A Look Inside MDMA-Assisted Therapy

A Trauma Specialist Straddles Two Worlds

Marcela Ot’alora G.

I have the privilege to work in two worlds: my private practice, where I use a range of therapeutic tools to help trauma sufferers, and an MDMA-research project, where I’ve been able to observe close-up the profound effect integrating a psychedelic drug can have in facilitating—and sometimes transforming—the often lengthy and difficult process of healing from PTSD.

Whatever the approach, when trauma survivors come to treatment, three things become apparent. First, they’re disconnected from themselves, from other people, and from their environment. Second, they have trouble accessing the innate capacity for resilience that would allow them to process the traumatic experiences continuing to disrupt their emotional life. Finally, a pervasive, paralyzing fear keeps them trapped in this state. As every trauma therapist knows, getting free of the debilitating symptoms of PTSD, if it happens at all, can take years.

As has been repeatedly demonstrated in our research, MDMA can serve as a powerful catalyst in the healing process. By slowing down the experience of time and making the fear more manageable, it can accelerate therapy. Not only does it enhance the participant’s connection with the present moment, but it strengthens the therapeutic bond, allowing for a process of self-exploration that respects personal pace and supports a fuller expression of deep emotion and insight.

Early in an MDMA-assisted session, what spontaneously emerges, no invitation needed, is something that might be called the “inner healer”: a wise, intuitive guide that can be more easily accessed through MDMA-assisted therapy than more conventional therapeutic methods. Participants recognize this inner resource because they begin to feel more self-acceptance and trust in the internal flow of their experience. The inner healer doesn’t have the same concerns as the everyday ego. It’s not influenced by ideas about hierarchies or right and wrong. Rather, it’s the part in each of us that’s free of judgment; it knows who we are and what we need.

As fear loosens its grip on the mind and a connection with the heart is restored, a gentle willingness and expanded ability to explore painful traumatic experiences develops, along with a fuller sense of inner knowing and trust. As a clinician, it’s humbling to witness this self-healing process unfolding, as clients unravel the fabric of their traumatic past and begin to weave it back together in a more life-affirming way. No longer feeling like a hostage to their trauma, they realign their sense of identity and are finally able to update the way they look at the world and their place in it.

My job as an MDMA-assisted psychotherapist is to provide a safe container, follow the client’s inner healer, and track the unfolding of their moment-to-moment experience. But this isn’t by any means a straightforward, linear process. MDMA is not a magic bullet that just takes the trauma away and miraculously frees people of suffering; even with its benefits, the healing journey is arduous. The sudden loss of deeply embedded protective structures is often destabilizing and always requires diligent integration of the material that’s unearthed along the way. Still, for many, the hard work results in the ability to face all aspects of life as a fully embodied person.

But what about the experience of therapists? Upon completion of our phase-2 study with 28 participants with treatment-resistant PTSD, the clinicians involved unanimously agreed that it was difficult to imagine going back to doing psychotherapy as they’d known it without the benefit of MDMA. The experience of being able to help bring about durable change in such a profound and relatively rapid way left us awed and personally affected. How could we not wish this option for the trauma survivors in our private practices?

Of course, I’m unable to offer MDMA-assisted psychotherapy outside a research setting at this time, though I get dozens of calls every week from people wanting to participate in a study. And even if I could, I don’t think it’s right for everyone, especially those who are effectively healing with other modalities. Part of our ongoing research is to determine which people won’t benefit from this treatment and why that is. Nevertheless, I continue to be inspired by the promising research results of MDMA-assisted psychotherapy, and I look forward to the day when it can take its place among the established approaches that therapists might offer the many people suffering from PTSD.

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Marcela Ot’alora G., LPC, has a private practice and is the principal investigator for MDMA-assisted psychotherapy research in Boulder, CO, sponsored by MAPS.

This blog is excerpted from "Between Two Worlds," by Marcela Ot'alora G. The full version is available in the September/October 2018 issue, Psychedelics: The Future of Talk Therapy?

Don't miss our video interview with Marcela, where she talks more about the process and payoffs of psychedelic-assisted therapy.

PHOTO © COURTESY OF MULTIDISCIPLINARY ASSOCIATION FOR PSYCHEDELIC STUDIES (MAPS)

Topic: Cultural, Social & Racial Issues | Psychopharmacology | Trauma

Tags: 2018 | childhood traumas | drugs | Ethics | MDMA | post traumatic stress disorder | post-traumatic stress disorder ptsd | psychedelics | Psychotropic drugs | PTSD | ptsd research | ptsd treatment | Trauma | trauma and recovery | traumas | Traumatic memory | treating trauma

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1 Comment

Tuesday, November 20, 2018 11:37:09 AM | posted by
I love the description of the "inner healer." It resonates with my concept of therapeutic catharsis, which is based on the assumption that there exists a natural healing process for "trauma." The facilitative condition for therapeutic catharsis is the unforced activation of the client's emotional experiencing; i.e., it emerges coincident with the client receiving sufficient support for his/her experiencing. Therapeutic catharsis is understood as a sympathetic-parasympathetic autonomic nervous system sequence, where the first phase is a delayed fight or flight reaction that when it reaches an intensity determined by the ANS it spontaneously transitions to a healing phase. There are two simultaneous reactions: a precipitous drop in heightened vital sign amplitudes and the replacement of fight or flight reactions by crying, often deeply, indignation - preferred over anger - for objectively unfair/unjust treatment, and the client arriving at his/her own insight into the effect of the trauma and that is predictably more profound than any I could possibly offer. For clinical examples, see Jessica: The autobiography of an infant, Kindle edition.