Summary: April M. Short of Reset interviews an underground therapist who explains how MDMA-assisted psychotherapy can be more effective for treating trauma and anxiety when compared to traditional talk therapy. The article reviews the process of conducting MDMA-assisted psychotherapy, and highlights MAPS’ continuous efforts to conduct the research necessary to develop MDMA-assisted psychotherapy into a prescription treatment. “Today, MDMA, used with therapy, is well on its way to becoming a legal medicine,” says April M. Short of Reset.
Originally appearing here.
In the late ’70s and early ’80s, a faction of therapists in Northern California were using a newly discovered substance in tandem with their sessions, and turning over profound results. The practice was so successful in mitigating various mental health problems that it inspired a new method of therapy that involved 8-hour-plus sessions — however long it took — rather than the old hour-long, “That’s all the time we have today,” method. The substance was MDMA. The yet-to-be criminalized psychoactive was helping therapists tap into unmatched realms of empathy and healing. Word spread, and in underground rave scene MDMA came to be dubbed “ecstasy,” “E” and “Molly.” Soon its recreational popularity freaked the federal government out so much that the Drug Enforcement Administration (DEA) declared its use — therapeutically and otherwise — a federal crime in 1986. Today most of what is sold as MDMA is cut with any number of chemicals and often contains none of the real thing whatsoever.
But the original MDMA therapists never forgot about the incredible healing they’d witnessed in MDMA. Thanks largely to a tireless labor of love on the part of a few of those therapists — in particular Rick Doblin who founded the psychedelic education and research nonprofit MAPS (the Multidisciplinary Association for Psychedelic Studies) — scientific study has continued to assess the real safety and efficacy of MDMA-assisted therapy in human clinical trials. Today, MDMA, used with therapy, is well on its way to becoming a legal medicine. Various studies are proving its incomparable potential to alleviate issues ranging from severe, treatment-resistant PTSD and depression to the most intense of all anxieties — facing your own impending death. Government-sanctioned clinical trials using MDMA-assisted psychotherapy are entering Phase II (after passing Phase III, a substance becomes a prescribable medicine in the U.S.), and the results so far throughout Phase I have been overwhelmingly positive. So much so that Doblin of MAPS, which sponsors many of the MDMA studies, predicts the medicine will be approved within six years.
Regardless of the existing scientific evidence — on top of countless personal testimonies that celebrate MDMA’s curative, often life-saving potential — today the U.S. government still categorizes it as a Schedule I illegal substance with no known medical value. It is a felony to use, sell or make MDMA outside of approved clinical research. However despite the laws, a number of therapists and healers continue to offer MDMA-assisted sessions in secret. These healers, many of whom are part of a close-knit community, knowingly jeopardize their own safety and reputations to provide the healing they know MDMA can offer.
One such healer, who has assisted more than 50 individuals in MDMA sessions, agreed to speak with April M. Short of Reset about the treatment, how it works, and why they’re willing to continue to offer it despite the risks. This particular healer was a massage therapist for more than 20 years and is a longtime practitioner of holistic medicine. They also completed a comprehensive somatic psychotherapy program, and are continuing to study more trauma-specific therapeutic methods. Due to the overt risks involved, they have requested to remain anonymous.
The following is taken directly from our conversation, edited for clarity and length:
April Short: How did you originally come to learn about MDMA-assisted therapy?
My former husband and I were going to marriage counseling and he mentioned he’d done some therapeutic work using MDMA before. That marriage counselor happened to know somebody, so I went to go meet this person. My husband started having therapy with this person and then he got involved with working with them more closely. He was using other medicines besides MDMA, he was using [psilocybin] mushrooms as well. I saw him looking at undealt-with stuff for the first time, and saw him growing before my eyes. Then I became interested, so I went to this person and had a mushroom journey for the first time. I’d taken mushrooms as a teenager for the first time but not in this context.
AS: It’s amazing how different it is depending on the context.
