Complex reports on MAPS’ upcoming study of MDMA-assisted psychotherapy for posttraumatic stress disorder (PTSD) in couples, highlighting MDMA’s ability to assist couples with increased levels of compassion, openness, and communication. “A lot of people have described MDMA as a heart-opening experience, full of empathy and compassion. You want the ‘non-affected partner’ in the couple to have that experience, as it could be exactly what’s needed to support and stabilize the patient who experiences PTSD,” says psychiatrist and psychedelic researcher Julie Holland, M.D.
Originally appearing here.
Autumn* first used MDMA in 2007, in Sarasota, while attending the New College of Florida. “There [were] thrice yearly parties called ‘Palm Court Parties,’ which were heavily themed and ritualized drug parties,” she explained. After testing the purity of her drugs with a Marquis and Mandelin kit purchased from Erowid, Autumn took the MDMA and suddenly the difficulty processing disparate thoughts she’d experienced all her life as a result of her autism began to recede.
“I participated in a study about autism, feelings, and MDMA, and I will tell you what I told them,” Autumn told Complex. “The usual barriers that exist within my headspace—my usual circuitry becomes more fluid and I can find the contour of the issue or the thing I’m usually unable to obtain.” Buoyed by her personal experience, Autumn decided to try MDMA with her partner to tackle some heavy issues—“mostly about my past, in which my abusive estranged husband subjected me to intensive, near-daily sexual abuse for years.” The trauma hasn’t completely diminished, but she claims they’ve broached her history while rolling “to some really interesting results.” Could MDMA strengthen a relationship? Could the burden of discussing traumatic events be relieved by a psychoactive drug?
There’s certainly some precedent for it. Before it was made illegal in the United States in 1985, MDMA was frequently used in couples therapy. In an article published in the German magazine GEO last year, Oxford University researcher Brian D. Earp highlighted a few examples, including the work of New Mexico-based researchers George Greer and Requa Tolbert, who used MDMA with approximately 80 clients from 1980 to 1985. Their findings indicating that individuals achieved “a more healthy and accurate perspective of who and what they were psychologically.” According to Greer and Tolbert, this might have been accomplished by the drug’s apparent ability, when used in combination with psychotherapy, to decrease irrational fear responses to perceived emotional threats. Greer and Tolbert posit that the same feelings of euphoria, emotional warmth, and empathy that made the drug beloved in clubs could help those afflicted with PTSD to re-live and reprocess traumatic events in a safe environment so that they can come to terms with those memories. Though MDMA became a drug of abuse with no medical value under Schedule I of the Controlled Substances Act in 1985, new clinical trials exploring its use in a controlled setting have begun to get approval and the data sets from older trials are finally receiving serious consideration.
THIS LACK OF FEAR SURROUNDING VULNERABILITY SEEMS TO BE A KEY FACTOR IN WHY MDMA CAN HELP COUPLES TO COMMUNICATE MORE OPENLY.
In treating those with Post Traumatic Stress Disorder, MDMA has shown impressive results. A recent trial conducted by psychiatrist Michael Mithoefer found that 83 percent of his treatment-resistant participants no longer showed symptoms of PTSD after therapy with MDMA. Piggybacking on Mithoefer’s success, California-based non-profit MAPS (Multidisciplinary Association for Psychedelic Studies) is currently awaiting approval for a clinical trial of conjoint therapy—that is, treating couples with MDMA-assisted psychotherapy when only half of the partnership experiences PTSD. Psychopharmacologist, psychiatrist, and author Julie Holland, M.D. hypothesizes that the use of MDMA on the non-affected party will inspire compassion and openness when the traumatized individual is opening up. Holland tells Complex, “A lot of people have described MDMA as a heart-opening experience, full of empathy and compassion. You want the ‘non-affected partner’ in the couple to have that experience, as it could be exactly what’s needed to support and stabilize the patient who experiences PTSD.”
Communications director of MAPS Brad Burge says the organization predicts the FDA could approve MDMA as a legal medication as soon as the end of 2021. This April, legislators, NGOs, academics, and members of the international scientific community will meet in New York City for a special session of the United Nations General Assembly to discuss and establish new goals for the “worldwide drug problem,” including but not limited to issues surrounding MDMA.
