Program Notes
Guest speakers: Michael and Annie Mithoefer
Annie & Michael Mithoefer
Year this lecture was recorded: 2017
Michael and Annie Mithoefer have been working for years to bring MDMA into the forefront as a treatment for PTSD. As a couple who works together holding space for these sessions, they share about what they learned of the promise and pitfalls of this medicine.
Also see Psychedelic Salon Podcast 86, which was posted on April 4, 2007 for Michael Mithoefer’s 2006 Palenque Norte Lecture.
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Transcript
00:00:00 ►
Greetings from cyberdelic space, this is Lorenzo and I’m your host here in Psychedelic Salon
00:00:23 ►
2.0.
00:00:24 ►
This is Lorenzo and I’m your host here in Psychedelic Salon 2.0.
00:00:33 ►
And now we get to hear from two of today’s most important researchers in the world of psychedelic medicine, Michael and Annie Mitoffer.
00:00:39 ►
I had the opportunity to meet them for the first time at a small conference in Palm Springs.
00:00:45 ►
It was many years ago. My wife and I were there as guests of Dr. Charlie Grobe, who was one of the speakers.
00:00:54 ►
Unfortunately, my notes from that conference have been lost, so I can’t tell you much more about it, not even the year in which it was held.
00:01:03 ►
But I do know that it took place not long after they began their research into using MDMA to treat post-traumatic stress disorder.
00:01:06 ►
And that was when I first began following their important work. A few years later, in 2006 to be exact, Michael Midoffer was one of our speakers
00:01:13 ►
for the Palenque Norte lectures at Burning Man, and you can hear that talk in my podcast number 86
00:01:20 ►
from here in the salon. This was one of his early talks about what was being learned
00:01:25 ►
in the initial pilot study that was still underway.
00:01:28 ►
Now, over a decade later, that dedicated work
00:01:32 ►
has led to the approval by the U.S. Food and Drug Administration
00:01:35 ►
to begin Phase III trials of MDMA
00:01:38 ►
to treat post-traumatic stress disorder.
00:01:41 ►
And this is the final phase of validation
00:01:44 ►
that’s going to be required
00:01:46 ►
before they can turn the party drug ecstasy into the legal medicine MDMA. So now I’m going to turn
00:01:53 ►
the microphone over to Lex Pelger, who spoke with the Mithoffers during his Blue Dot tour,
00:01:58 ►
and I think that you’re going to really enjoy this interview. patreon.com. As a two-person production, any help goes a long way. Join us at patreon.com
00:02:28 ►
slash nononsense. I’m Lex Pelger, and this is a Psychedelic Salon 2.0.
00:02:41 ►
It’s always wonderful to meet a couple who knows how to be together while doing the good work.
00:02:47 ►
The Mithofers probably need little introduction for any long-time followers of the salon.
00:02:53 ►
Lorenzo featured a talk from Michael in episode 86, just over 10 years ago.
00:02:58 ►
But now we get to hear from both Michael and Annie as they sit in a space where they’ve done some of their landmark work for MAPS,
00:03:06 ►
studying MDMA for the treatment
00:03:07 ►
of PTSD.
00:03:10 ►
Not only were they gracious with
00:03:11 ►
their time in talking with us for the salon,
00:03:14 ►
they even attended a storytelling
00:03:15 ►
session later that night in Charleston,
00:03:17 ►
South Carolina.
00:03:19 ►
As one of the last stops of the Blue Dot
00:03:22 ►
tour, you’ll be able to hear Michael
00:03:23 ►
tell a story there in a few weeks.
00:03:27 ►
Speaking of, I missed one announcement from last week’s storytelling in Chicago.
00:03:32 ►
There’s also an excellent group there called Psychedelics and the Future of Psychiatry,
00:03:36 ►
for anyone who wants to be more grounded in the science surrounding these intriguing medicines.
00:03:42 ►
So now to hear from two stalwart leaders in the field.
00:03:54 ►
I’m very pleased to be sitting here with Michael and Annie Mithofer, who probably a lot of you
00:03:58 ►
know as doing the work for MAPS, getting this MDMA through FDA-approved trials as a treatment for PTSD.
00:04:07 ►
Thank you so much for being here with us today.
00:04:10 ►
Yeah, great to be here. Thanks.
00:04:12 ►
Yeah, thank you for coming, and I’m so glad to be meeting you finally.
