Originally appearing here.
The following is an excerpt from the book, “Through the Gateway of the Heart; Accounts of Experiences with MDMA and Other Emphathonic Substances,” by Ralph Metzner. The first part of the text includes the Foreward to the 2012 edition, and following it, a first-hand experience by a former nun. (Four Trees Publications, 1986. 2012 Edition).
Ecstasy, empathy, openness, compassion, peace, acceptance, being, forgiveness, healing, re-birth, unity, emotional bonding, caring, celebration”these are some of the terms people use to describe their experiences with a class of substances, of which MDMA 3,4-methylenedioxy- amphetamine (also known as Adam, Molly, Ecstasy or XTC) has become the best known. Although related in a general way to the psychedelic “mind-manifesting” substances such as LSD, psilocybin and mescaline, these substances are different in that they do not usually produce visions, hallucinations, or altered perceptions of reality.
Even more importantly, these substances seem to consistently induce a positive affect and reduce or attenuate anxiety”in significant contrast to the classical psychedelics which can amplify and elaborate both positive and negative affects. Because of the high percentage of major positive insight experiences reported with these substances, and the relatively low incidence of undesirable side-effects, these drugs have attracted favorable attention from a number of psychotherapists, who regard them as facilitators of therapeutic insight and change. They have also been used by some teachers and practitioners of meditation, who see them as important amplifiers of emotional and sensory awareness, and as aids to spiritual practice.
The Use of MDMA in Overcoming Fear and Trauma
The book “Ecstasy: The Complete Guide,” edited by Julie Holland, MD (Park Street Press, 2001) offers a comprehensive look at the risks and benefits of MDMA, as well as a summary of the pharmacological effects identified thus far. Jessica Malberg and Katherine Bonson in their chapter on “How MDMA works in the brain,” summarize the effects the main brain neurotransmitters as follows:
“MDMA acts in the brain through three main neurochemical mechanisms: blockade of serotonin re-uptake, induction of serotonin release, and induction of dopamine release. With these actions, MDMA is essentially a combination of the effects of fluoxetine, a serotonin reuptake inhibitor and anti-depressant; a serotonin releaser and amphetamine, a dopamine releaser (op. cit. p. 29).”
More recent studies by Gillinder Bedi and others have used functional magnetic resonance imaging techniques to show that MDMA attenuated amygdala response to (pictures of) angry facial expressions, but did not affect amygdala response to fearful expressions. Responses to happy emotional expressions were enhanced with MDMA. Further studies done with recognition of emotions in facial expressions in photographs suggested to these authors that MDMA reduced the perception of fear in the images, leading to more “pro-social behavior.” Summaries and detailed descriptions of these and other studies may be found by consulting the MAPS website (www.maps.org), which maintains a comprehensive database of all published research on MDMA and other psychoactive drugs of potential value and interest.
These findings of reduced fear-perception are consistent with anecdotal reports (including many of those in this book) that MDMA significantly attenuates interpersonal fear and anxiety. This is probably the basis for its marked therapeutic utility, especially in the treatment of PTSD, where the perceptual fixations on a real life-threatening situation blocks the normal processing of memories.
The potential applications of MDMA in the treatment of debilitating post-traumatic stress disorder (PTSD), which is now being researched by Michael Mithoefer and associates at the University of North Carolina, is exemplified in two of the accounts in this book, whose authors were able to confront the traumatic experience of rape. One is called “I Can Now Move through the Trauma.”
“There seemed to be some quality of the Adam that broke down the repressive/defensive network and took me back into the experience of the attack that was too much for my psyche to bear. Over a period of eight to twelve months I was able to re-experience fragments of the attack, thereby recreating and de-sensitizing me to the experience.”
The other account, by a school teacher, is titled “To Speak of What Was too Painful to Remember,” and she writes about realizing that a rape that had occurred eight years ago, had been,
“… hidden in the back of my mind” and all the little details that I had wanted to ignore were eating at me like a cancer”The suffering became more intense, but I still wanted to talk about it and I felt that I could deal with the pain, that this was a start to try to defeat this cancer.”
The potential value of using MDMA in the treatment of PTSD can hardly be overestimated, considering that there are some 350,000 veterans from US wars in Vietnam, Iraq and Afghanistan, who are suffering from this and who only receive palliative support, if any, from the usual prescriptions of SSRIs offered by the over-burdened Veterans health care system.
