Psychedelics-assisted therapy

happy to contribute! and i hope more people will engage with the conversation and share how they feel about this topic.

getting ready to leave for a holiday (and do another mdma session with hubby while away), so i will try to check in when i have a moment and reliable internet access, but apologies in advance if it takes me a while to join back into the conversation.

BTW glad to see you back here!

Thank you koru_kiwi so much for sharing your fascinating journey with MDMA, it is incredible even to read! I never heard of the Trip of Compassion documentary before but watched it last night and completely shared Tim Ferris' enthusiasm afterward. Thanks so much for suggesting it, I've already also recommended it to some others. It changed my subjective perception about psychedelic psychotherapy sessions as well quite a bit - the way it's done in the film does not look aversive to me at all, it rather induced a desire to try this myself someday. My Ayahuasca experience was kinda similar in the sense that there was a group of people and the providers and I never met them until a couple days before the first trip. I personally loved sharing parts of my experiences with the group and with some specific individuals afterward. I saw quite some variety in how the different group members wanted to experience their trips in the social context, which was interesting. But I also know more about doing it with an intimate partner as that's how most of my mushroom trips happened in my late 20s.

I would be curious about how you coordinate your own MDMA experiences. For example, how do you time them, do you plan long ahead and prepare for them somehow? How about frequency and dosage, how do you decide on these? Do you vary what exactly you do during? Do you discuss it with your husband in depth afterward? Only if you would like to share more, of course

Here is MAPS director Rick Doblin's TED talk for those who would like a quick overview from the head of the organization that manages and promotes most of the psychedelic studies and mental health applications in the US these days:
Rick Doblin: The future of psychedelic-assisted psychotherapy | TED Talk

Here today - I have some colleagues who work on those questions about the DMN and social environment now. They try to model some things in a research study, but also collect many different details about their study subjects' life and history. The experimental part is a mix of brain imaging, surveys, and computer games that mimic certain situations.

Rick Doblin does seem to equate the sense of self with the ego in the above talk, but I would also argue it's much more complicated and multi-faceted.

Here are some relatively recent articles about the DMN and social functions, including some related to early life. Most are quite technical articles but it's probably not that hard to get some of the conclusions. They also show examples for how scientists study these things.

Neuroscience: The Default Mode Network - Brighton Talk Therapy

Default Mode Network Connectivity and Social Dysfunction in Major Depressive Disorder | Scientific Reports

influence of relationship closeness on default-mode network connectivity during social interactions | Social Cognitive and Affective Neuroscience | Oxford Academic

SAGE Journals: Your gateway to world-class journal research

https://www.sciencedirect.com/scienc...78929317302153

I don't think anyone knows that type and level of social dysfunction, trauma, when in development etc can be effectively helped with psychedelics. What kinds of DMN, self and social issues can be helped with these medicines and what may be resistant to treatment. I think the accounts that well-known, persistent developmental disorders can be helped in this way for some people is very encouraging, IMO. It's always so fascinating to me to hear when someone with dissociation and a long-standing fragmented sense of self reports these things improving and how they start to experience a more cohesive identity and self - fascinating, because I don't personally understand dissociation from the inside, I can't even imagine well when people talk about working with parts... what it might be like to experience oneself that way. I couldn't even apply one of the widely-used mental methods to addiction recovery, which involves consciously splitting our sense of self and desires in two and accepting one while rejecting the other, the max I could kinda try is realizing the addictive urges were specific moments and elements of the same person. That method didn't work for me to develop better inhibitions, or any inhibition at all, I just could't compartmentalize and isolate "parts" of me in that way. I think one serious limitation why psychotherapy is often not very effective for those things is also that the Ts do not really comprehend it... probably a bit like psychedelic states in a sense that you can't truly imagine before having a fist-hand experience. You can study and analyze intellectually, but it's not the same.

People are really just starting to study these things about the DMN and psychedelics in depth, but a lot is coming out and and will in the next years, I think. If you want to give it a try, I would also think why not - you have already tried many other things. What you said earlier about starting with a lower dose is probably a good idea. That's how I also started my explorations and gradually increased the dosage when I felt I wanted more. I found that I was very sensitive to the effects of these drugs from start, doses that apparently did nothing or very little to other people (even considering body size) gave me pretty interesting and engaging experiences.