00:04:18 ►
So my first question was, how were your early experiences as healers influential in moving into this kind of
00:04:28 ►
work? Well, for me, when I decided to go into psychiatry training after I’d been doing emergency
00:04:38 ►
medicine for 10 years, one of the reasons I did that was because i read some a book of stan groff’s and so i went
00:04:48 ►
into the i joined the um stan groff’s a groff transpersonal training to be a holotropic breath
00:04:56 ►
work facilitator at the same time i started my psychiatry training so right from the beginning
00:05:01 ►
i was oriented toward the you know value of non-ordinary states,
00:05:07 ►
what Stan Grof calls the healing potential of non-ordinary states.
00:05:13 ►
And we had also had our own psychedelic experiences in college back in the 60s,
00:05:18 ►
and we’d had some experiences with MDMA with the therapist when it was legal.
00:05:24 ►
So we had an idea that these compounds could be useful.
00:05:29 ►
Yeah, and so when Michael switched to be a psychiatrist
00:05:33 ►
and have a private practice and do breathwork,
00:05:38 ►
I also joined the breathwork training,
00:05:40 ►
and I was trained as a Hullotrip breathwork practitioner, and we led
00:05:46 ►
groups for 10 years, and we also saw some patients together in Michael’s private practice,
00:05:56 ►
so we were, we worked together a lot doing that, and pretty intense experiences. So we were already oriented sort of towards that kind of healing and, you know, not ignoring
00:06:12 ►
the body and in all of the therapy.
00:06:15 ►
And yeah, always, we were always looking for new things to do and ways to help people.
00:06:23 ►
In the beginning, we assumed it wasn’t possible to use MDMA or psychedelics, but the breath
00:06:30 ►
work was very powerful, so we thought we needed to be content with that for a long time, and
00:06:35 ►
we were really struck by how much it offered that other types of less powerful experiential therapies, less treatments that didn’t help people shift to an ordinary state,
00:06:50 ►
we’re really missing something.
00:06:52 ►
And then gradually, in spite of how helpful the breathwork was,
00:06:56 ►
we realized that, like anything else, not everybody responds to that.
00:07:00 ►
So we decided it would be really important to try to research some of these compounds.
00:07:06 ►
So how did those first personal experiences with these psychedelics and MDMA affect you?
00:07:13 ►
Well, you know, I came away from my early psychedelic experiences in the 60s
00:07:18 ►
with being very impressed that these were important experiences.
00:07:26 ►
Being very impressed that these were important experiences, that was really clear. And I had some very powerful spiritual experiences as well as some very frightening experiences that I wasn’t sure what to make of at that time.
00:07:37 ►
But I knew they were all important.
00:07:39 ►
And then, you know, I sort of left that behind eventually.
00:07:42 ►
We decided to go to medical school.
00:07:42 ►
I sort of left that behind eventually.
00:07:44 ►
We decided to go to medical school.
00:07:50 ►
But actually when I read Stan Gross’ book,
00:07:58 ►
it brought a lot of understanding to the difficult experiences I’d had 20, 25 years before.
00:08:09 ►
And then in our MDMA experiences, one thing that really struck us both was how much it helped with deep communication between us.
00:08:15 ►
We did it together as a couple adult that were not guided or didn’t have any kind of
00:08:29 ►
help with their experience or integration or anything like that. So my only experience
00:08:38 ►
with that form, which is obviously what we’ve done, is having the therapist, like Michael mentioned,
00:08:45 ►
with MDMA and just seeing how powerful that could be and also doing integration after it and
00:08:54 ►
continuing to work with the process. So, I mean, I think that was the enlightenment about how this
00:09:02 ►
therapy could be, was it was a different context
00:09:06 ►
not the recreational context that you know so many people do these um substances with but
00:09:13 ►
with a you know a guide and um somebody that is willing to help you work with the process after it
00:09:19 ►
uh so what did you learn from working under a therapist for that early about holding space and that you could bring later on to your work?
00:09:46 ►
back in the 60s, but also, you know, getting over the, and this is partly what we learned from Stan Groff also, and our therapist understood that too, you know, getting away from the idea of
00:09:53 ►
bad trip versus good trip and understanding that sometimes very difficult experiences come,
00:09:59 ►
and that’s not a bad thing. If you’re prepared and have proper context to work with it, it can be extremely
00:10:07 ►
valuable. But if you try to move away from it and don’t have support to work with it,
00:10:13 ►
it can be a real problem. But I think that was one of the most important things, the importance of
00:10:18 ►
holding space and support with the difficult experiences, well as, you know, really integrating the, the very
00:10:26 ►
affirming experiences as well. Is there a special power that you both bring to the table combining
00:10:32 ►
your backgrounds in psychiatry and nursing for helping people deal with these difficult experiences?
