but there was also evidence to suggest that the molecule did not trigger a strong sense of “reward,” which researchers use to determine whether a substance is addictive. Furthermore, the molecule showed no signs of organ damage or harm—quite the opposite: In obese rodents, metabolic function significantly improved, and we also saw changes in energy expenditure, fat storage, and glucose utilization to promote weight loss.

There are promising research initiatives going on in the field right now, working to take the high out of psychedelics in order to remove some of the potential obstacles keeping a lot of folks away from these drugs. Whether or not the “trip” is the true lynchpin of psychedelic healing experiences is being questioned, and new solutions discovered, tested, and regulated.

I got into the field of psychedelic research and development because I truly believe in the healing available here. But we can’t shy away from shining light into the dark corners of our industry. Identifying harm does not mean regression—rather, it’s a way of moving forward with open eyes, clearing a path for the true potential of this movement to bring safe and effective health solutions to the world.

EMOTION REGULATION-
What Is Emotional Lability?
A guide to the causes, symptoms, and treatment of emotional lability.
Reviewed by Abigail Fagan

KEY POINTS-
Emotional lability is a rapid and intense change in a person’s emotions or mood, typically inappropriate to the setting.
Emotional lability is a symptom of various disorders including borderline personality disorder and bipolar disorder.
Ways to deal with emotional lability include being aware of symptoms, taking care of yourself, and asking for help.

Do you feel like your emotions swing all over the place? Once you start experiencing emotions, does it feel hard to stop? Or, do your emotions feel especially intense? Then you may be experiencing some form of emotional lability.

Emotional lability is a rapid and intense change in a person’s emotions or mood, typically inappropriate to the setting (Posner et al., 2014). For example, a person can suddenly start crying uncontrollably because of any strong emotion, even though they do not feel sad, frustrated, or happy. The term originally comes from the Latin word labilis, meaning “transient, fleeting, slippery” (World of Dictionary, n.d.), which highlights the dramatic and frequent shift between emotional experiences. Emotional lability can also be an over-expression of positive emotions, such as enthusiasm or energy, either disproportionate to the event or improper to the circumstance (Posner et al., 2014). One example is when a person suddenly laughs uncontrollably at a funeral.

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5; American Psychiatric Association, 2013) states that emotional lability appears as a symptom in various disorders, including:

Borderline personality disorder (BPD), which is a mental illness characterized by unstable moods, impulsive behavior, and problems in relationships.
Bipolar disorder (BP), which is characterized by episodes of intense mood swings, with depressive lows and manic highs. In bipolar disorder, emotional lability often lasts longer (e.g., days-weeks; Posner et al., 2014)
Substance use, which can include alcohol or any illicit drugs.
Attention-deficit/hyperactivity disorder (ADHD), a common disorder defined by inattention, hyperactivity, and impulsivity.

Post-traumatic stress disorder (PTSD), a disorder in which a person struggles to recover after witnessing or experiencing a traumatic event.
What Are Emotional Lability Symptoms?
Extreme emotions and sudden mood shifts. For example, those suffering from emotional lability experience intense feelings that change rapidly and often fluctuate throughout the day.
Improper reactions. If a person laughs uncontrollably at a funeral, it is a sign of emotional lability, as it refers to inappropriate reactions.
Difficulty controlling emotions. People who experience emotional lability may have little control over their feelings, which can make it more difficult to stop them.

​Emotional lability can negatively impact a person’s daily life and these behaviors can be confusing or embarrassing.

How to Deal With Emotional Lability
If you, or someone close to you, are experiencing emotional lability, here are a few things to do to better cope with it (Acquired Brain Injury Outreach Service, 2021).

Be aware. It is important to be aware of what triggers emotional lability and to try to avoid them whenever possible. Some of these triggers include extreme fatigue, stress, or certain social situations or environments.
Take care of yourself. By taking care of yourself, both physically and mentally, you may reduce tension and stress. Make sure that you get enough sleep every night, have a balanced diet, and exercise regularly. By doing something that makes you feel better, such as going on a stroll or spending quality time alone, you may increase your overall well-being.
Take a break. If you experience lability, it’s OK to take a step back for a few minutes to cope with the emotions.

Find a distraction. Sometimes it can be helpful to change the topic or to engage in a different activity to reduce stimulation and regain control of the emotions.
Acknowledge the feelings. It’s important to realize that sometimes you can’t control your emotions, and that’s OK. You just have to take care of yourself and practice self-compassion.
Educate. Other people can be confused or frightened about what they can’t understand. If you feel comfortable, you can let people know what happened.
Ask for help. It is important to remember that you are not alone in this. You can talk to your friends or family members, or ask for help from a professional, such as a therapist or psychiatrist. ​
In summary, emotional lability can be a challenge. By understanding its roots, it may become easier to manage.