One of the people I (RM) worked with in MDMA-supported psychotherapy in the early 1980s was a Vietnam War veteran, who was able to release an enormous amount of war-related trauma in one intensive session, and subsequently turned his life completely around, becoming a dedicated peace activist and co-founder of the group Veterans for Peace, giving talks with fellow veterans on the realities of war to groups of high-school students (Ed Ellis & Ralph Metzner, From Traumatized Vet to Peacemaker Activist. MAPS Bulletin, Vol XXI, No. 1, 2011).
MDMA, Intimacy and Sexuality
Torsten Passie, MD, a research psychiatrist at the University of Hanover medical school in Germany, has done studies on the neurohormones released in the MDMA state and how this relates to the subjective effects. He states, on the basis of his studies, that MDMA deactivates the amygdala (the seat of fear-rage emotional reactivity) and reciprocally activates prefrontal brain circuits (which underlie calm thinking). This is the neurophysiological counterpart to the empathic understanding of self and others, reported by the patients. There is also a massive release of serotonin, the neurotransmitter associated with a non-depressive, non-fearful attitude. Passie’s research is described in a monograph published in 2012 by the Multi-disciplinary Association of Psychedelic Studies (MAPS): Healing with Entactogens: Therapist and Patient Perspectives on MDMA-Assisted Group Psychotherapy by Torsten Passie, M.D.
To my mind the most provocative of his findings is that MDMA results in a massive release of prolactin, the hormone associated with breast-feeding, as well as oxytocin, sometimes called the “cuddle hormone.” Both of these hormones are released during non-sexual post-orgasmic intimacy. As Dr. Passie points out, this release of non-sexual intimacy hormones correlates perfectly with the often-remarked subjective experience of MDMA-users” that they feel intimate with others, wanting to touch and be physically close, but not sexually aroused.
The experience of sensory and sensual intimacy without sexual activity or even desire is expressed in this book in the account titled “Desire Transcended by Being Fulfilled.” In this account the subject, a 48-year old male, reported an experiment of having a massage at the Esalen retreat center, on two occasions ” once without MDMA and once with. The man reported that the second massage
“seemed longer and slower, and my body responses much deeper and more tot
al. I felt blissful. I recalled my wanting and desiring the masseuse, from the first session, and realized I did not have that craving or desire now; instead I felt as if we were making love! The desire was transcended by being fulfilled, virtually (p.125).”
Even couples who were intimately involved have reported that with MDMA the sexual drive was often just not there. This effect is, in my opinion, one of the main reasons why MDMA has such unparalleled usefulness in enhancing psychotherapy: it facilitates the heart-felt, empathic, verbal and postural expression of emotional intimacy, without the slightest hint of sexual arousal or interest (which is often a confounding issue in therapist-patient interactions, as is well-known).
Entactogens vs. Empathogens
I want to say a word here about terminology. Torsten Passie, like most of the European researchers uses the word entactogen to describe the class of drugs like MDMA, whose primary neuropsychological action is a marked decrease of interpersonal and intrapsychic fear “thereby facilitating a seemingly effortless re-integration of previously defended and traumatic memories and perception. This is in marked contrast to the primary effect of the classical psychedelics (LSD, mescaline, psilocybin) which involve visual and affective amplification of all psychic contents and processes, including fear”thereby making difficult or “hellish” trips much more likely than with MDMA (where they are virtually absent). Entactogen means something like “touching within” or getting in touch with one’s own inner processes.
In a friendly debate which I had with a couple of my colleagues in the pages of the MAPS bulletin several years ago, I suggested that “touching within” doesn’t really distinguish the MDMA-type experience from the LSD-type experience. My own preferred term for these substances (and the experience they can facilitate) is empathogen”generating a state of empathy, both empathy for others and empathy with one’s own self in past or present conflict situations. This to me is the basis for the heightened affective understanding, the integration of emotion and reasoning, consequent upon the absence of fear and anxiety, that Dr. Passie’s study demonstrates.
The Use of MDMA in Alleviating Terminal Anxiety
A dramatic and powerful account of MDMA’s ability to attenuate fear and terminal anxiety is given in the book by Marilyn Howell “Honor Thy Daughter,” also published by MAPS (2011). In this book, Howell relates how her 27-year old daughter who had colon cancer, struggled terribly to marshall her life-forces and resist the illness, in spite of the increasingly discouraging feedback from the medical professionals and increasingly painful side-effects of the chemotherapy drugs she was receiving. She fought for her life, using one extreme, technological method after another. She didn’t want to hear, think or talk about her possibly impending death. I think most researchers would agree that actually, for end-of-life palliative care the classical entheogens like LSD and psilocybin are better than MDMA at expanding awareness into the spiritual dimensions. But in the case of this young woman, since she was so relentlessly committed to fight for her life, and in denial about death, the turning point came when she could accept the possibility that the MDMA would ease her existing pain and anxiety, without thinking about death, the after-life or similar concerns. She was able to have a relatively peaceful and painless dying, in the company of her loved ones.
