These excerpts should be useful to anyone interested in MDMA therapy, or anyone participating in MDMA psychotherapy research trials.
If you’re involved in MDMA therapy, it is important to follow safety guidelines for using MDMA. View the page on how to use MDMA.
“MDMA is a psychotherapy tool par excellence,” Wolfson said. “It allows us to work with people with an open mind and an open heart in conversation for prolonged periods of time.”1
Subjective desirable results of MDMA therapy
“MDMA not only opens up trust in the other person, but trust in yourself. You can go back to situations you are not ordinarily able to even think about and start talking about them, looking back, but then realizing that you are no longer there anymore. You are safe now and don’t have to react in those old ways.”1
Thirty years later the woman, a successful professional, says she still finds the experience too disturbing to want to discuss at length. “But the most important part,” she says, “is that, yes, I had chronic PTSD and I tried lots of different things and my life was really difficult and MDMA really turned it around and saved my life. That’s what is important.”2
“I was able to see myself as separate from my negative experiences. I had thought of those negative experiences as expressions of who I was. I felt guilt and shame about a lot of things and had internalized a lot of that. Because of the sessions, I realized that things that happened weren’t my fault and there wasn’t anything wrong with me. It was just life.”1
Excerpt From: Tom Shroder. “Acid Test: LSD, Ecstasy, and the Power to Heal.” iBooks.
General information relevant to the therapist and the participant
It’s not a 6 hour process.
“As we’ve said—I can’t emphasize this enough—the process isn’t just the six hours when you take MDMA. We know that some of the most important stuff happens in the hours and days that follow, and sometimes the unfolding is difficult.”2
Beyond the MDMA therapy session
Information for the partner to adjust.
Beverlee, who at least had been used to Nick’s icy, silent rages, found it difficult to adjust to him needing to be alone even when he was feeling perfectly fine. He was so different, it made her wonder if he was still going to need her. After an awkward first night, they both sat down with Michael and Annie, who helped her see that it wasn’t that Nick was upset with her or that they’d lost their connection. “It was just that he still needed to go within himself to finish the healing. But I noticed a huge difference,” Beverlee said. “Like, things that I would say or do that would cause him to blow up before, he would just laugh it off or he would just calmly talk to me. He wouldn’t blow up at me anymore.”2
The MAPS MDMA Therapy Manual
This manual provides researchers with a method of MDMA-assisted psychotherapy to be used as a model in conducting these trials. This manual is intended only for use with subjects of an approved clinical trial who have provided their informed consent.
Don’t fix, encourage curiosity and courage.
Rick knew from sitting with people in Grof’s workshops that he couldn’t attempt to “fix” the traumas that were emerging under MDMA’s influence, but that by encouraging the woman to face them with curiosity and courage instead of fleeing or denying them, which the drug theoretically gave her the strength to do, she would gain power over the memories rather than continue to let fear of them shut down her life.2
Accept things that come up, even if they seem strange to you.
He’d learned from Grof, and the entire history of psychedelic therapy, that what was important wasn’t if they were “real” but if they could help heal.
In the therapy training manual Michael was writing for future MDMA therapists, he put it this way:
“Such experiences can be difficult to interpret, and in some cases may challenge the therapists’ own belief system. The therapists are not required to understand or even have an opinion about the ontological status of these experiences, but it is essential that they accept them as real and important aspects of the participant’s experience and convey respect for and openness toward the participant’s own view of them without dismissing or pathologizing any experience based on its unusual content.”2
Encourage them to have no expectations, and to go with the flow.
“Good,” Michael says softly, nodding. “It can be really useful to identify that intention and then let go of any idea of what that should look like. You may find yourself having experiences that don’t look like that at the time and then later you realize, ‘Oh, wow. Look at the way that healing intelligence responded to that intention in a way I never would have expected.’ That’s kind of the beauty of it. Rather than a plan in your rational mind, go with the healing intelligence. The medicine will respond to that intention.”
In other words, don’t push the river, which seems to be good advice for both psychedelic drugs trips, and life itself. One of the secrets to a successful session with MDMA or psilocybin is getting out of your own way. Stop trying to control your thoughts or feelings. Go with the flow. Face your fears. Don’t try to hide or repress them.1
What are the sessions like?