It’s very different. It was very eye opening. There was a sacred element to it and there was a psychological, bringing-old-stuff-up part of it. And so, then I started training with this person. And the person wanted me to have more skills, since I did come from a psychological background. I took the two-year [somatic therapy] program. [Somatic therapy] deals with how things are stuck in the body, and how you might deal with things more mindfully in looking at what’s going on in the body. It’s not just talk therapy in and of itself. It looks at character strategies and how we might have defenses up for different developmental needs that weren’t met.
In that program they talked about attachment and they also talked about trauma. And in the [psychedelic] medicine community, trauma would come up. I also kept hearing this word there as well as within the [somatic therapy] community, of “retraumatizing.” That became sort of the Boogieman. I thought, ‘Oh no, am I gonna retraumatize someone by using this work?’ And so to face that Boogieman, I wanted to learn more about trauma. And so now I’m in this three-year somatic experiencing program, starting the advanced portion soon.
AS: Do you have a specific title you call yourself in the work you do?
Not really. I say I do shamanic-type work, healing work.
AS: How long have you been doing healing work in general?
I started to do massage in my late 20s after a profound spiritual awakening that was not induced by medicine, but, my face was on the ground so to speak. I was looking forsomething, and I had a profound awakening experience that changed my whole direction in life. I started studying and looking at yoga and meditation and I was getting into massage at that time. I started to see that the more relaxed I am and the more relaxed my mind is, the more present I am, and the more mindful.
AS: That’s the kind of experience many people turn to medicine like MDMA for, right?
Yeah, medicine can bring that kind of experience on. It can bring a lot of things on. It can bring on young memories, it can bring frightening shadow stuff that a person may or may not be prepared to see. I have a great respect for it. In no way do I advocate for it for everyone. It should be used by people who do this work with the right intention, in the proper setting with the right facilitator, and having done some personal psychological work so that you know some of the things that are gonna come up. The medicine is not necessarily going to shoot you to the moon and grant you instant enlightenment.
AS: I think that’s such an important point, because so often people hear about this kind of thing, and maybe they’ll hear about someone’s positive experience with medicines, and they think, “This is perfect for me, this person has the same problems I have, so I should definitely u
se this medicine, it’s going to cure me.” It’s important to note that it doesn’t work the same for everyone, and set and setting are key.
Yeah. And there are a lot of contraindications, or a lot of precautions to look at. Like with MMDA, have you heard of serotonin syndrome? Do you know that if you’re on antidepressants and you take MDMA it can be potentially fatal? There are a lot of things that you need to look at. Is somebody really drained and exhausted? I heard of a woman in the community whose client was really drained and exhausted and took MDMA and had to go to the hospital. So, you really need somebody that’s mindfully looking at things rather than just giving you a substance and saying, “I’m sitting here with you.” I think that you need to really know some things about the context, and contraindications especially.
AS: I’m wondering if you could just talk me through an actual session, from start to finish, and describe how it happens.
I’m inclined to start with the pre-sessions because those are important. I won’t do a medicine session with somebody until I’ve gotten to know them a little bit. That’s part of the contraindications I’m talking about — getting to know whether I feel like they’re physically capable, or if this is a good time in their life, or what experience they have. So I do have a few pre-sessions where I talk to them. I ask about any diagnoses they’ve had by different therapists in the past — that’s important to know. Somebody could be manic-depressive and then you give them this and they could go way over to the depressive side or something like that. I need to know if somebody is borderline. I wouldn’t do it with somebody who’s borderline. I need to know whether they’re on antidepressants.
They might be a good candidate and be on antidepressants, in which case they could taper off of [the antidepressants] with the help of their therapist or whoever, and then we do the session, and then maybe they get back on the antidepressants afterwards. That’s pretty common, that’s something that’s done. I have somebody in the medical field I can talk to about different antidepressants, I can ask them how long they need to be off [before an MDMA session], so that’s a good situation.
So, it starts with these pre-sessions. And we’re also talking about what they’re hoping to find out. I try to encourage that it might be a general thing they’re wanting to look at rather than something specific. It does have a truth serum-y quality to it, but I encourage them to think, “What is my relationship to intimacy with people,” rather than, “Why am I not intimate with this particular boyfriend,” or something like that. Because, blending with your own psyche, the medicine will reveal what you can handle in a certain time. That has been my experience.
