On this page, we cover:
- What MDMA therapy looks like
- Why MDMA therapy helps
- Benefits of MDMA therapy
- MDMA & PTSD
- How to become an MDMA therapist
- Other beneficial resources related to MDMA therapy
General Overview Video of MDMA Therapy
This is a great video if you’re new to the topic of MDMA psychotherapy.
What Does MDMA Therapy Look Like?
“A full course of treatment involves three 90-minute Preparatory therapy sessions, three total 8-hour MDMA therapy sessions, and nine total 90-minute Integrative therapy sessions, summing about 42 hours of therapy.”1
During the therapy, the client is provided eye shades and headphones, and they spend the majority of the MDMA session time with their eye shades and headphones on, listening to a provided MDMA therapy music playlist.
Here’s a good description of the MDMA therapy process:
There’s three prep sessions, MDMA Day 1, three sessions, MDMA Day 2, three sessions, MDMA Day 3, and three integration sessions to follow up. It takes five months overall.
After the three prep sessions, people are screened to make sure they don’t have high blood pressure, heart disease, or any number of problems. People have to wean off most, if not all psychiatric medications. On the MDMA day, people come in, and we test them to make sure they’re not pregnant or taking other substances. We check in with them, and then, usually around 10AM, they take the medication — or the placebo, in terms of the double-blind study. Then we sit with them.
Typically, they wear headphones and blinders, and they go inside — we encourage them to be inside at least 50% of the time. We check blood pressure. At some point, they’re offered a supplemental dose, which is a dose of MDMA in addition to their initial dose, usually about half of the amount.
We sit with them for eight hours, encouraging them to go inside, processing when they’re not, helping them through difficult points and helping integrate the experience. Usually, by around 5PM, they’re feeling ready to make a transition, and we hand them off to a sitter, who spends the night with them in the clinic. They have their privacy in the room — the sitter’s available on the other side to keep them safe overnight. The therapy team comes in the next morning, checks them out for a 90-minute session, and helps them process their experience. If all is well, they go home.
They have three more prep sessions the following month, and then we schedule their next MDMA session.2
What is the MDMA experience like? The best way to answer that is to watch the MDMA therapy documentary “Trip of Compassion.” You might also want to read this page: How does Molly (MDMA) make you feel?.
Note: MDMA psychotherapy is the same thing as MDMA assisted psychotherapy and the same thing as MDMA therapy.
Why Does MDMA Seem To Help?
MDMA therapy seems to work by helping you trust yourself and helping you accept parts of yourself. MDMA provides a feeling of safety, peacefulness, and love, that allows you to revisit both past experiences and parts of yourself that you don’t fully accept. The MDMA also enhances the bond between the client and the therapist, which also seems to help enable deeper healing.
“MDMA is known for increasing feelings of trust and compassion towards others [editor note: and towards the parts of yourself that you don’t fully accept], which could make an ideal adjunct to psychotherapy for PTSD.”3
MDMA Therapy Benefits
Reports and in some cases clinical evidence highlight the promise for MDMA therapy helping with:
- Relationship satisfaction and couples therapy
- General personal growth and life enjoyment
“One day, I met a therapist who recommended using MDMA to get ‘unstuck.’ From the very first session, I began making amazing breakthroughs. The split between my mind and my body began to dissolve. Being present in my body became an experience, not a concept. My heat opened. I could access blocked emotions as never before. As I continued psychedelic therapy, I discovered and worked through trauma of childhood neglect and abuse. Hidden sources of my chronic illness, anxiety, and depression were revealed. My colitis healed, my depression vanished, and my health improved. As my sexual and relationship issues healed, I was able to manifest the healthy, happy marriage I enjoy today. I spent years in cognitive and Reichian therapy before I discovered psychedelic-assisted psychotherapy. I meditated, practiced yoga, got Rolfed and rebirth. All these were helpful, but were only able to take me so far. I believe that without the help of psychedelics I would never have healed. Psychedelic therapy saved my life.” – R. Coleman in the book Psychedelic Psychotherapy: A User-friendly Guide for Psychedelic Drug-assisted Psychotherapy
“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.”4
“I did MDMA therapy. It was a deeply profound and life-changing experience. I did two treatments, one in early September, another in early October. I would rank it as one of the top 3 most important things I’ve done in my life, at least in terms of my personal development. I’m writing about it because I think this therapy could help a lot of people, and more people need to know its an option. In this piece, I’ll explain why I did it, what it was like, how it impacted me, and resources for how to seek out more info. I’m not trying to convince you to do MDMA therapy, but I won’t pretend to be objective. I do have a viewpoint: MDMA therapy fundamentally changed my life, I think it could be impactful for many people, and I believe it will become a major part of the future of therapy.” – Tucker Max in What MDMA Therapy Did For Me
Where Can I Do MDMA Therapy?
Unfortunately, there aren’t any legal MDMA therapy centers that we’re aware of.