I have not, but I would if I had the opportunity to do so. In fact, I did try growing my own mushrooms. Unfortunately, contamination ruined everything. I have not tried since as I know the spores had been released into the air in my house. I'd forgotten a wet dishcloth in my instant pot, and it started growing on that, too. It was particularly undesirable because they were contaminated with aspergillus flavus, which produces aflatoxin. I'm fairly certain the contamination originated with the popcorn kernals I used. Aspergillus flavus is very heat resistant, so the usual methods to sterilize (using heat or a pressure cooker) do not work.

The therapist is a bit square and was very against me trying psychedelics. She is very ignorant on the subject and persisted in her willful ignorance despite my attempts at educating her and pointing her in the direction of scholarly sources.

I still hope to try mushrooms at some point.

I did most of my mushroom trips in the past in a country and during a time when they were legal there, similarly to how cannabis is dealt with in the US now where it is legal for recreational use. It was even too free I would say, as you could buy them even on a market, just like vegetables. I liked much better the specialist shops where they also had information on all the different types and we could discuss any question or concern with the employees openly, without feeling that we were talking about some underground secret. Ironically, they banned them around the time when I left that country.

I don't think I would have ever done that much and that comfortably if they had been illicit drugs as I never feel very comfortable breaking the law (one reason I also tried Ayahuasca in an environment where it is legal and the providers have demonstrated experience). Well, surely I still did some psychedelics under the table, but never felt truly comfortable in that way, including because you never know what you get. The promise of all these current movements is that it would be open and available to people but at the same tome highly regulated. Of course then we would still have to face similar things to what is going on about CBD now, for example... not so easy to find a reliable product that is marketed transparently, and the hype is way too much, selling it like magic that can help everything.

there are quite a few resources that i found helpful when i was first researching and learning about doing the mdma assisted therapy:

the manual (protocol) that MAPS uses for their mdma assisted therapy sessions (free to download) A Manual for MDMA-Assisted Psychotherapy in the Treatment of PTSD - MAPS

'Psychedelic Psychotherapy- a user friendly guide to psychedelic drug assisted psychotherapy' by R Coleman Amazon.com

there is also the Castalia Foundation (founded by Timothy Leary) that has released a protocol for solo mdma therapy. some aspects of the guide were quite helpful, others were not: https://ia902906.us.archive.org/5/it...DMA%20solo.pdf

and if you are familiar with reddit, the community in the sub r/mdmatherapy has been is incredibly invaluable for me with many of the personal stories, experiences and information shared there.

in the beginning, i was doing my sessions about 12-14 weeks apart, but for these last two, the time in between has been longer because i have been doing them based on when the time has been feeling right to me...more on a gut feeling, listening to what my mind/body seems to be craving. but as i've done more sessions, and have integrated more issues, i've noticed that need or desire seems to waning and i don't need to do sessions as frequently.

in regards to planning the sessions, i do spend time preparing, like putting together a personalised music playlist that will be long enough (7-8 hours). i often do sessions on a weekend so i have time to relax and reflect after the session. i also go into the session with an intention of at least one issue i want to focus on, but the best thing is about this powerful medicine, is it seems to know exactly where to take you and often i unexpectedly address something that i was not even considering. a lot of healing can happen because of the insight that is revealed and this is where the integration work afterwards comes into play. i'm discovering that the integration process actually can last for many weeks afterwards. i often write or journal to help with the integration process and also talk and share aspects with my husband.

what i like best about the mdma therapy is how internal the process of the sessions are with most of what is going on is taking place in my mind and body. i talk very little and my husband mostly is sitting with me, offering words of comfort or encouragement if i seem to be struggling a bit with the process, or he offers physical comfort by holding my hand and/or holding/cradling me. he often says very little unless i'm the one talking to him. i actually find the physical holding and comfort he can provide me to be one of the most helpful aspects of this therapy with him and it actually has helped promote some of the most profound experiences of my healing.