When MDMA first became known in therapists’ circles in the early 1970s, its possesion or use was not illegal”until the FDA, invoking emergency powers, placed it on Schedule I in July 1985, just around the time the first edition of this book was published. Because of the change in its legal status, and for obvious reasons of confidentiality, the individuals reporting, the therapists or group leaders facilitating, and the researcher who compiled and edited the accounts all chose to remain anonymous. Now, more than 20 years later, MDMA is still illegal, and listed on the FDA’s Schedule I (along with heroin, cocaine, LSD and marijuana) although researchers can obtain small amounts for their controlled and approved research studies. Such studies all have to be privately funded, since no pharmaceutical company can put its development resources behind it. In spite of the promising research studies demonstrating the relative safety of MDMA, and the positive anonymous self-reports published on the Erowid website”MDMA is no closer to being formally and legally available for any condition or purpose than it was in the 1980s. However the informal, underground distribution of Ecstasy at rave concerts, and in the context of small, anymous, secretive groups, has led some observers to estimate (though of course no hard statistics are available) that several million doses of Ecstasy are distributed and consumed every year”in the US, most European countries, as well as India, Japan, Australia, South Africa and possibly China.
The research with the classic psychedelic drugs (psilocybin, LSD etc) carried out during the 1960s had led to the hypothesis, widely accepted by workers in the field, that psychedelics are non-specific psychic amplifiers, and that the content of a psychedelic experience is primarily a function of the “set” (expectations, intention, attitude, personality) and the “setting” (physical and social context, presence and attitude of others, including the guide). This set-and-setting hypothesis is a useful model in coming to understand the experiences with MDMA also. The specific insights, feelings and resolutions of problems that occur are of course unique to the individual, although there is a commonality in the kinds of feeling states that are named, such as “empathy”, “ecstasy”. Individuals are often able, if their intention in taking the substance is serious and therapeutic, to use the state to resolve long-standing intrapsychic conflicts or interpersonal problems in relationships. One therapist has estimated that in five hours of one MDMA session clients could activate and process psychic material that would normally require five months of weekly therapy sessions.
Because of the importance of the set and setting variables, a brief description of the nature of the set and the setting was requested of each of the individuals whose accounts were included. These are shown at the bottom of the first page of each account; and one can obtain a pretty clear sense of the operation of this principle by comparing that statement with the content of the experience. In addition, the text lists as “catalyst” the precise identity and the amount of the particular substance used. In many of the sessions, an initial dose was followed after an hour or so by a “booster” of a lesser amount of MDMA, or with a related compound called 2-CB. Invented by Alexander Shulgin, the famous independent chemist who identified and synthesized hundreds of previously unknown psychoactive compounds (described in his booksTIHKAL and PIHKAL), 2-CB is in many ways analogous in its effects to MDMA, though much less research has been done on it, nor is it as widely available in the underground scene.
With all these empathogenic (or ‘entactogenic’) substances, the catalyst triggers a change of feeling state, in which insights and perceptions take place. These insights and perceptions, though they may appear ordinary and commonplace when they are afterwards heard or read by others, are felt with a depth and poignancy of emotion that was for most people unheard of in their lives before the time of that first experience.
None of this is meant to say or imply that similar or identical changes of consciousness could not be produced or arrived at without the use of these empathogenic substances. Obviously, many people have in the past, and continue to have, empathic and heart-opening experiences without the use of any external aid, pharmaceutical or other. For the people whose exper
iences are recounted in this volume, the heightened and deepened state of awareness facilitated by the drug served as a kind of preview, as it were, a taste of the possibilities that exist for much greater emotional openness and relatedness than they had imagined.
