MDMA (ecstasy) is once again being researched for use in therapy. This article from H+ offers a great overview of the history of psychedelics in mental health research and therapy. It's worth noting as well that psilocybin and LSD are also being researched again - all of which is long overdue.
Soul Medicine: Ecstasy (MDMA) as Therapy
Date Published: December 23, 2009In 1912, Jung publishes Transformations and Symbols of the Libido. The book introduces the concept of the collective unconscious and furthers his position regarding the mytho-poetic nature of the psyche; in 1912, ambient trance music has never been heard; in 1912, the German pharmaceutical company Merck files a patent that includes an aside about two new molecules that will spawn 100,000 raves, fortify the cult of the “Burning Man” celebration, and just possibly be the cure for at least one undeniably debilitating affliction. The molecules:
3,4-methylenedioxyamphetamine (MDA) &
MDA reached the psychedelic underground in the mid- '60s. Nicknamed the love drug, it reportedly induced a feeling of sensuous euphoria. It was declared useless as medicine and dangerous for citizens, (though many of those citizens wanted it), and made illegal in the United States by the Controlled Substances Act of 1970. MDMA however remained under the radar until well into the ‘80s and underground chemist continued to manufacture and distribute the drug.
3, 4-methylenedioxymethamphetamine (MDMA)
— also known as the street drug EcstasyIn 1978, Dr. Alexander (Sasha) Shulgin (who had synthesized the drug in 1976) with Dr. David Nichols of Purdue University) published the first human study of MDMA in the scientific literature. He described the MDMA experience as “an easily controlled altered state of consciousness with emotional and sensual overtones.”
Dr. Shulgin completed his Ph.D in biochemistry from the University of California, Berkeley in 1954. He completed his postdoctoral work in the fields of psychiatry and pharmacology at the University of California, San Francisco. It was while working as a senior research scientist with Dow Chemicals that he created the world’s first biodegradable insecticide and was thus given free range to pursue his own research by the chemical giant.
Highly influenced by that perennial of psychedelic literature, Aldous Huxley’s Doors of Perception, in which Huxley analyzed and praised the effects of mescaline, a psychoactive alkaloid of the peyote cactus, the young Dow Chemicals scientist decided he too had to experience first hand the wondrous "Heaven and Hell" of psychedelics. One mescaline trip was enough to transport the chemist on the journey of his life. His life's purpose would be to study, synthesize and experiment with some of the most powerful and intriguing psychoactive molecules on this and probably any other planet. MDMA, which is structurally similar to both mescaline and to amphetamine, particularly tweaked his interest.Photo: harpercollins.comDr. Shulgin was in contact with many practicing psychotherapist in and around the San Francisco Bay area. He suggested they try out this new phantastica of personal discovery, a short acting, non-addictive drug with apparently few undesirable side effects that seemed to invoke a most agreeable experiences of empathetic understanding and blissful bodily sensations. An enticing additional effect -- Shulgin found that the drug triggered the recall of emotionally charged memories.
The therapists were intrigued and started their own investigations. They quickly ascertained that the pill did act as the research scientist suggested -- it could be used quite handily in relationship therapy, and its ability to facilitate access to traumatic emotional content, when contextualized within the right setting and support, advanced the healing process many fold.
Handled with Care
Though there was excitement about this new drug, the attitude held by the research community was tempered by experience. Mainstream psychiatry had been seriously burnt when it had embraced psychedelic drugs in the ‘60s, as the media broadcasted the remarkable findings with sensational and bizarre but enticing tales that spooked conservatives. Before Dr. Timothy Leary took centerstage and the youths swallowed up the message to experiment with these powerful substances, psychiatry was making use of them to treat alcoholism and neurosis, to study creativity and to understand how the mind works. (They also occasionally misused them, as in the criminal behavior of the McGill University hospital in Montreal, where psychiatrist Dr. Ewen Cameron had been pioneering a technique called "psychic driving.” Supported with money from the CIA, Cameron experimented on patients, literally driving them insane by dosing them with LSD, confining them to isolation chambers and bombarding them with looped taped suggestions. Later, Charlie Manson and his crew became the most cogent example of how psychedelics could be used to help fuel the realization of demented, violent fantasies.)
Even mainstream religion tripped to nirvana. One of the most remarkable documents of the early history (1957) of psychedelia comes from a monsignor at Vancouver's Holy Rosary Cathedral, Vancouver’s central Catholic church. He wrote a prayer for those about to embark on a LSD journey: “We therefore approach the study of these psychedelics and their influence on the mind of man anxious to discover whatever attributes they possess respectfully evaluating their proper place in the Divine Economy. We humbly ask our Heavenly Mother the Virgin, help of all who call upon her to know and understand the true qualities of these psychedelics, the full capacities of man's noblest faculties and according to God's laws to use them for the benefit of mankind here and in eternity.”