00:10:38 ►
Yeah. I mean, I think Michael and I, um, bring, uh, we balance each other a lot.
00:10:46 ►
You know, we’ve been together 43 years.
00:10:50 ►
Mazel tov.
00:10:51 ►
So we’ve worked through a lot of our own issues, you know, with breath work and like Michael said, the MDMA sessions.
00:11:01 ►
So, you know, we’ve just had a chance to really kind of get through all that.
00:11:06 ►
And so I think when we started doing the research, it came at a good time for us as far as Michael being an emergency room doctor
00:11:27 ►
and not being afraid of things happening, you know, powerful things,
00:11:34 ►
and me being a little bit more grounded and more, you know, noticing things
00:11:41 ►
and being aware of things could, I mean, there’s some things that could happen you know um so yeah the nurse doctor relationship kind of um we do that pretty well
00:11:52 ►
but um I don’t know I think what we learned from breath work and leading the groups and going
00:12:00 ►
through the training ourselves and being witness to some incredibly powerful healing that people from all over the world.
00:12:08 ►
I mean, just like at the breathwork trainings, it was just so incredible to be a witness to to that and to be able to just sit there and not have to do anything, you know, just be a witness or listener, open-hearted, you know, person.
00:12:25 ►
So I think we learned a lot of that from our breathwork training.
00:12:29 ►
A lot about getting out of the way, let the experience go forward.
00:12:34 ►
Yeah, a lot about really trusting the person’s own healing intelligence, inner healing intelligence,
00:12:41 ►
which is something we learned from Stan Grof as well as our therapist.
00:12:47 ►
So that 10 years during breathwork groups with lots of challenging things coming up
00:12:53 ►
just allowed us to build a very deep trust in the process and people’s ability to have the experience they need
00:13:02 ►
if they have the right support and be able to, you know,
00:13:08 ►
convey that trust to people that it’s okay to stay with the difficult things. I think it took
00:13:13 ►
a lot of direct experience, both in our own experiences of staying with our own difficult
00:13:17 ►
stuff and those, you know, 10 years of doing that with the breathwork before we started doing the MBMA research was very helpful, I think.
00:13:28 ►
And when I first went to breathwork, I had had psychedelic experiences over 20 years before.
00:13:34 ►
And I thought, well, how powerful can this be?
00:13:37 ►
Famous last words, huh?
00:13:38 ►
It blew my socks off, yeah.
00:13:42 ►
How powerful it was.
00:13:48 ►
And at first I thought, my my god this is an incredible technique and after a while when it kept having these i kept having these powerful experiences and annie did
00:13:55 ►
and we saw so many people i realized it’s a good technique but the main message really maybe is
00:14:02 ►
these realms of consciousness are not as far away as we thought they were, as I had thought they were.
00:14:09 ►
Definitely, I think the medicines can be very, very useful in reaching them.
00:14:14 ►
But we are also – it was really good to have a solid grounding in the fact that you can also reach them in other ways and you can really trust your inner intelligence when you do.
00:14:25 ►
That is powerful.
00:14:26 ►
The MDMA is helpful, but we always have something right there.
00:14:30 ►
Wow.
00:14:32 ►
I’m curious what it would be like to go from leading these groups of people
00:14:36 ►
doing breathing exercises to going to the MDMA work,
00:14:40 ►
which seems much more concentrated on one person
00:14:42 ►
and doing more one-on-one experiences or two-on-one.
00:14:49 ►
Well, in a way, there was that change,
00:14:52 ►
but also those 10 years when we were doing the breathwork groups,
00:14:57 ►
a lot of people would come to the office in between
00:15:00 ►
to do their own individual work.
00:15:03 ►
Sometimes we did breath work with individuals.
00:15:06 ►
Usually it was in the group,
00:15:07 ►
but individuals often came and did powerful emotional release work,
00:15:14 ►
sometimes on a mat working with the body
00:15:16 ►
and using kind of a similar approach of helping them release things.
00:15:23 ►
So it wasn’t in that way.
00:15:25 ►
We were also pretty used to working with individuals together.
00:15:29 ►
Yeah, I think maybe having the groups
00:15:33 ►
and having an all-day group with people breathing
00:15:38 ►
and then having process takes a lot of energy
00:15:41 ►
and a lot of stamina.
