Summary: Playboy’s newest article on psychedelic-assisted psychotherapy features an interview with MAPS Founder, Rick Doblin, Ph.D, exploring current therapeutic applications of psychedelics, scientific research results, and the developing “psychedelic renaissance.” Playboy highlights the success of the current FDA-regulated clinical trials of MDMA-assisted psychotherapy, stating, “Over the past few decades, MAPS has sponsored a number of very successful studies on MDMA-assisted therapy for PTSD. So successful, in fact, that the FDA gave MDMA a “breakthrough therapy” designation in 2017, and they’re now moving into a third phase of clinical trials for FDA-approval as a legal prescription medication for PTSD, in conjunction with therapy.”
Originally appearing here.
It’s 6 am on a Saturday morning and Mary*, a veteran with Post-Traumatic Stress Disorder (PTSD), is waking up to start a full day of heavy therapeutic work. But she’s not heading to a retreat or intensive group session. No, she’s tried that without success. Mary is about to take five grams of magic mushrooms to do some serious introspection and work on her debilitating PTSD and depression.
“I tried it and I felt great, even after the first dose,” she reports. “I felt calm. I felt good, I felt human again and not scared or jumpy or just angry all of the time. I felt like it gave me tools and it showed me stuff that helped me even in my sober kind of state, that helped me cope with things that I wouldn’t be able to typically cope with if I hadn’t have tried psychedelics.”
Mary joined the U.S. Air Force in 2006 and loved it. She traveled the world, helping people and moving up in rank over the course of more than half a decade. It wasn’t combat that gave her PTSD. She was roofied and raped while stationed in England, and then was called a liar, emotionally abused, demoted twice, and eventually discharged two weeks before her court case, over the course of two long and disturbing years.
Now, her PTSD and depression has spiraled so out of control that she can’t hold a job. She’s tried all types of talk therapies for the flashbacks, nightmares, and anger she carries around, but they made her feel worse. “My treatments weren’t very effective,” she insists. “I hated taking the medication for the side effects and therapy was just very brutal and just left me very drained and very upset with myself. And I’ve tried individual, I’ve tried group and it just wasn’t doing it. I didn’t feel good about what I was doing.” The laundry list of medications Mary was on included Trazadone, Klonopin, Prazosin, and Lithium, which she particularly hated. “[Lithium] actually made me feel worse. It made me feel really, really, really numb. Like there was just no emotion whatsoever which is awful, just horrible. You just don’t feel human. You feel like… you’re just a zombie and it gave me really, really bad shakes.” Seemingly at the end of the road, her husband stumbled upon some research on psychedelic therapy and they started exploring the idea together. Although, in comparison to her husband, Dave*, Mary was much more apprehensive about the idea. “I was really wary about it [taking psychedelics], I fought tooth and nail, like I really did not want to take any,” says Mary. “Being in the military for so long, it’s instilled in us that drugs are bad. It doesn’t matter what they’re called, what form they come in, they’re all bad and we are fighting that war…I’m thinking it’s going to turn my brain to mush, I’m just going to turn into a potato.”
However, the more the desperate couple looked into it, the more legitimate psychedelic therapy seemed as an option. As many psychonauts will proudly tell anyone within earshot, scientific studies on psilocybin (the psychoactive ingredient in magic mushrooms), LSD, and MDMA started in the 1950’s for a variety of mental health issues, including alcoholism, depression, OCD, and end-of-life anxiety. Although many of those studies had promising results, they weren’t performed under the scientific standards we have today. After the 60’s and the counterculture’s full embrace of psychedelics, the Controlled Substances Act of 1970 stopped most of that aboveground research, but not all.
The Multidisciplinary Association for Psychedelic Studies (MAPS), founded by Rick Doblin in 1986, has been a driving force in the current “psychedelic renaissance” we find ourselves in. Over the past few decades, MAPS has sponsored a number of very successful studies on MDMA-assisted therapy for PTSD. So successful, in fact, that the FDA gave MDMA a “breakthrough therapy” designation in 2017, and they’re now moving into a third phase of clinical trials for FDA-approval as a legal prescription medication for PTSD, in conjunction with therapy. During the second phase trials, 68 percent of 107 participants saw their PTSD symptoms subside one year after their three MDMA-assisted psychotherapy sessions.