MDMA, aka Ecstasy, though considered by some a psychedelic, has singular effects that place it within a subset of that genre of drug, or even within its own completely novel category. Dr. Ralph Metzner, an elder pioneer of the psychedelic therapy movement and one time student of Dr. Leary, christened MDMA as an “empathogen” -- a drug that encourages empathy. Dr. Nichols, considered by many as the foremost psychedelic researcher has called it an “entactogen”, — "entactogen" is derived from Greek and Latin roots and means being able to touch within.
Ecstasy might be old news to you, but it is big news to civilization. Humankind does not come up with a psychoactive drug with unique properties every day. The rough, addictive depressant alcohol has been in use since at least 10,000 B.C. People have been stinking up their caves with cannabis from the 3rd millennium BC. People have been tripping on psilocybin mushrooms at least since the domestication of cattle, And humans were, of course, impatient to start using stimulants, which have been around for just as long.
MAPing the Way to Medicalization
Rick Doblin, a 5' 6' man with the bearing of a guy who wrestled for the high school team, has a doctorate from Harvard’s Kennedy School of Government and is the founder and director of MAPS, the Multidisciplinary Association for Psychedelic Studies. MAPS is Rick’s brain child, the driving force behind a worldwide movement to encourage medical professionals to study the prudent therapeutic application of MDMA with the goal of rescheduling it for medical use — the current tag lines in MAPS publications is “MAPS: Putting the MD back in MDMA”.The only completed study of MDMA assisted psychotherapy for Post Traumatic Stress Disorder (which was sponsored by MAPS) created headlines in 2008 throughout the media landscape, from Dr. Gupta on CNN suggesting that “people will be amazed at the results”, to a double spread article in The Economist -- “MDMA assisted patients showed statistically significant improvement of their PTSD symptoms compared with those who received the same day-long therapy sessions with an inactive placebo.”
A patient under the influence of MDMA, remains calm, centered, and can speak clearly. Relative to LSD, it is an extraordinarily gentle delving into one’s own psyche, rather than a wrenching toss into dimensions unknown. Depression, anxiety and any sense of suffering are usually lifted completely. The burden of trauma and stress gone — the patient is made profoundly at ease with herself, and the sense of self -- rather than being lost or dissolved (as with the temporary "ego loss" sometimes experienced under other psychedelics) is made reflective -- meditative, calm and loving. Dr. Julie Holland, of Bellevue Hospital, Faculty, NYU School of Medicine, and editor of Ecstasy: The Complete Guide wrote: “Any psychiatric disorder that can be ameliorated by psychotherapy can be treated more quickly and more profoundly with MDMA-assisted therapy.”
The Use and Misuse of this Technology
A profitable way of understanding MDMA and psychedelic drugs is to think of them as technologies.. These technologies are reflectors of self, of the complexity of one’s own mind -- the abstract mind, the rational mind and the emotional mind all twined together permitting us to see our emotional history, and the present state of our psyche, our self. At the peak of these experiences, the psychedelics can show the world as an unconditioned given, as the world is without firm tags of language, yet it is imminently poetic and symbolic. Contradictory? Sure. But I would claim that psychedelics provide a glimpse into the soul.During the late ‘70s and early ‘80s the therapists thought it best to keep the lid on. Not wanting to see a repeat of the clampdown on LSD in the late 1960s, they did not talk to the media about MDMA at all. The drug underground had other ideas. MDMA was taken up by countercultural activists and entrepreneurs (drug dealers, by another name). Quite consciously rebranded as Ecstasy, a black market encouraged casual use and a whole new music culture came into existence. Overreacting, in 1985, the state made MDMA Schedule One (illegal and with no medical use. MDMA/Ecstasy is now a demonized substance in the USA, slurred as a narcotic. It cannot be prescribed by a physician, and is prohibited for every application under threat of incarceration.
Prohibition has created a much more dangerous but quite massive underground use and abuse, creating problems with adulterated, sometimes poisonous ‘product,’ use of the drug in circumstances that don’t support the value of the experience, overuse, and use with other drugs. Meanwhile, the lawful community of therapists and researchers have lost a surpassingly valuable tool. Professor David Nutt, (past) chairman of the Advisory Council on the Misuse of Drugs, U.K, wrote in the Journal of Psychopharmacology: ‘There is not much difference between the dangers of horse-riding and the dangers of ecstasy.’
