Can MDMA Revolutionize Trauma Recovery?

By Leona Kashersky, PsyD

©️5/22/23

World-renowned trauma experts whose research focuses on the effects of trauma on the body and mind are now exploring alternative medicines like MDMA to aid in trauma recovery. In their work, leaders like Bessel van der Kolk have identified a common issue among traumatized individuals: the overwhelming and often unbearable nature of traumatic memories. Trauma has become more widely recognized in psychology and psychiatry, there is a tendency to trivialize it as simply a "bad experience" or to ask people to "tell me your trauma story." However, trauma is much more than just a story, as it can be all-consuming and difficult to bear.

One of the challenges clinicians observe among trauma survivors is the self-blame and self-loathing that often accompanies their experiences. This is particularly true for those who feel that they played a role in their own victimization or for soldiers who have committed atrocities. While mindfulness and self-reflection have been shown to be helpful for trauma survivors, they are only effective if accompanied by self-compassion, which is often lacking in traumatized individuals. As a result, experts are turning to alternative treatments, such as psychedelics, to offer individuals a vision of a larger universe of possibilities and perspectives. In particular, drugs like MDMA can dramatically increase the capacity for self-compassion and offer access to a very different inner experience.

A Psychiatrist’s MDMA Experience 
Bessel van der Kolk, a renowned trauma expert, has shared his own experience with using MDMA for healing psychological trauma. In an interview, he described his experience as both intense and profound. He felt overwhelmed by the thousands of traumatic experiences that his patients have shared with him over the years, but the MDMA allowed him to feel it all without being defensive or protective.

Van der Kolk has been a long-time proponent of using psychedelic substances to help people overcome trauma. He believes that MDMA can dramatically increase the capacity for self-compassion and provide access to a very different inner experience. He has even gone so far as to call it a "revolutionary treatment for PTSD." However, he acknowledges that more research is needed to fully understand the benefits and risks of using MDMA for trauma recovery. Nevertheless, van der Kolk remains optimistic that MDMA and other psychedelics can offer new possibilities for healing that were previously unavailable.

Implications for Change in Trauma Recovery
MDMA has the potential to revolutionize the field of psychology and psychiatry by providing individuals with a profound inner experience that can help them confront and overcome past traumas. The drug has shown promise in helping people enter a state of self-awareness and self-compassion, where they can view their past experiences with a new perspective and move forward with a sense of peace. This approach to healing trauma could significantly improve the efficacy of existing therapeutic interventions and offer hope to those who have previously struggled to recover.

However, it is important to approach the use of MDMA with caution and not view it as a "magic pill." While the drug may help people access a deep state of introspection more quickly than other methods, it is not a panacea. There are many different approaches to trauma treatment, and it is crucial to study and compare these methods to determine which is the most effective for each individual. Additionally, there is a risk of over-reliance on medication to solve mental health problems, rather than addressing the root causes of the issues. Therefore, while MDMA may hold promise as a tool for healing, it should not be viewed as a quick fix or a replacement for other therapeutic interventions.

The Second Revolution in Mental Health 
In the ’60s we had our first revolution so, this wave is more like a second revolution. Bessel van der Kolk was the research assistant to a Dutch psychiatrist while he was treating Holocaust survivors with LSD, and he once had an office at Harvard that was rumored to have been occupied by Timothy Leary. In that first revolution, people studied LSD, psilocybin, and ayahuasca with drug-addicted and depressed clients and saw very good results. But then that effort was completely destroyed during the Nixon administration. Let’s hope the revolution succeeds this time.

The success of this revolution in mental health will depend on whether or not it is done responsibly. MDMA and other psychedelics should only be taken under the guidance of well-trained professionals to ensure optimal therapeutic advantage. There is a risk of people being careless and taking these substances without proper supervision. If this happens, it could lead to negative outcomes and set the entire field back. Ultimately, this revolution has great potential, but it will require careful attention to ensure that it is done in a responsible and effective manner.

How Can Psychedelics Treatments Change Delivery of Care?
The growth of psychedelic therapy could lead to a fundamental shift in how people approach mental health treatment. Instead of simply addressing symptoms, therapists may focus more on guiding clients to develop their own truth and expand their sense of self. This approach requires a safe, whole-day session in which the therapist is fully present and absorbed in the client's experience. As a result, the practice of therapy may become more focused on providing a supportive, immersive experience that allows clients to confront and process their trauma in a profound way. Additionally, psychedelic therapy may require more extensive training for therapists, as they will need to be equipped to handle the unique challenges and experiences that arise during these sessions.

Reference
“Learning to Bear the Unbearable," by Rich Simon. The full version is available in the September/October 2018 issue, Psychedelics: The Future of Talk Therapy?