“It is the most rewarding job I could think of doing,” says Shannon Clare Carlin, MDMA-assisted therapist on the MAPS trials and program manager of the MDMA Therapy Training Program. “Most of the people that we work with, they’ve had PTSD for a long time, and have tried a lot of other treatment options… and none of them are helping.”
“A common experience with PTSD is suicidal [thoughts] and it’s like it feels like life and death sometimes to somebody with PTSD,” Carlin cautions. “Like, if I don’t heal, I might not be able to keep living. And that’s a lot of pressure… [But] then seeing the work that’s actually happening in those eight hours [of MDMA-assisted therapy], it’s like, oh, yeah, we’re going to get there… We do really, really hard processing that’s challenging, and sometimes dark, and then we do these moments of celebrating, and it’s kind of this feeling [that patients get during MDMA-assisted sessions] like, wow, I have my life back. I’m not fearing that I can’t go on living.”
MDMA isn’t the only psychedelic moving toward FDA-approval—psilocybin (or mushrooms) isn’t far behind. Similar to MAPS, there are two nonprofits supporting research into psilocybin’s therapeutic effects, the Heffter Research Institute and the Usona Institute. Heffter has been the leader of psilocybin research since it was founded in 1993, supporting research at John Hopkins, New York University, and other top universities, and exploring issues such as psilocybin for addiction, treatment-resistant depression, obsessive-compulsive disorder (OCD), eating disorders, terminal illness diagnosis anxiety and depression—and even, criminal recidivism. Their eventual goal is to get psilocybin approved by the FDA, like with MDMA, so that it will be possible to receive a prescription for psilocybin assisted-therapy for treating these diverse issues, among others.
And psychedelic therapy has more options than MDMA and psilocybin. ketamine, LSD, ibogaine, and ayahuasca are also helping people with a variety of mental health issues, including depression and PTSD. While the amount of scientific evidence stacking up to support these therapies is inspiring, many believe these life-altering substances should be limited to the clinically ill if FDA-approved. But that doesn’t include Rick Doblin. “We’re all fucked up,” Doblin says, “If you look at the world, there is so much pain and suffering and tragedy going on everywhere, that if someone has the slightest degree of empathy they’ll have a certain amount of PTSD just living in this world, knowing there’s all these refugees, knowing there’s people being tortured.”
But Doblin believes, that’s one way psychedelics can help the rest of us, without diagnosable illnesses, to help process our emotions and move forward. “A psychedelic experie
nce helps because you get deeper insight, you let certain emotions rise closer to the surface,” explains Doblin. “One way to say it is—you’re building your capacity to overwhelm your defenses, to let your defenses down so these difficult, painful emotions can come to the surface and you’re not suppressing them.”
These substances help to give people perspective; they help people see themselves from a new angle, one that’s more forgiving. In more scientific terms, researchers believe MDMA works particularly well for this process because it reduces activity in the amygdala, which is responsible for fear and the “flight or fight” response. When the amygdala is calmed, it makes confronting trauma and talking through it with a therapist, or two, less stressful. “People are able to recount their trauma and process their trauma without the same feeling, like they’re in imminent danger,” explains Carlin. “That’s a common symptom of PTSD, is something happened in the past, and it feels like it’s threatening today…So, having that reduced activity in the amygdala really lets people go back there and fully process it, kind of like… putting some of the pieces to rest at their place in history.”
Researchers are finding that the people who are the most positively affected in the long term from psychedelic substances are those who have full-on “spiritual” or “mystical” experiences during their trips. Relatively high doses of psilocybin, LSD, or ayahuasca can help distance users from their egos, which often has a profound impact on how they view themselves and the world long after the drug wears off. A 2011 study at John Hopkins looked at how psilocybin was affecting people’s personalities in the long term. What they found was that participants who had “mystical experiences” during their psilocybin session were more likely to score higher on “openness” personality tests more than a year after their trip. What kinds of experiences facilitated this change in personality? The researchers define “mystical experience” as “feelings of unity and interconnectedness with all people and things, a sense of sacredness, feeling of peace and joy, a sense of transcending normal time and space, ineffability, and an intuitive belief that the experience is a source of objective truth about the nature of reality”—so clearly not everyday stuff.