I talk to them about preliminary diet, making sure you eat good, and then eating a light meal the day before. Maybe just some tea or something that morning, or maybe just starting on an empty stomach. We meet in a location where they feel safe, where there’s a place for them to lay down, a couch or a bed, and then they take the medicine.
It takes a while for it to come on, for it to peak. Probably about an hour or so. And it’s during that peak time that is so fruitful for them. It’s, in therapeutic terms, so resourceful for them. It makes it easier for them to look at different things in their lives. It has this whole chemical and hormonal aspect of what it does in the system. It also has a spiritual aspect.
I put on music that’s kind of soft and new agey or shamanic, but not harsh drumming or anything. Just something that can be in the background. The music can also be emotionally provocative at certain times. I sort of set it to the timing of the medicine.
AS: How much are you involved in the process? How much are you talking to them?
It depends. It can be really talkative, and if they’re talking a lot and not really checking in a little bit more with their direct experience, I’ll encourage them to talk a little less and go in and see what’s really important. I’ll offer them a blindfold too, so that they’re really using this time to get the most out of it, rather than just chatting away with me about some art project they’re gonna do. Because it can really go off into a zillion different directions. And doing some art might be really relevant for them, they may really need to do something creative, and maybe they’ve left their art behind. But it’s just a matter of distinguishing between rambling, and talking because it’s really what they want me to do at that point in time.
…
So, I’m taking notes for them as they’re talking. I’ll record things that they’ve said of their own experience, not necessarily my interpretation. There are events where I will bring in my [somatic therapy] and trauma skills. There was an instance where a woman felt kind of powerless and young and she seemed trapped in that a little bit. It didn’t seem overwhelming or scary to her, but one thing I did to help show her that she had power was have her push against my hand, and encourage her to feel the “I am”-ness of that. It did kind of bring her out and bring her into more her resource-self. And it kind of opened up this whole other world of this lady she used to be in a different lifetime or something. But it was a significant step so she didn’t just stay trapped in that powerless place.
I know a man who did this work who would just give people medicine and then leave them alone. I don’t think that’s really helpful, and I think it can be damaging — especially if being abandoned was one of your issues. You need somebody there to at the very least hold space, but maybe even intervene at different times. It can move energy through the body and it can be helpful to have a couple different techniques on hand.
AS: That’s something most protocols say, for example at MAPS and also taught in harm reduction training…, that you need a guide.
“Yes. And hopefully a guide with a couple tools.”
AS: Definitely. Is there anything else you want to share about the actual sessions?
Just that there will be a coming down period, and taking notes is fruitful. People may not even get it at that time, they might not get everything that’s relevant, but in the days and weeks later they’ll go, “Oh, yeah, this is significant.” It kind of starts to seep in more. And I encourage them after that day to journal and to be mindful and to be aware that this can be an open time for their psyche, so they should be gentle with themselves, not putting themselves in harsh situations. Even that day, going home, they should not really watch a particularly violent movie. Just being gentle with themselves.
AS: It’s amazing what a difference, in my experience at least, the more therapeutic setting versus the recreational setting can make. Could you say something about the importance of the set and setting?
Well I would go much farther. It’s much more than the set and the setting. I think the person you’re with having some experience and some training is key. You could get a good, kind friend that is sitting there with you. But what if the experience triggers a traumatic event? It’s not really helpful to go right into the memory of trauma. And that’s why I’m so grateful I’m learning about trauma. It’s not about going into that memory and re-experiencing it, it’s not about that at all. It’s about energy trapped in the nervous system, and dealing with that energy, and processing it over time, and gaining a better ability, or resourcing ability, to handle all of that.
So I think it’
s more than set and setting, but the skill that the person has to sit with you too. If you are kind of veering off into “Oh, that night that I was hit,” the person can say, “Let’s just pause there and notice how you feel in your body. Notice that your feet are on the ground. Look around the room and notice that you’re safe.” You know? Rather than opening up an unnecessary can of worms.
AS: Where do you actually get the medicine that you use? You don’t have to give me any names or anything. And how do you know that it’s tested, and pure, and all of that? Because that’s a big concern for everyone.