Fay* and Dean* met in 2009, at DEMF, better known as Detroit’s Movement Electronic Music Festival. “We met sober,” Fay says, “but eventually took [MDMA] and it was super fun.” Even before they met, the Portland, Oregon based couple had a lot of experience taking MDMA, with 10+ years of experimentation each. While they take it semi-frequently—“probably 3 or 4 times a month in the summertime”—they see their ingestion habits as being far more moderate in comparison to those just looking to roll face at a concert. “We’re talking about pretty homeopathic dosages compared to what most people would consider a solid dose,” Dean told me via Skype. “Small amounts, so maybe 10, 20 milligrams, hours apart over a long period of time,” he said, taken by snorting the drug or licking it off of the tip of a finger. The more popular alternative is a large dose, often up to 100 to 200 milligrams.
The benefits of taking MDMA for the couple goes far beyond the blissed feeling of being high on drugs in earshot of electronic music. “It’s brought us closer, not even just with romantic relationships but also with friendships,” Fay explained. “It’s brought out a sense of openness, and you feel more okay to put yourself in a vulnerable position.” This lack of fear surrounding vulnerability seems to be a key factor in why MDMA can help couples to communicate more openly. “Being able to be vulnerable with another person helps reinforce bonds,” Dean told me.
WE DON’T KNOW ENOUGH RIGHT NOW ABOUT THE RELATIONSHIP CHARACTERISTICS THAT WOULD POTENTIALLY MATCH WELL WITH CONTROLLED, THERAPEUTIC MDMA USE, VERSUS THOSE THAT WOULD END IN DISASTER.
And while the research done with MDMA has mainly been investigating fear as it pertains to Post Traumatic Stress Disorder and reliving traumatic events, Holland wouldn’t be surprised if its effects on the amygdala were also tied to shame. She related the few MDMA studies performed in controlled environments, such as those by groups like MAPS, to the ones performed by Catherine Mclane at John’s Hopkins that focused on openness using psilocybin (the compound found in ’shrooms). “You could make a case that openness is sort of the opposite of shame,” Holland explained.
Vulnerability can be a desirable attribute for some relationships, but it can be an opportunity for harm in other scenarios. Brian Earp, of Oxford University, cautioned that the drug could make it easier for someone prone to betraying your trust to take advantage of you. “This is why experimenting with MDMA can be potentially dangerous,” Earp warned. “We don’t know enough right now about the relationship characteristics tha
would potentially match well with controlled, therapeutic MDMA use, versus those that would end in disaster.” Like in a scenario where the MDMA user is in a violent relationship and the “openness” attributed to the drug makes them more vulnerable to abuse.
Even though Dean and Fay’s opinions and anecdotal evidence are enough to convince them of the drug’s value, they know how untested their discoveries are, due to slow progress in MDMA-based research. When I spoke with him in late 2015, neuroscientist and MDMA researcher Matthew Baggott agreed there are legitimate concerns about the drug’s harmful long term effects but noted there has been little indication of problems in controlled clinical experiments. “We’ve seen people in our studies feel tired and a little emotionally unstable the next day, but they are also positive, as if they’ve accomplished something big,” he said. “We don’t see the midweek blues that users report in uncontrolled settings, maybe because we use single, modest doses and our participants are not taking other drugs.”
Baggott also suggested that the doses most recreational users ingest aren’t optimal for lasting emotional effects. “Pioneering psychedelic therapist Leo Zeff said his clients often wanted more intense MDMA experiences than they really needed,” Baggott explained. “It was as if they preferred to be pushed through to a state of bliss rather than relax into a state of clarity and then do some psychological work.” The MDMA doses favored by therapists are less likely than higher doses to compromise the memory of the experience. “When people take MDMA in party settings they often get so blissed out that they remember almost nothing. People at lower doses remember their thoughts and feelings and what they shared with each other,” Baggott said. “All those memories last beyond a trip.”
WHEN PEOPLE TAKE MDMA IN PARTY SETTINGS THEY OFTEN GET SO BLISSED OUT THAT THEY REMEMBER ALMOST NOTHING. PEOPLE AT LOWER DOSES REMEMBER THEIR THOUGHTS AND FEELINGS AND WHAT THEY SHARED WITH EACH OTHER.