Allow me to make two suggestions that may help you understand what happens during an MDMA-assisted psychotherapy session. First, forget everything you think you know about the drug known as Adam, Ecstasy and Molly. Stop thinking about gay dance clubs, or hipster raves with hundreds of wired revelers crowded into warehouses dancing all night to industrial/techno/tribal beats. Don’t picture people sucking on lollipops or running around naked at Burning Man. Second, free your mind of whatever associations you have about the standard fifty-minute therapy session between a patient and a psychotherapist. Instead, try to imagine a therapy session where no one ever says, “That’s all the time we have now. Let’s continue this next week.”1
There’s quite a bit of encouraging new ways of looking at things.
“They asked pointed questions about my memories. ‘Was there another way I might have looked at that? Did I have evidence for that particular belief?’ Sometimes I didn’t have evidence for things I’ve incorporated into my narrative.”1
Beginning a session / session setup
Asking for intentions.
Nick’s second session with MDMA came a month after the first.
“Any intentions for today?” Michael asked as Nick settled back into the futon.2 … Nigel looks a little nervous, which is not surprising for someone who is about to take a mind-altering drug and talk about traumas he hasn’t wanted to discuss for seven long years. He’s been asked to come into the session with an intention of what he hopes to get out of the time he’ll spend with Michael, Annie and the MDMA, which they referred to as “the medicine.”
Did he get a chance to think about his intention?
“Well,” he says, “I’d like a greater depth of understanding of my mental processes, to understand myself better. Why do I do the things I do?”1
Eyeshades, noise-canceling headphones, and soft music.
“Are you ready to take your capsule?”
Nick gingerly plucked the pill from the bowl Annie handed him and swallowed it with a nervous smile and a swig of water, then sat back against a cushion propped against the wall. Minutes passed. He wasn’t certain how many, but it seemed like quite a while. He chattered nervously.
“Would you like to try the eyeshades?” Annie asked a half hour in.
He put on the green foam eye mask and the large noise-canceling headphones she handed him and lay back. A gently tinkling piano, like a sleepy spring rain, played over the headphones. The piano gave way to a plaintive violin and then to a flute that sounded at first almost human, then like the lonely cry of a wolf. There was something vaguely Native American about the sound of the music.”2 … Evocative music and eyeshades encourage the research subjects to go within for long stretches, and then emerge from this inner journey when they feel the need to talk about whatever thoughts, feelings or visions arise.1
More about the soft music.
After a few minutes, Nigel reports that he’s feeling a little anxiety, more in his body than his mind. He decides to lay back, put on the eyeshades and let Annie start the soundtrack that will accompany his journey for much of the next six hours. It starts with sounds of a gentle tinkling piano, almost like rain. Nigel chooses not to wear headphones, so the music is played over speakers in the room.1
During the session
Checking in, and asking if they are feeling something.
“Nick was lost in that memory when he felt a touch on his shoulder. It had been an hour since he’d swallowed the pill.
“Just checking in,” Michael said.
Nick pushed up the eye mask, blinked, and said, “It’s brighter out here than I thought.”
“Are you feeling anything, Nick?” Annie asked.”2
Suggesting that they go back inside (with eyeshades and headphones back on)
“Nick shot up from the futon and yanked off his eye mask. “Ohhh, I have to tell you something! I breathed when I had anxiety, and it just vanished.”
“Just do that every time,” Michael said, “and let us know if you need any help with anything. Would you like to go back inside?”
“Oh, yeah,” Nick said. “Let’s go back.”2
Why are you talking?
It just kept spilling out. Michael sat to his right on a blue-leather office swivel chair, in his jeans, this-is-who-I-am ponytail, and gray Mister Rogers sweater; Annie to his left on a wide, neutral-colored armchair, her thick, curly brown hair held off her broad, strong face by a hair clip. Annie said that the main thing she learned about being a therapist from watching tapes of her sessions was Why are you talking? and she’d learned her lesson well. Nick’s flow of words were self-directing. You could almost see his brain turning these new ideas over, shuffling them, tilting them at different angles.2
Helpful suggestions. And just because it looks like nothing is happening, doesn’t mean nothing is happening.
“If there’s a splinter,” Michael said, “it’s important to get the splinter out, but there may be a scar; that is part of healing. It’s still there, but it’s healed. I don’t know if that resonates.”
“I still feel like there’s something there that’s … that’s … kind of lurking around in the background.”
Michael’s experience told him it wasn’t up to him to talk whatever it was out in the open. It was up to the MDMA.
“Now might be a good time to go inside again with the music and just see what might be there,” he suggested. “Does that feel right? Then come out and let us know.”