They are clearly aware, too, that the drug-experience is a temporary state, and one that can be converted into the ongoing reality of everyday consciousness only with continuing therapeutic and spiritual practice”and not with the continued use of the drug. Most people do not want to repeat the experience very often”it is felt to be too intense, too sacred. Although the possibility of becoming psychologically dependent on this, or any drug, cannot ever be ruled out, there is a fairly high degree of consensus that MDMA is not addicting, in the way that opiates are. None of this positive potential therapeutic work with MDMA discounts or denies the existence of patterns of extreme overuse of Ecstasy that have become associated with the international rave culture, nor do we intend to minimize the potential harm from such overuse.
Under favorable circumstances and with a supportive set and setting people feel that the MDMA experience has elicited true compassion, forgiveness, and understanding for those with whom they have important relationships; and most importantly, for themselves, for their ordinary, neurotic, childish, struggling persona or ego. The relative absence or attenuation of normal amounts of anxiety and fear in these states is perhaps the single most important feature in regard to their therapeutic value. People report being able to think about, talk about, and deal with inner or outer issues that are otherwise always avoided because of the anxiety levels normally associated with those issues.
The accounts presented in this book derive from about fifty individuals, of various ages, professions, and degrees of psychospiritual sophistication. They were apparently gathered from about twenty anonymous therapists, mostly, though not exclusively, from the West Coast of the United States. Some of the reports are from guided therapeutic sessions; others are from sessions with serious psychological or spiritual intention, where the “sitter” might be a trusted friend or partner, rather than a therapist. A considerable number are by individuals who are themselves therapists”which suggests that some of the most promising potentials of these substances may lie in the training of therapists ” where the capacity for empathy is a highly-valued.
A smaller number of the reports are from group experiences, usually of a highly structured or ritualistic nature. Although the relatively unstructured, recreational use of Ecstasy in informal small groups of friends is probably more common, most people are agreed that the use of rituals similar to those of the Native American Church, or other shamanic traditions, is the preferred mode of operation when powerful sacramental substances are taken in a group context.
The editor of this volume, the writers of the Foreword and Guidelines, and the publishers, do not advocate the use of any illegal substance. Nor do they advocate that individuals attempt to treat their own medical or psychological problems with the use of this or any other substance. Nor do they recommend the use of these substances by individuals without the supervision and consultation of one’s physician. Given these obvious limitations on the use and accessibility of these drugs, the question might be raised as to the point of publishing these accounts since the experience with MDMA is now one that has become illegal. The answer to this question that the therapists and their clients using these substances would give, is that it is in the public’s interest to be aware of what is an extraordinarily promising new tool for the exploration of the human mind and for the improvement of human relations.
Perhaps greater public knowledge of these substances and their potential human benefits can lead to a considered re-examination of the social and legal framework with which our society deals with such matters, so that as other substances of similar import are discovered, their uses and potentials will not be wasted. Many of the individuals whose experience are recounted in this volume expressed the wish and hope that, given the gravity of the planetary crisis in which we find ourselves, aids to the evolution of consciousness such as these substances will be thoroughly explored, and applied to the solution of the immense human problems that confront us.
The following is another excerpt from “Through the Gateway of the Heart.” This excerpt, titled, “I Was Resting in the Palm of His Hand,” includes the experiences of an ex-nun during an MDMA treatment.
35 year-old former school teacher, ex-nun
Set: therapeutic, spiritual.
Setting: therapist’s office, with guide.
Catalyst: 150 mg MDMA plus 50 mg MDMA.
Perhaps the most obvious feeling for me at the beginning and throughout the session was the incredible sense of peace and release from the bondage that I felt. My body was no longer a trap, a prison, but instead became like a kaleidoscope, a mingling of different energies. I felt myself being several “I”s in a very strange way. Sometimes I felt myself very wise, sometimes I was the adult me (not so wise) and sometimes I was a child. I felt a deep friendship with the guide, as if I had known him for a long time. Certain other relationships came up and I saw them as equally lovable. I was able to detach from intense attachments that bring pain and was able to love gently and freely, a truly wonderful gift for me.
I found myself thinking of God the Father and felt that I was resting in the palm of His hand, just as Isaiah says in the Bible. I was being rocked in a large hand with darkness as universe all around me. It was incredibly soothing and loving. When the guide put on certain music, I felt romantic, and instead of being with God the Father, I was dancing with a very handsome man whom I don’t know. It was very peaceful, not passionate; very graceful and free. Then I was confused, and it became the figure of Jesus. I was amazed. I told the guide that Jesus was my brother whom I loved very deeply. The guide suggested that Jesus was also my lover and yes, I have felt that, though a bit guiltily. But love like that with a man is what I have sought”passion and gentleness together”peace. In my life both aspects have always been separate. A man is either passionate or gentle, and I love both, but they are separate.