We’ve been told by multiple people that it might be legal for someone to set up a legal MDMA center in a place that isn’t a regular country: possibly Antarctica, the Isle of Man (or similar), or perhaps in international waters. But, we’ve not heard of one that exists yet.
Hopefully later in 2019 MAPS will have an Expanded Access protocol with the FDA that will allow some clinics to provide MDMA therapy to people with PTSD, even if those people aren’t in the MAPS clinical trial.
Available MDMA therapy alternatives
If you’re interested in MDMA therapy, we highly recommend looking into IFS therapy. It’s a primary method used by MAPS MDMA therapists and you can work with it today, with or without a therapist. You may be able to get some, but not all, of the benefits of MDMA therapy just by doing IFS therapy. Check out our page on IFS therapy here.
Volunteering and Participating in MDMA Research and Clinical Trials
FDA has granted MDMA “Breakthrough Therapy” status, which means that “preliminary clinical evidence indicates that the drug may demonstrate substantial improvement over available therapy.”5
Basically, ecstasy has massive promise for treating PTSD.
In studies analyzed, MDMA for PTSD had a large treatment effect, and effectively cured 54% of the participants’ PTSD.6
“After two blinded experimental sessions, the active group had significantly greater reductions in CAPS-IV total scores from baseline than the control group [MMRM estimated mean difference (SE) between groups − 22.0 (5.17), P < 0.001]. The between-group Cohen’s d effect size was 0.8, indicating a large treatment effect.”6
“After two experimental sessions, more participants in the active group (54.2%) did not meet CAPS-IV PTSD diagnostic criteria than the control group (22.6%).”6
MAPS was founded in 1986. MAPS’ goal was to make MDMA an approved medicine. They’ve made massive strides since then and are in the home stretch. MDMA has passed Phase 1 and Phase 2 studies, and is now in Phase 3 studies with the FDA to treat PTSD.
If approved, MDMA would be legally prescribable by doctors for medical conditions. That said, patients are unlikely to be able to take the MDMA home. It’s more likely that it’ll be prescribed for in-clinic use only, and the MDMA will be sent directly to a therapist who will then give the MDMA to the patient, and then sit with them for the next 8 hours during their MDMA therapy.
“In the early 1990s, the FDA approved the first human trial exploring whether MDMA could help relieve pain in terminally ill patients, as well as serve as an adjunct to psychotherapy.”7
The primary phases that a drug must go through to get FDA approval are Phase 1, Phase 2, and Phase 3. If you’re interested in learning about the FDA approval process, we recommend reading the book “New Drugs: An Insider’s Guide to the FDA’s New Drug Approval Process for Scientists, Investors and Patients.”
PTSD Clinical Trials
How To Become an MDMA Therapist
It might be possible to become a legal MDMA therapist in the USA in 2019, via MAPS’ FDA Expanded Access program. To apply you need a prescribing MD or similar, a licensed therapist, and a qualified site. To begin applying, see the instructions under “how to apply” on this page: https://maps.org/training
Is MDMA Therapy Safe?
It has a pretty great safety track record. “In laboratory studies, pure MDMA has been proven sufficiently safe for human consumption when taken a limited number of times in moderate doses.”10
Please note that the MDMA research trials exclude people with uncontrolled high blood pressure, certain heart issues, symptomatic liver disease, and history of hyponatremia or hyperthermia, amongst other criteria.9
MDMA Therapy Playlists
MDMA Therapy vs Psilocybin Therapy
“IMO, MDMA is much easier to handle than Tryptamines and involves less risk (assuming you’ve reagent tested it to confirm it’s actually MDMA). This means that it’s a good starting point. If the therapy with MDMA doesn’t help in the desired way, then therapy with Tryptamines should be tried. Also, I’ve found that MDMA is very good at helping to deal with past traumas, things that you find very hard to think about while sober. Tryptamines help to deal with questions we don’t have the answers to, questions that we would like resolved to help live a less confusing life. Such as; What happens when I die? What is the purpose of life? And other existential dilemmas.”11
“I’ve always seen it that MDMA is about changing your patterns of emotional appraisal and changing your evaluations of the propositions/facts you believe about yourself and the world. The tryptamines seem to be about changing your patterns of metaphysical appraisal and changing your beliefs (i.e your very understanding of propositions/facts or those ‘facts’ themselves) about yourself and the world. As an example: MDMA can make you content with the fact that there is suffering in the world, and mushrooms can make you see that ‘suffering’ doesn’t actually exist as we live under a veil of ‘maya’ or illusion, or something of the likes. This means that MDMA might operate on more epistemically sound principles (as they change your emotions more than metaphysical beliefs), but tryptamines (whilst risking a compromise of belief systems) seem to work at a much deeper level.”11
“The classic hallucinogens (fwiw, LSD isn’t a tryptamine) seem to be well-suited for mental conditions marked by rigid, compulsive processes of thought and behavior, such as depression and addiction. The drugs seem to “break up” these routinized, reified processes. The posttraumatic psyche may be too vulnerable, too loose, have too little ego strength/integrity for the ego-dissolving properties of the classic hallucinogens, which may be why MDMA (which seems to reliably invite deeply felt self-compassion, self-forgiveness, and self-love) may be better suited for PTSD. That said, most cases of addiction and depression likely have trauma in their etiology, and there is plenty of anecdotal evidence supporting the efficacy of the classic hallucinogens in treating trauma as well, so these formulations are very tentative (hence the abundance of “seem”s and “may”s). Clinically, the unique interpersonal effects of MDMA (trust-enhancing, empathy-promoting) facilitate the psychotherapeutic process (the therapeutic relationship is more salient in MDMA therapy than psilocybin therapy, which focuses more on the mystical experience than interpersonal therapeutic processes per se). MDMA seems to be gentler and tolerated more easily, but IMO the healing it catalyzes is less profound & global. IMO the ideal therapeutic model would integrate the use of a variety of psychedelics (psilocybin, MDMA, ketamine, & others), as they all seem to produce different & valuable curative effects.”12
See TripSafe.org’s page on psychedelic therapy for useful info about psychedelic therapy with other substances like psilocybin and LSD.