your shroom trips with your partner in your earlier days may have had similar aspects to what i'm doing with my husband. there is an incredible sense of safety being able to do the sessions at home with my husband who i trust like no other. after my 'less than satisfying' experiences with regular psychotherapy and never being able to fully trust or feel safe with my ex-T in the relationship throughout my therapy with him, i'm pretty confident that i will continue to do my sessions this way and not seek the assistance of a therapist. these mdma assisted sessions have such an immense quality of sacredness for me that i have no desire to share that experience with someone i fear could potentially let their ego or issues get into the way. but i'm not adverse to others seeking the assistance of a therapist if that is what they desire or reckon they need. there definitely are many ways and options to heal with psychedelics and i believe it's quite personal and about finding what works best for each individual and the healing they are seeking achieve.

i have not tried shrooms yet, but definitely would like to one day. currently, i like doing the mdma because i understand it's 'gentler' for dealing with developmental trauma. there are a couple of psychedelic shroom species that grow here in my country during the wetter autumn and winter months, and if you know were to find them and what they look like, they are not too difficult to find. they actually grow in many of the places where hubby and i like to walk the dog and this past winter we picked some for the first time. there is a bit of a competition though, because some of the locals also know about the good growing spots

forgot that i wanted to share this podcast the other day: #65 - Rick Doblin, Ph.D.: MDMA — the creation, scheduling, toxicity, therapeutic use, and changing public opinion of what is possibly the single most important synthetic molecule ever created by our species - Peter Attia

it's an interview from 2019 with Rick Doblin where he goes into great detail talking about the history of mdma and other psychedelics, the MAPS study and research, and the therapeutic potential of mdma and psychedelic assisted therapy. it's a bit long, but i absolutely enjoyed listening to it and found it fascinating and incredibly informative.

In my teens I did mesculine, LSD, and mushrooms. Can not imagine they would help anyone with a mental health issue. I can see them causing MORE of an issue.

I think that the risks outweigh the potential benefits. The risk of psychosis is very high and if it lasts for months that could do irreversible damage to the brain. Imagine a bad trip lasting months? That would be torture.

I can’t imagine any therapists encouraging their clients’ use of psychedelics or any other unapproved drugs. In session or out of session. Wouldn’t they risk their job by doing that? Plus drug use is known to cause problems for people with MI. I am not knocking drug users. I am just not grasping how and why therapists would condone or encourage such thing. It’s trouble waiting to happen

i suspect many Ts who may be understanding to and in support of psychedelics won't openly discuss or encourage the use of psychedelics to their clients, unless the client brings the topic up first or unless they advertise specifically as an integration therapist. MAPS does provide a list of integration therapist on their site:
Psychedelic Integration List - MAPS

there are some very positive research results currently being released in regards to the use of psychedelic/mdma assisted therapy for helping with PTSD and depression and there are many therapist who believe in, and have witnessed, the powerful potential of these healing substances (my ex-T is one of them and he currently is seeking training and approval to do this kind of therapy in my country). many therapist who may be interested in working with the healing potential of psychedelics, but want to keep their noses clean, will offer to help with integration sessions (the client does the psychedelics in their own setting and meets with the T for regular sessions afterwards to help process and integrate the experience). the therapists who are administering any drugs are either involved in clinical studies with clients (which have been approved) or there are some underground Ts willing to help. it's those underground Ts who provide access to illicit drugs who will carry the greatest risk to getting into trouble when it comes to doing this kind of therapy. but for whatever reason, some chose to do this and take that risk.

i personally feel that the main area where this may become, as you said, 'trouble waiting to happen' will be after mdma/psychedelic assisted therapy is approved by the FDA and available in clinics for clients. i don't fear that the influx in the use of this medicine for those who are suffering will be the issue, i fear it will be the influx of psychologists wanting to become trained in the 'latest and greatest' to be part of the fashionable trend of the newest therapeutic modality, and that they won't fully achieve the proper competency needed too do this kind of delicate work. and similar to normal psychotherapy, if these therapist don't have their s*#t together, their issues sorted, etc, then i fear there is even a greater potential to client harm due to the increase in vulnerability that these substances will cause.