George Greer, M.D., one of the first MDMA therapists, recalled hearing of “couples back in the ‘80s who would take MDMA and get very close and intimate,” but afterwards they still had problems in the relationship that went unresolved. Greer became interested in experimenting with altered states of consciousness during psychotherapy between his third and fourth years of medical school, after attending a six-week seminar at Esalen Institute in Big Sur, led by Czech psychotherapist Dr. Stanislav Grof. It was shortly after his time in med school when Greer learned that MDMA was being used therapeutically by a small group of psychologists and other therapists. What’s more, the drug was found by this group to be much more benign than psychedelic drugs and extremely useful for deepening and accelerating conventional psychotherapy. But as Greer said, “There are no guarantees; it all depends on the people and their intention, their willingness to work it out.” In the early ‘80s, MDMA users recognized this “instant marriage syndrome” and there were shirts and bumper stickers advising people not to get married for at least 6 weeks after falling in love during an MDMA experience.
Earp is hesitant to put a generalized stamp of approval on taking MDMA in a relationship setting—especially now, when it’s illegal and the research into its effects is limited. But even if more substantial research were being done, there would be many factors to consider in terms of the drug’s usefulness for any individual couple. “It depends on the relationship, the people involved, what their issues are, what the specific effect of the drug was on each of them, and the context in which they took it,” he said. In a forthcoming paper, Earp compares this paradigm to another drug, SSRIs, which are used clinically to treat depression. One well-known side effect of SSRIs for some users is a diminished sex drive. But whether that’s “good” or “bad” for a particular couple depends on their situation. For example, SSRIs are known to delay or diminish orgasms. According to Earp, “For couples for whom an extended period of intercourse or other sexual activity prior to ejaculation is judged to be desirable…SSRIs that make it harder to ejaculate may…have a welcome effect.” But the opposite might be true for others. “For other couples, the very same outcome—namely, a delay or difficulty in achieving orgasm—may be judged to be undesirable, for any number of reasons.”
DRUGS LIKE MDMA DON’T JUST WORK IN A VACUUM.
Earp sees the lack of a body of research as the main factor behind medical science’s failure to develop a clear clinical use for MDMA, saying that “much more sustained, systematic, high-quality research would be needed, going forward, before we could say anything definitive in this area.” There are many factors involved even outside of the couple’s relationship, such as “the dose, the quality (or ‘purity’) of the drug, the person’s own chronic dispositions, their current mental states/moods, who they’re with, what the circumstances are, and so on.” He does see how MDMA could potentially improve communication skills, or help couples to get over unproductive grudges and so on, but stresses the need for these studies to be done in a controlled, supervised, and therapeutic setting. “Drugs like MDMA don’t just work in a vacuum,” he said.
When 26-year-old Brooklynite Jenny* first began taking MDMA in 2013, it felt like a breakthrough. “I know it sounds ridiculous,” she says, “to talk about doing drugs that way. Normally I wouldn’t say that—I’m not some overly spiritual person from Topanga Canyon—but I think it has strengthened a lot of my [relationships] and even non-romantic friendships.” Beyond her boyfriend, she told me about a recent friendship that was mended by the substance. “My friend Jim and I had this weird fight years back and afterward we would still hang out, but we suspended the seriousness of our friendship for months,” Jenny said. But eventually the two were hanging out one night and there was MDMA on the table. “We found ourselves doing this drug together and then we just stayed up till 5 in the morning and going, ‘Oh god, I’m so glad we’re still friends, I wanted to be friends with you still.’”
For Jenny, MDMA worked in many of the same ways it did for Fay and Dean—she felt less shame and was unafraid to confront difficult conversations. “It makes you less self-aware and fearful of repercussions, and you’re also more cognizant of the feelings of others.” Jenny’s been with the same boyfriend for the past few years, and while she experiments with drugs on occasion, her boyfriend is less inclined. One night, they took MDMA together, despite having company over. Jenny refers to this as a bonding experience, explaining that it felt like they were on a “funny little voyage together.” When the visitors did leave at 5 a.m., Jenny and her boyfriend had one of the most open discussions of their relationship. “We were at a point where we were kind of at a crux of our relationship being serious or not serious and I was able to talk about it extremely openly without fear of reprisal,” Jenny explained to me over the phone. “It was almost as if it sped the trajectory of our relationship up by a few months.”
The benefits of MDMA use are already more than apparent in the lives of these couples, as Dean was quick to note how it helped him to talk about uncomfortable topics. “I think I experience a lot of shame in general and if a conflict (in our relationship) is centered on something I did, that sense of shame makes h
ing a frank, open discussion about something really difficult for me,” Dean said. “Drugs are a pretty powerful way of shifting your perspective.” And it could help many others if the policies surrounding the drug steer away from fear tactics and binge culture, and move towards control and moderation.
*Names have been changed for reasons of privacy.