From a private source. These people have been working with it for a long time, and worked with a lot of people for many, many years. And, then I have personal experience with this medicine. So, I don’t actually know factually but I have my own personal experience that it’s clean, comparing it to, only one time really that I took [MDMA] when it felt really more jangly and speedy, not quite right.
AS: Yeah. It’s just a symptom of prohibition really, but if people wanted to go do this on their own with a friend, or with a therapist of their own or something, it’s so hard for them to figure out how to go about doing that.
It is. And there are testing kits out there.
As: That’s true, and there are places you can send it to get it tested. But that’s interesting, that’s good that there are some places people like you can go for medicine that are time-tested.
Yeah, time-tested is a good way to phrase it. And trust in these people, too.
AS: Yeah. That’s important. So overall with the people that you’ve worked with, what have the results been?
I think it has been at the very least insightful. I think it has opened up a whole world of, well, like Carl Jung says, we are only really privy to a certain amount of our consciousness. There’s so much that’s unconscious. And until you actually look in there and experience that, you don’t really know what’s there. There are lots of parts that can be healed or integrated. That’s been my own personal experience: I’ve seen very young stuff come up over time, which I had no idea was there. So it’s opened up a whole world of healing possibilities for me.
So to get back to your original question, I think insight, and healing, and hope are the main results. And I’m not really a big fan of the word hope, because it does kind of take you out of the present moment in hoping that life as it is will change — and there’s a lot to be said about accepting life on life’s terms. But if somebody is trapped in depression or trauma or PTSD or something, giving them hope that things can heal and be met is something that happens.
AS: Right. Because in those situations part of what’s really debilitating is when you feel like they’re gonna last.
Right. Look at all our returning vets and the high suicide rate. (Editor’s Note: More than 22 veterans kill themselves per day in the U.S. according to the Department of Veterans Affairs statistics.)
AS: We cover a lot to do with vets. We recently ran a piece I wrote about a veteran who actually reached out to us wanting to tell his story on the record, which I think is really courageous. He tried ayahuasca when he was on the verge of suicide due to lasting, overwhelming depression and PTSD, and it ended up saving him.
That’s heartbreaking.
AS: Yes, it is… I’m wondering, have you had any negative outcomes from MDMA sessions?
I haven’t. There was one time where I had a woman who — nothing happened for her in the session. And I didn’t get to know her well enough prior, which was really good learning thing for me. I did do a few pre-sessions, but I don’t think it was enough. The medicine didn’t, seemingly, take effect and I don’t know whether her psyche just kind of blocked it from taking effect, or if there was something with her chemistry, or if there was something she didn’t tell me. Like, oftentimes people who smoke marijuana frequently, it won’t be as effective. Or with antidepressants it won’t be as effective. But, for not much at all to happen, that had never happened to me. So she was disgruntled. And we just had a few conversations about how to handle it. I think that was the only negative thing.
AS: Interesting. Is there a specific dose that you usually use?
I do it according to their weight and what I feel is right for them.
AS: Ok. Is there an average dose, or a ballpark figure?
I would say maybe 120 milligrams is kind of an average.
AS: Alright. You already kind of shared a couple, but if you could, would you share another anecdote from a session that was powerful or that you remember strongly?
There was a woman who, in one of her sessions she was laying down. And for me, I don’t have a lot of physical energy, I want to lay down, and that’s a lot of people’s experience. But in this particular session she wanted to stand up and be able to stomp her feet. And I saw it as kind of a step of empowerment, a way of making decisions about how she wanted to do the session. And maybe it was relevant for her life, then. But it could also be recalling a developmental stage when she was two years old or somewhere else in her life, where it was really important to make her own decision and be more in her body and standing up.
So it was kind of unusual, and of course I was going with it, but I did have this tendency to say, ‘Don’t you want to sit down and kind of check in with your heart?’ But that’s not what was happening, she really wanted to stand and walk and she was getting angry about different family members, and so on.
AS: Interesting. And when something unexpected like that happens in your sessions do you tend to just go with it and let them kind of do their thing?