Few deaths have been linked to the use of the millions of tabs of MDMA throughout the decades (125 tonnes of E is consumed annually world wide according to the UN). But most of those few can be attributed to the setting of specific raves and the miscalculation of users. Dehydration, overhydration and heat stroke are real dangers, but one does have to put to rest the idea that MDMA was the principal cause of death in most of these cases. MDMA does increase body temperature; dancing all night while high without supplying the body with fluids is not a good idea, but neither is drinking water excessively. There are a few cases of individuals on MDMA who -- heeding the advice to keep hydrated --drank an excessive amount of water and died of water intoxication. In other words, cause of death: water intoxication. The point is critical; it brings home the most central dictum of pharmacology, quoting from the father of the science, Paracelsus: “All things are poison, and nothing is without poison. For example, every food and drink, if taken beyond its dose is poison; the result proves it. I admit that poison is poison; that it should, however be rejected is impossible.“
The most grievous misuse of MDMA is related to overuse and improper attention to the set and setting of the user while under the influence. The normal dose is between 100-125 mg., and generally, the dose should not be repeated to extend the length of the trip unless supervised by a therapist. Also, one trip every three to four months is a reasonable maximum use window, permitting the individual enough time to integrate the knowledge gained by the psyche's refocusing (initiated by the drug) and permitting the body and brain neurochemistry sufficient time to return to normal baseline functioning. There is no physical craving for MDMA; it is not an addictive substance. MDMA should not be used by anyone with cardiac problems, or with a history of seizures. Swallowing it every weekend for partying is not at all wise and can prove to be dangerous for long-term mental health. It’s also highly ineffective. The drug provides quickly diminishing returns with repeat use.
The peak engagement is short acting, 3 to 4 hours, as compared to the 8 or more hours of a high dose LSD experience. Incredibly and importantly, most pain -- even chronic pain disappears during an MDMA session. These effects are consistently reported and observed with the majority of patients.
The Pusher Man
Sales of antidepressant drugs in the United States doubled between 1996 and 2005, and remains on an upward swing. In 2008, sales of these drugs totaled $9.6 billion in the US alone. Direct to consumer advertising for them is about 122$ million per year. These pushers are busy, busy, busy; one company spent $34.7 million to pay 2,000 psychiatrists and primary care doctors to deliver 15,000 lectures to market their product to their peers. These legal, corporate mind drugs are meant to be used on a daily basis for as long as the patient is considered unwell, which could be the rest of his or her life. That's quite a fantastic cash cow, as people return for their prescription refills. Conversely, in psychedelic therapy, the drugs are used on rare occasions. They are combined with psychotherapy and -- with luck -- within a supportive community and there are no patents on the molecules. No one is going to finance a villa in Venice on magic mushrooms when it can grow in a field strewn with organic sheep manure.
It’s a long road from prohibited drug, and one with little market value, to a prescribed medicine. Doblin is confident that MAPS will be able to move forward with the final phase of research -- one requiring many more subjects. Because of the hundreds of millions of dollars spent by the government to investigate the harms that MDMA might cause, there are over 3,000 scientific papers on the subject all in the public domain. This state sanctioned and financed groundwork will allow MAPS to jump the hurdles of the FDA’s approval process for about $10 million dollars — that’s a third of what the Ang Lee movie about Woodstock cost and a hell of a lot more true to the heritage of the psychedelic experience.
A monsignor at Vancouver's Holy Rosary Cathedral, Vancouver’s central Catholic church... wrote a prayer for those about to embark on an LSD journey.
Because of ignorance and fear, psychedelic medicines have been left to languish in the underground and are still refused entry into polite society. No corporation can make a dollar on them. The patents have expired and they are still taboo. But prohibition against these non addictive drugs -- these mind manifesting enhancers -- is a law against our own nature. We crave -- and even desperately need -- to feel the fullness of ecstatic mind states; the disappearance of the bounds that constrict us to our day to day identities, and to fully experience the condition of grace -- the condition of being grateful for life.
Our entire society is under constant, ever-increasing stress. Trauma is prevalent and the old standbys of family and social order are, for many, inadequate. Civilization is in a chaotic flux. Only the steady heart of the Self, the emotional self that sees and appreciates our common humanity, in empathy and humility, can right the imbalance. As we face upsetting economic, social and cultural changes globally and locally, should we not be making use of every technological advancement?
Oliver Hockenhull is a Vancouver based filmmaker currently producing and directing a documentary essay on the resurgence of psychedelics and psychoactive drugs in therapy (A PERFECT PILL: FROM NEURONS TO NIRVANA — www.aperfectpill.com)
Thank you for this thoughtful article.
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