Ecstasy-assisted psychotherapy shows promising results for PTSD

An illegal drug popularized by the rave culture of the 90's could have beneficial applications in psychological science.

Using ecstasy, known scientifically as methylenedioxymethamphetamine (MDMA), to assist psychotherapy could be a viable treatment for post-traumatic stress disorder (PTSD), according to research published today in the respectable Journal of Psychopharmacology.

PTSD is a debilitating and often chronic condition characterized by anxiety, hypervigilance and intrusive recollection of traumatic memories, including nightmares and flashbacks. The disorder is most common among those who have experienced warfare and victims of sexual assault, along with others who have experienced traumatic situations like car crashes. It is associated with a heightened risk of suicide.

Previous research conducted by Dr. Michael C Mithoefer and his colleagues found a significant difference between those who received MDMA-assisted psychotherapy and those who received psychotherapy without MDMA. Among the group of participants who received MDMA-assisted psychotherapy, about 80 percent no longer met the diagnostic criteria for PTSD after treatment.

Mithoefer's most recent study found that of the 19 participants who received MDMA-assisted psychotherapy treatment, 17 showed long-term improvement in their PTSD symptoms about 3-and-a-half years later.

Most of the participants were women who experienced sexual abuse or assault. None of them had responded well to other forms of treatment.

"These results indicate that there was a favorable long-term risk/benefit ratio for PTSD treatment with just a few doses of pure MDMA administered in a supportive setting, in conjunction with psychotherapy," the researchers concluded in their article. "Should further research validate our initial findings, we predict that MDMA-assisted psychotherapy will become an important treatment option for this very challenging clinical and public health problem."

MDMA is known for its "empathogenic effects." The drug has been shown to increase feelings of empathy and social connection, along with producing feelings of euphoria and some mild visual hallucinations. Mithoefer and his colleagues believe that MDMA could be an effective tool for psychotherapists because it allows patients to emotionally engage traumatic memories without becoming overwhelmed by fear or anxiety.

The MDMA-assisted psychotherapy, outlined in a manual (PDF) published by Mithoefer and his colleagues, requires the therapist to first develop a "therapeutic alliance" with the participant, gaining his or her trust and fostering a more intimate relationship. During this preparatory phase, the therapist also seeks to gather personal information about the participant and explain the upcoming therapeutic process, addressing any concerns the participant may have.

During the MDMA-assisted session of the psychotherapy, the manual instructs therapists to create a private, comfortable and aesthetically-pleasing setting for the participants to experience the drug in. After consuming the drug, the participant sits or lays comfortably on a futon. Therapist provides the participant with eye shades, headphones, and soothing music -- helping to direct the participants attention inward. While experiencing the effects of MDMA, the therapist encourages the participant to be open to any feelings or thoughts that may arise, and freely explore his or her emotional states. The therapist acts as a guide during the MDMA-assisted session, allowing the experience to unfold rather than trying to direct it.

"The therapists' responsibility is primarily to follow and facilitate rather than direct the experience," the manual explains. "At times this will be best accomplished by silent, empathic presence and listening. At other times the therapist will provide more active support and occasionally guidance if the participant encounters emotional or somatic blocks or has undue difficulty processing trauma-related memories or any other painful memories, thoughts, and feelings."

Mithoefer and his colleagues warn that the research is still in preliminary stages. Due to the small sample size and inability to control a number of variables long-term, the results of the study are open to doubt. However, the researchers have obtained approval to conduct another study and note that additional research is being conducted elsewhere.

The research was sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS).

[Post-traumatic stress disorder via Shutterstock]