What it's like to take MDMA during therapy

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CJ Hardin, a 40-year-old avionics manager and aircraft mechanic in Charleston, SC, developed PTSD after serving in the military. This qualified him to participate in a study several years ago by the Multidisciplinary Association of Psychedelic Studies (MAPS), which used MDMA — commonly known as molly when used as a party drug — to aid in psychotherapy sessions.

Hardin underwent three eight-hour therapy sessions, which each involved two therapists, under 125 mg of MDMA. “I was able to access my feelings without fear and convey them to people who were not in my immediate circle,” he recalls. “[The MDMA] allowed me to talk about things that I wouldn't normally talk about, and it also allowed me to have the introspection to look back and determine the history of how I got to my condition and diagnosis. Once I was able to do that, the healing process seemed to happen without my assistance.”

Since then, he’s been able to get married and hold a full-time job that involves working with people, which he hadn’t considered possible before the treatment. “I had resigned myself to a life of numbing myself and communicating to the outside world via Facebook whenever I wasn't too anxious to open the page, which was often.”

Hardin is one of only a few people to have participated in this kind of trial, but soon, MDMA-assisted therapy will be available to more people. In January, the FDA announced that it was opening 10 sites across the country for 35 more people with treatment-resistant PTSD to receive MDMA-assisted psychotherapy through its Expanded Access program, which may grow to accommodate larger numbers of patients if the new motion yields positive results.

Marcela Ot'alora G., MAPS’s principal investigator for MDMA-Assisted Psychotherapy Research, is leading a phase III study — the last needed before applying for FDA approval — on MDMA-assisted psychotherapy as PTSD treatment. She tells Mic the typical process includes three MDMA-assisted therapy sessions (or placebo-assisted sessions so the researchers can see which benefits are attributable to the MDMA), as Hardin experienced, and three preparatory therapy sessions before and after each.

Participants are given the option to use headphones and eyeshades to focus on their internal experiences, and music is usually played throughout sessions. Ot'alora has seen patients develop greater trust in themselves and others, healthier coping strategies, and better understanding of who they are after undergoing this process.

These benefits may stem from MDMA’s ability to down-regulate activity in the amygdala, the brain region responsible for fear, so people are able to discuss and work through things that would previously trigger them, explains Bruce Poulter, a sub-investigator on MAPS’s MDMA-assisted psychotherapy studies. As a result, they can potentially develop better relationships to these memories. MDMA may also improve therapy sessions by fostering a sense of closeness between the therapist and the client.

While it may feel cutting-edge, this type of therapy has been happening since long before researchers began formally investigating it. People received an estimated 500,000 doses of MDMA in psychotherapy sessions in North America before the US criminalized it in 1985, according to a MAPS brochure on the topic, and it continues today underground. Anthony, a 29-year-old project manager in Denver who chose not to disclose his last name to avoid legal ramifications, underwent this kind of therapy with his husband last year. They first participated in four months of non-drug-assisted therapy with a licensed psychotherapist, then the therapist came to their home and did a day-long MDMA-assisted session with them.

Both of them delved into past traumas; Anthony recalls punching a pillow while expressing pent-up anger from childhood. “I recognized that my experiences had warped my perspectives on the world, but now, that warped lens was shattered,” he recalls. “It was one of the most liberating moments of my life.” Similar to Hardin, Anthony describes MDMA as allowing him to “waltz into the bank vault of [my] mind without setting off all the internal alarm bells and protections that are usually barricading the entrance.”

Even after the drug wore off, Anthony retained the emotional space it brought him into. “I got a very different view of my mind. In turn, I learned a very different way to interact with all the feelings and thoughts that come into it on a daily basis,” he says. “My neutral state is a lot calmer than it used to be, I interact with myself and others more mindfully, and I've started living a life more centered around my values and what is important to me instead of revolving my life and choices around the management of my own feelings.” Even though couples’ therapy wasn’t the intended purpose (sometimes it is), the session also brought Anthony closer to his husband.

Using MDMA is not without risks, recreationally or therapeutically. When patients relive painful memories under the drug, there’s a chance that they could be retraumatized, says Poulter. However, this problem is usually avoided with proper emotional support from therapists.

MDMA can also have negative physical side effects, including depression in the days following treatment due to depletion of the neurotransmitter serotonin. Telaroli describes feeling “less social and more introverted” in the weeks after his MDMA session and says 5 HTP supplements helped restabilize his mood.

Research on MDMA as therapy is still in its nascent stages but in the meantime, health experts are working to make it a reality for people who can benefit from it. MAPS has proposed that once the first 35 patients in the new program have received treatment, it will submit data to the FDA and seek approval to expand it. The organization is also wrapping up its phase III trials for MDMA-assisted psychotherapy, which could make this type of therapy a legal prescription treatment for PTSD if it yields positive results.

“I did feel a bit overwhelmed by the sheer volume of changes that started happening on their own in my life as I unpacked all that I had learned,” he says. “Continuing to go to therapy helped me stay centered and grow. I have continued to remind myself that I need to be gentle with myself and integrate changes slowly and lovingly, and so far, I’m happy to say that I’ve succeeded at doing so.”