However, many of these research institutes will advise those curious in trying this at home that having a trained therapist present is crucial to success, never mind intentions and thought-out “set and setting” to work on your issues. Participants in these psilocybin and MDMA clinical studies are in a controlled setting, often a comfortable room with two therapists, one male, and one female, for six to eight hours. They usually also spend the night at the facility and have an integration period after, which consists of talking out the experience with the same therapist, and doing some serious reflection on the “trip”. But outside a research context, these guided trips are still illegal, and while underground psychedelic therapists exist, they are financially out-of-reach for most folks.
But let’s be realistic, if you were to try this approach at home, how do you choose which drug is right for you, therapeutically? First of all, it will depend on your intentions and previous experience. Rick Doblin explains that mushrooms, LSD, and ayahuasca can be more “challenging,” so he suggests MDMA as a good jumping off point. “MDMA being the most gentle, that’s a good place for people to start if they haven’t done this before,” Doblin tells Playboy. “There’s a certain amount of letting go and confronting fears and anxieties when your ego is dissolving, when stuff that you’ve repressed or you haven’t been aware of comes to the surface and that requires sort of a learned skill and a learned trust of your own unconscious.”
For those dealing with treatment-resistant depression, ketamine might be the way to go. Right now in the U.S., there are at least 50 “ketamine clinics” where people with treatment-resistant depression and other mood disorders can receive 45-minute infusions of ketamine in a comfortable setting. Even Johnson & Johnson (yes, the “family company”) is developing a ketamine nasal spray to be used in conjunction with anti-depressants in those with treatment-resistant depression and for those at high risk for suicide. At the moment, there’s no “fast-acting” treatment for depression or suicidal thoughts, and standard anti-depressants can take over a month before they take effect. Johnson & Johnson’s ketamine nasal spray, which is in its third phase of trials with the FDA and was also designated a “breakthrough therapy” recently, would fill that gap in treatment by providing instantaneous relief for suicidal thoughts.
Although, in general, Big Pharma has mostly stayed out of the psychedelic renaissance. Psychedelic therapy totally breaks our current mental health care model of long-term psychotropic drugs and weekly talk therapy. Psychedelic therapy is a quick fix in comparison, one high-dose session can have such a lasting impact, it has the potential to turn our whole system inside out. But it’s a broken system in need of renovation—depression is the foremost cause of disability worldwide affecting over 300 million people according to the World Health Organization (WHO). Not to mention, the suicide rate of PTSD sufferers and veterans is so high, they should have the right to alternative therapies.
However, Doblin did explain that this won’t be a mental health “cure all.” He tells Playboy that people who score high on scales of dissociation don’t respond as well to certain psychedelic therapies. That can include people with schizophrenia, bipolar disorder, or even those with PTSD who are more dissociative. That doesn’t mean psychedelic therapy isn’t an option for them, but Doblin explains, it might take more sessions and may require safer, “more controlled” environments. However, the range of possible therapeutic uses for MDMA and psilocybin are astounding.
Plus, when you start talking to Doblin about the ultimate goal of MAPS, you begin to realize that this is only the tip of the psychedelic iceberg. He believes psychedelics and psychedelic therapy will be a standard, alternative option in the near future. By 2035, psychedelic therapy will be covered by your insurance, from MDMA-assisted couples counseling to psychedelic hospice centers, this is only the beginning of a bigger cultural shift.
As for Mary, her trips might not be a quick fix, but the insights she’s gaining are helping her to have perspective on her emotions and trauma and more appreciation for the day-to-day, stepping out of her anger and feeling like she matters again. “It [tripping on mushrooms] really made me feel like I matter,” says Mary. “It was very personal and just like, I can do so much. There’s so much that I can do and I still have yet to do, that I should do. It just gave me the courage and the strength and I could—I don’t know, love myself.”