I knew instantly what my life’s purpose was”to continue to seek the heart and mind union, to continue to remember the essence within which was so peaceful, in spite of worldly activities. Adam revealed a new potential which I knew was there, but was too afraid to experience alone. As far as my studies, I realized they were important, but they only mattered in the world. I saw that I was worrying too much about others’ opinions of my work. I realized that the intellectual work has been a saving grace for me”I truly love the work of the mind, I have always been an avid reader. But, now I can put it in perspective. I have been putting too much energy in concepts and theories that may change in ten years, whereas the eternal principles of love, truth, self-realization, etc., remain the same. Now I can, with the help of Adam, tap into the deeper resources which were always my goal. I am still a bit afraid of the future, of going back “into the world,” but after the session, I feel that the inner connection will guide me through and I will find my place. The place will definitely be working directly with love energies.
When the guide played Vangelis’ Odes I felt as if my soul had been called. I remembered my Greek heritage and I went back to ancient times in feeling and memory. I felt very, very old. I could have died at that point and not felt bad about leaving my loved ones. Somehow I felt that they would understan
d. Death was so natural, so peaceful.
With the South American jungle music, I felt very earthy and that felt threatening. I felt that I was going to be sacrificed, and my dream of running away over the mountain was remembered. Going into instinctual waters is very scary for me, I realized then. I felt the possibility of the mind gone wild, of no principles to live by, of evil sorcery and of life being worthless. Since then I have realized that I feel the same way about certain areas of the ghetto where I grew up. in fact, some were even called “the jungle.” There is a sense of being ripped open and apart. I have felt that passion does that, when it is purely egotistical desire without taking the beauty and dignity of the human being into account. In some ways, my quest for the spiritual was to purify myself from those threats. I have never seen that before. But I think I definitely have to face those instincts now, though I am afraid.
During the session I saw my mother’s life and realized that her suffering was hers, not mine. This has been a great release for me. I saw that, just as I could have died then and there and known it was right, that she also, at some level, perhaps had that feeling. I could see under the normal layers, in a way, and know that we all know the truth underneath. So too my mother may have known that someday I would understand and accept her death, without feelings of abandonment. This was a wonderful gift. When I thought of my father, I missed that sense of security and power that comes from the male (at least for me) but I was getting it from God the Father as energy and love. I was able to see my parents as earthly extensions of Divine parents and as such of course limited. But since I now felt the presence of Divine parents, it was O.K. I still hold that feeling to this day, though not as strongly as during the session.
I realized that I have a hard time receiving love, I mean, really experiencing it. I know that I am loved, but I feel shy and don’t seem to give it much importance. I felt a deep sense of self-love, a feeling of rightness about me, as I was. In loving freely, I want to give without expectations but also receive without judgment. I see this very clearly. It will be my life’s goal. I’m really excited about it. Life now becomes a mystery, but a good one. Before, it was always a problem. As a mystery, I am not judged if I am me, I am looking to see who that “me” is. And looking, in itself, is worthwhile. Another relief.
One of the most beautiful experiences of the session was the resolution of Christian and Buddhist compassion. This has been an inner question for me for many years. How could Buddha love and not feel sad; how could Jesus feel sad in loving and still be enlightened? Somehow, during the session, they came together. I saw that Jesus’s heart, sad with the ignorance of the world, was an expression of his life externally, but that internally, he was absolutely sure that he and the Father were one and so, his soul was at peace. Buddha’s external expression was mind, a peaceful, harmonious mind, but his internal experience was a deep sadness and heartfelt compassion for the suffering of the world. So he, too, gave his life to save others from suffering. For me, Jesus and Buddha, in front of whom I pray and meditate, became two sides of the same coin, two perspectives of one experience. That question is over and I am truly grateful, for I can cultivate both heart and mind, knowing that sadness and peace can be simultaneous emotions or feelings, and not judge them as separate. Also, that sadness and love are one aspect and that joy and love are also expressions of love. Love can and should also be practical.
Alternet shares excerpts about the therapeutic potential of MDMA from researcher Ralph Metzner’s book, Through the Gateway of the Heart; Accounts of Experiences with MDMA and Other Emphathonic Substances. The article explores the potential benefits of using MDMA-assisted psychotherapy for PTSD, details the possible beneficial effects of the drug on people with anxiety, and highlights an ex-nun’s experience with MDMA treatment.