My therapist is on this MAPS list, though I didn't know that for a long time. He currently offers ketamine treatments in a collective with doctors other therapists etc, but I am in his private practice.

I did not do any drugs ( except for drinking ) growing up, but I am ready to try MDMA therapy when it becomes available. My therapist shared that for people with childhood trauma , the biology of safety might not ever have been there as a reference point, a set point. What is it like to feel safe? The body, the biology, does not know. He feels MDMA can offer that first experience , and that it can be profoundly teaching. He has worked with MAPS since the ground floor.

He is my second T, and my first one was four years of immense and intense competing realities, battles of wits, and definitely not establishing safety. This T does not have the same charismatic , "brilliant" presence / cult of personality , but is more gentle, genuine and collaborative. I hope I qualify , and can try MDMA.

i was pretty straight laced growing up and i never did any drugs either, except alcohol. it wasn't until i was in my mid 40s when i first dared to try marijuana during an overseas trip to the States, not long after Colorado legalised it for recreational use. i think after that experience, it definitely had an effect on changing my perspective in regards to how i felt about these type of substances.

your therapist is correct in what he is saying and for me, the mdma has helped immensely in helping my mind come to feel safe within my body after the traumas. i will never forget my first time using it and how completely relaxed, 'loose', warm, free and safe that my entire body was feeling at times...it was absolutely amazing to finally be free of the tight trauma bonds that have held my body prisoner for practically most of my life. i was none the wiser to ever knowing any different. i find it difficult to even find the proper words to fully describe the experience.

i'm really happy for you, that you have been able to find a new T who seems to meet your needs better than your prior one. i recall you sharing some of the struggles of your ex-T and i'm glad you have been able to more forward from that experience. it sound quite promising for your progress that your current T is affiliated and familiar with MAPS and psychedelic assisted therapy. keeping my fingers crossed for you that you will qualify for the treatment as soon as it is approved

Sorry to drag up an old thread, but for anyone who has tried psychedelic's, have you noticed any improvement in depression?

My psychiatrist yesterday was discussing options with me yesterday for my severe, treatment resistant depression and mentioned that there may be a possibility that I could get on a clinical trial for psilocybin. The early clinical trial results look quite promising but I just wondered if anyone has any personal experience...

I’ve done a course of ketamine infusions follower by a number of months of maintenance troches (lozenges) at home for PTSD as well as a few mdma sessions (illegal, solo). The results have been nothing short of life changing.

The infusions really wound down my symptoms and made it possible for me to do the work in therapy ever since. I’m a work in progress, but it’s been like a miracle. Hard work. But miraculous.

I would think that ECT would be a better choice for treatment resistance depression? Along with EMDR for trauma? Class A Drug's cause irreversible damage to some people. Even when a person is desperate and at the end of their tether are mind altering drugs really worth the risk?

yes, the clinical trials they are doing on psilocybin do look promising and it's exciting to see that Oregon voters have recently passed Measure 109 for a statewide psilocybin assisted therapy program.

if you can't get into a psilocybin trial, has your PDOC mention anything about trying ketamine?

I have looked into ECT before and TBH I really don't think it is a safer option. The risk for cognitive side effects is huge, the remission rate is only about 30% and even then the relapse rate is 50% (and that is with maintenance ECT and therapy which it is highly unlikely I would get on the NHS).

I was very wary about psilocybin as I know the harm that hallucinogenic drugs can do when used recreationally, but the science behind it is compelling and the early data are impressive.

The pdoc I saw last week also mentioned esketamine, and told me to look into it, which I did and it doesn't seem to be available in my country. Confirmed this with my usual pdoc today - although it is licensed in the UK it is not considered cost-effective and so is not available through the NHS at the moment

that's unfortunate and sounds frustrating. sorry to hear that.

i agree. and as there are more studies being conducted about the potential health benefits of these psychedelics, this will lead to increased knowledge to understanding both the positive and negative effects of these medicines. which in turn can be helpful in regards to availability and regulation. i reckon there would be fewer people causing harm to themselves if psychedelics were regulated and legally available under the care of health professional so people didn't have to get to that point of desperation thinking that their final glimmer of hope for relief means they have to rely on dubious and illegal means to obtain it.