Nick went back into Native American chants and wispy space music. The face behind the eye mask revealed nothing. Michael would later use the video of Nick’s session to make the point to would-be therapists that in MDMA sessions it could often look as if nothing were happening when in fact worlds were being created or destroyed.2
Suggesting that they ‘be with’ things.
“The only thing that was coming to my mind was being a kid, just kind of being apart from everyone else, feeling significantly different,” he said when he pushed the eye mask up. “I just feel connected to how I did when I was younger, out of place.”
“Just be with it,” Annie said. “Try not to move away. It’s coming for you to see and feel it.”2
Helping them re-write their stories, and also encouraging them to ‘go back inside.’
“I don’t like saying it, but part of me wanted to go over there and shoot someone.”
Michael leaned in closer. “It makes sense that there was a part of you that wanted to,” he said, his voice calm, low, as if wanting to kill was the most natural thing in the world. “But it’s just a part. It’s not all of you.”
Nick’s eyes moved, rippling the closed lids.
“I feel bad that I wanted to do that,” Nick said, as if Michael’s words hadn’t quite registered. “We all have those kinds of feelings,” Michael said. “What matters is that’s not all of you. Your heart is much different than that.”
“I don’t like how I cannot feel,” Nick continued. “That part right there seems not human. I just blamed it on the PTSD.”
“You’re exploring another level of it,” Michael said.
Annie, who’d been taking this all in from the other side of the futon, gave Michael a glance. “Seems like maybe this would be a time to go inside, if it feels right to you,” she said.
“We’ll be right here,” Michael said.
A half hour later, Nick pulled off the eye mask.
“I realized that I’d come to believe because I got picked on and was an outcast that I believed I was supposed to be, so I pushed people away too.”
“Sometimes,” Annie said, “these stories we tell ourselves about our childhoods need to get rewritten.”
Nick nodded. “I had a vision of me now telling the young Nicholas, ‘When you’re older you’ll have better friends than you have now, and people will like you,’ but that young Nicholas wasn’t getting it; it wasn’t sinking in.”
“Sometimes that’s what it takes with our young parts,” Michael said, “to bring them into the present. Anything that young part wants to show us or you before he’s ready to come to the present?”2
“Tell us more about that”
“Just a lot of fear,” he said. “Being alone in the world. I felt haunted when I was a kid; that’s why I felt scared.”
“Tell us more about that,” Annie said.
“Seeing the things I saw, I felt haunted.”
“What were the things that you saw?”2
“What is it about it that’s uncomfortable?” Annie asked. … “But it still scares me.”
“What scares you about it?” Annie asked.2
Asking about stress
Before the session and several times during it, Michael will ask Nigel how much stress he feels, on a scale of one to seven. At the beginning of the session, before he took the medicine, Nigel said his stress level was a three. It went down to two as he was coming onto the drug, but after this round of going inside, Nigel reports a stress level of four.
“Can you say something about the stress?” Michael asks.
“It feels like an inner conflict,” Nigel replies, “but nothing really specific.”
“Where is that energy in your body?” the therapists ask.
“In my chest area,” the patient replies.1
Encouraging breathing methods
Michael asks him to talk more about the stress he’s feeling.
“It’s a feeling of being at odds with the world around me,” Nigel says.
“Try breathing into that place in your body where you feel that and see what the medicine may tell you about it,” Michael says. “It may feel like a teaching or an energy shift.”1
Then something odd happened. He heard a voice inside his head say, Breathe! You’re too tense.
In the prep sessions, Michael and Annie had warned him that some people got anxious when the drug effects began, and told him to try to take deep, slow breaths if that happened. He tried that now. He visualized the tension in his body and directed his breath into the tension, just as they’d told him to. As his lungs drew in the air, the tension vanished like fog before a rising sun. He could feel it evaporating through his skin, leaving a warm, evanescing glow, as if he had been lathered in Vicks VapoRub.2
MDMA for PTSD
“Their scores on the assessment test given four days after their MDMA sessions, and again, two months later, no longer merited a diagnosis of PTSD, a clinical success rate of 83.3 percent after just two therapy sessions. Of the eight participants who initially got therapy with a placebo, only two (25 percent) had similar improvements in their PTSD symptoms, and all but one opted to do an additional open-label session with MDMA. All seven who did the further session responded dramatically and retested below the threshold for PTSD at four days and again at two months.”2