00:15:49 ►
takes a lot of energy and a lot of stamina so um that probably helped us for sitting for eight hours with people and you know being there for sometimes very difficult processes and also
00:15:58 ►
energies that were coming so um i think that really that really helped helped us in that way.
00:16:06 ►
Yeah.
00:16:07 ►
Yeah, we learned, you know, the modeling from Stan and our other teachers
00:16:12 ►
and also our own experience over those years,
00:16:16 ►
we learned that if you’re going to work with non-ordinary states,
00:16:19 ►
it’s not a 9-to-5 job.
00:16:21 ►
And if you’re going to invite somebody to enter into these states you need to
00:16:25 ►
be prepared for being with them for as long as it takes so stamina is an important part of this work
00:16:31 ►
too so your work is on call you it take it’s it’s calls in the middle of night it’s it’s lots of
00:16:38 ►
follow-up you might not expect that kind of therapy yeah we we tell people they can call us
00:16:42 ►
you know during this period when we’re working this people they can call us during this period. Remember, we’re working this way.
00:16:45 ►
They can call us any time, 24 hours a day.
00:16:48 ►
We don’t get a lot of calls in the middle of the night, but sometimes.
00:16:51 ►
But we need to be prepared to support them because, as we say to people,
00:16:56 ►
this is one of maybe the more challenging things to convey to people in the beginning
00:17:00 ►
before they’ve experienced it.
00:17:02 ►
We say it’s not just what happens during the MDMA effect.
00:17:07 ►
This is a process that gets catalyzed by that,
00:17:10 ►
and then it keeps unfolding, and it may come in waves.
00:17:13 ►
There may be waves of difficulty in between,
00:17:17 ►
just as there may be really nice waves.
00:17:21 ►
But to really support people if they’re having waves of difficulty
00:17:27 ►
and help them process it, stay with it, and move through it
00:17:30 ►
rather than trying to shut it down or move away from it.
00:17:34 ►
That’s part of the integration that’s extremely important
00:17:37 ►
that can really make a difference in how people do ultimately.
00:17:42 ►
I think the other thing we learned from the, you know, working together was
00:17:47 ►
that we worked a lot with a lot of people with PTSD. I mean, Michael’s practice really,
00:17:53 ►
you know, not wasn’t totally PTSD, but a large percentage of it. So we had worked with people that had that going on for them.
00:18:08 ►
And so we knew some of the challenges of healing that and being with people during the integration process.
00:18:17 ►
And when people who have been numb to feelings or avoid feelings, that’s, that’s one of the challenges when they start feeling again.
00:18:28 ►
So we knew some of that, which was really good.
00:18:33 ►
I just want to add something.
00:18:35 ►
You know, yes, it can be hard work and it takes stamina.
00:18:38 ►
It’s a big commitment.
00:18:39 ►
But also it’s an incredible privilege to be able to sit with people who are willing to take the leap and go into these states and share their experience with you.
00:18:51 ►
So at the same time as sometimes being pretty tiring, it’s also really nourishing and invigorating.
00:19:02 ►
And we do consider it a huge privilege
00:19:05 ►
to be able to sit with people when they’re doing this deep work.
00:19:10 ►
To see the transformation, you know,
00:19:13 ►
if you could see the snapshots of the people when they walk in the first time
00:19:18 ►
and then see them, you know, three months or five months later,
00:19:23 ►
depending on how people were randomized,
00:19:25 ►
but it’s just mind-blowing to see the transformation in how people are.
00:19:32 ►
And, you know, the other thing I want to add is we have a lot of gratitude toward the people that
00:19:37 ►
volunteer to be in the research and end up having really wonderful relationships with them.
00:19:44 ►
But also, we’re constantly aware of how lucky we are to be able to do these sessions
00:19:49 ►
knowing it takes an incredible amount of work by the whole MAPS team.
00:19:55 ►
You know, doing this research is a very complex and challenging thing to bring,
00:20:01 ►
you know, for a small nonprofit to bring this work all the way to now starting
00:20:05 ►
phase three trials after doing six FDA approved phase two trials. That’s it. It doesn’t happen
00:20:13 ►
much. It’s usually, you know, government or industry funding. So it’s, you know, the friends
00:20:22 ►
we have at MAPS that we’ve made in this work is part of the blessing of it,
00:20:28 ►
and we really are constantly grateful
00:20:30 ►
to how hard Rick Doblin and all the other people at MAPS
00:20:35 ►
are working for us to be able to do this.