Alternatives and Complements to MDMA Therapy
Things you might want to look into:
- Eye Movement Desensitization and Reprocessing (EMDR)
- Internal Family Systems (IFS)
- Voice Dialogue
- Sensorimotor Therapy
- Holotropic Breathwork
- Jungian psychology
- Buddhist psychology
- Other somatic therapies
These are mostly sourced from methods that MAPS believes are valuable for MDMA therapists and researchers.13
MDMA Therapy and Internal Family Systems (IFS)
MDMA therapy seems to enhance IFS therapy. IFS is a primary therapy method used by MDMA therapists. Comments on IFS I’ve seen include “IFS is the most useful form of therapy that you can perform on yourself” and “this method led to more progress than any other tactic I tried in therapy.”
“In our experience, MDMA in a therapeutic setting often raises awareness of different “parts” of the psyche and simultaneously brings forth more “self-energy” to allow exploration of the parts with greater compassion and clarity (“parts” and “self-energy” are IFS terms; other models would describe the same phenomenon somewhat differently). We’ve been conducting a small internal pilot study within our current study of veterans, firefighters, and police officers with PTSD, tracking how often awareness of parts comes up. Our preliminary analysis reveals that study participants have spontaneously brought up their awareness of different parts of themselves in 81% of the MDMA-assisted sessions, and greater understanding and acceptance of these parts have often been important elements in the therapeutic process.”13
See our separate page on why you may want to look into IFS therapy if you’re interested in MDMA therapy.
Other MDMA Therapy Resources
See our page on psychedelic therapy for useful info about psychedelic therapy.
Check out the MAPS MDMA therapist training manual.
Check out an example MAPS MDMA study protocol.
Check out our recommendations of the best books about MDMA therapy here. For example, if you want to understand why MDMA therapy is important, and the history of the field: read Acid Test. If you want a practical guidebook to psychedelic (including MDMA) therapy: read Psychedelic Psychotherapy by R. Coleman. See the full list of book recommendations here.
Tucker Max notes that “if you are thinking about taking MDMA for the treatment of trauma, I would highly recommend reading Trust, Surrender, Receive. This is the book that started it all for me.”14
MDMA Therapy Documentary
Rent and watch the MDMA therapy documentary “Trip of Compassion”. Highly recommended.
- https://maps.org/training [return]
- https://maps.org/news/media/7455-rooster-magazine-an-mdma-therapist-on-how-it-works-and-why-it%E2%80%99s-better-than-current-treatments [return]
- https://maps.org/research/mdma [return]
- Changing Our Minds [return]
- https://www.fda.gov/patients/fast-track-breakthrough-therapy-accelerated-approval-priority-review/breakthrough-therapy [return]
- https://link.springer.com/article/10.1007/s00213-019-05249-5 [return]
- https://www.drugabuse.gov/publications/research-reports/mdma-ecstasy-abuse/what-is-the-history-of-mdma [return]
- https://clinicaltrials.gov/ct2/show/NCT00090064 [return]
- https://clinicaltrials.gov/ct2/show/NCT03537014 [return]
- http://www.maps.org/research/mdma [return]
- https://www.reddit.com/r/PsychedelicTherapy/comments/blvkjz/mdma_vs_tryptamines_lsd_psilocybin_in_therapy/ [return]
- https://www.reddit.com/r/PsychedelicMedicine/comments/blvey3/mdma_vs_tryptamines_lsd_psilocybin_in_therapy/ [return]
- https://s3-us-west-1.amazonaws.com/mapscontent/research-archive/mdma/TreatmentManual_MDMAAssistedPsychotherapyVersion+8.1_22+Aug2017.pdf [return]
- https://medium.com/@tuckermax/what-mdma-therapy-did-for-me-41ffe5f15971 [return]