I do, especially if I can see they’re not harming me, or anybody, or any objects in the room. And we make those agreements prior, that they’re not gonna harm me, or themselves, or any objects in the room. And yeah, I pretty much tend to go with it, unless I think they’re really just taking up time. Like, with a male client I have, I do tend to reel him in a little bit and suggest that he go inward after a certain amount of time.
A: So, if they might be doing it as a distraction or something you’ll reel them in?
Yeah, or if they’re just too focused on it. Like I was saying, you can get really jabbery about an art project when that’s not really relevant. So I’ll just say, “Ok, let’s come back and let’s check in with what’s really important.” And I’ll really encourage them to go inside.
A: I would imagine, especially, with your background and all the different types of healing work you’ve done, you’re good at kind of feeling it out.
Yeah, I think it’s party all of them together, but I would say most importantly the trauma work, and working with my different trainers and mentors in group settings. And experience.
A: What do you typically charge?
I charge on a sliding scale, and that would be, the pre-session is anywhere from $60 to $100, for the individual one hour sessions. And I do post-sessions too, because I want to make sure they’re integrating it. There might only be one post-session, or there might be more. But the day itself, I charge $450 for.
A: How do you find clients, and do you get nervous? If I were in your position I’d be really scared to try and solicit clients. I guess I’m really wondering how it feels for you, and why it’s worth it.
Well, I don’t’ solicit, so that answers that. It happens through word of mouth, and I do tell what I do in certain settings where I feel l
ike I’m with a liberal crowd, or especially trustworthy, receptive person. I’m very careful about which settings I talk about it. I might just say I do shamanic work, and if somebody has some interest I’ll talk about it more.
I try to be very careful, and I do it because think that it’s very useful. There are people who think that its legal status could possibly change in the next ten years or less.
A: Six or seven years is what I heard.
Yeah, exactly. I’m hoping it will change. The statistics out there for people getting healing from this is are so high.
Although I place a lot of value on this work, now that I’m doing the somatic work I see that as just as, or more, important. You need to get to the energy that’s lodged in the spine. If you go on Youtube and look up “Peter Levine energy” and maybe “slinky,” there’s a six-minute video where he’s talking about a slinky, and how that energy works (Editor’s note: You can view the video below.)
He talks about that energy we have that’s enough to mobilize a mother to lift up a car and free her child if she needs to — that can get trapped in our physiological nervous system. And I don’t think the medicine will necessary address that. I think it can open up a way to look at trauma and heal trauma and do the chemistry and brain part, and some of the healing part. But I don’t think it will necessarily address that energy that’s trapped in the nervous system. So I think that they’re good compliments to each other. Waking the Tiger is a good place to start, it’s a good book on this.
A: Could you speak a little more to why you do the work that you do? Why is it all worth it? Why do it at all?
That is a good question. I think because I’ve healed so much from it myself. I think that it really is a beginning for people to see that unconsciousness that is there that we don’t deal with. We pretend in our culture that everything’s okay, we buy the clothes and we put on a smile and we have the job and the car or whatever, and everything’s “Okay.” …So when I see the potential of healing in things I have done for myself — and you come across so many wounded people — I guess I just want to help, and in a deeper way, rather than just sitting down. I don’t think I’d ever be interested in doing talk therapy. I mean, talking is certainly a part of it, but I don’t think it really gets to the root of the problem. It’s all in our system, in our body, in our psyche. I don’t mean to put [talk therapy] down, I just think there are more effective tools.
A: What do you see as the future of these medicines, and these therapies, everything you’ve been talking about? Do you think we are headed in a direction as a society that’s gonna be more embracing of these different healing modalities?
I don’t know. I would like to think so given the research that’s being done in establishments and universities around the globe. That makes me think that it’s possible. And then, sometimes when I look at regular life and I see a mom or a dad staring down at their cell phone instead of looking at their baby, I just think, ‘Who knows?’ I hope so.
A: Is there anything else you’d want people to know about this kind of work?
Just, I think it deserves a healthy respect in terms of looking at contraindications and researching, and making sure you’re talking with somebody to determine whether you’re a good candidate for it or not. It really could be potentially harmful if you are on antidepressants or exhausted of numerous things. So I think it’s something to be respected, and not taken lightly.