00:20:40 ►
It’s pretty amazing.
00:20:43 ►
And to everyone out there, you can always become a MAPS member
00:20:46 ►
and get an excellent book in exchange for your support
00:20:48 ►
buying MDMA for veterans.
00:20:51 ►
Never forget.
00:20:51 ►
Yes, and to not forget all the donors and members that fund this,
00:20:57 ►
that make it possible.
00:20:59 ►
We’re very grateful for all those people.
00:21:02 ►
It feels like a community effort.
00:21:05 ►
People have the vision that this is worth doing and important to do. for all those people. It’s like it feels like a community effort, you know?
00:21:08 ►
People have the vision that this is worth doing and important to do.
00:21:10 ►
It’s a great gift to be able to be part of the community.
00:21:15 ►
And would you have any advice
00:21:17 ►
for the aspiring psychedelic therapists out there
00:21:21 ►
who feel drawn to move in this kind of work
00:21:23 ►
about what you would suggest
00:21:25 ►
they might study or do or practice or work on well a big shout out to him first of all because
00:21:32 ►
it’s so great to see a lot of young people saying this is what i want to do with my career because
00:21:38 ►
it’s there’s it’s you know so many people are needed to carry this forward. So I used to say in the beginning, there are a lot of people,
00:21:49 ►
quite a few people that want to do this, but they don’t have the credentials,
00:21:53 ►
and there are a lot of people that have the credentials, but they don’t want to do it.
00:21:56 ►
But more and more we’re seeing people have both.
00:22:00 ►
A lot of people are showing up that have both.
00:22:03 ►
So I think the education, the credentials are important,
00:22:07 ►
whether it’s in psychology or psychiatry or medicine or neuroscience,
00:22:14 ►
kind of whatever someone’s passion is,
00:22:16 ►
but to get the graduate education that will put you in a position
00:22:21 ►
to be able to really contribute to this area is great.
00:22:26 ►
And I think I know what Annie’s going to say, so I’m going to let her say it.
00:22:30 ►
And breathwork training, going to breathwork.
00:22:34 ►
But other than that, I mean, there are lots of other things that are really good to study,
00:22:52 ►
to study, like internal family systems and Hikomi and somatic work with, like, somebody that’s trained with Peter Levine.
00:22:54 ►
So there are all those kinds of things that you can do.
00:22:57 ►
You can do an introductory weekend workshop, you know, and just try it out.
00:23:03 ►
And then there also are trainings. So all of those
00:23:06 ►
things that combine the body and mindfulness and parts work are all really good.
00:23:16 ►
And there’s advice I sometimes give out I should probably pass by professionals like you.
00:23:20 ►
I often tell rooms full of young people are excited is that they can sit for each other too,
00:23:26 ►
since they’re often taking these drugs out at a party just to remind them that you could also
00:23:31 ►
take it just one person and another person sitting next to them on the couch and let them have their
00:23:35 ►
own experience. That’s not something to do with someone with severe trauma, but I think we can
00:23:40 ►
forget how powerful these medicines are and we can be healers for each other within the community i’m not sure how you think of that advice well it’s better than going and you know
00:23:52 ►
taking you know huge combinations of psychedelics and having no support yeah obviously the set and
00:23:59 ►
setting and having friends be there to support you is incredibly important.
00:24:06 ►
Yeah.
00:24:08 ►
So getting back to the sessions a little bit,
00:24:11 ►
what are some of the lessons you learned about preparing people for these experiences?
00:24:17 ►
Well, first thing is just to form a relationship with them
00:24:21 ►
so you get to know them and have them get to know you enough to
00:24:27 ►
be able to trust that you can support them is really important and then you know
00:24:34 ►
talking to them about this i this reality of their own inner healing intelligence because
00:24:40 ►
that’s pretty new to a lot of people who’ve come to treatments thinking that somebody else has to do something to them to get better.
00:24:50 ►
So really emphasizing that, the inner healing intelligence, is a big part of it.
00:24:54 ►
And also the way, what I said before about the way it unfolds.
00:24:59 ►
Can you describe more about the inner healing intelligence for us?
00:25:04 ►
Well, we see the evidence for it all the time.
00:25:08 ►
You know, for instance, you know, we take the point of view that the non-directive approach
00:25:16 ►
that we don’t know what experience people should have or what order they should have their
00:25:21 ►
experiences in. And we just see again and again, if we just invite people to, as much as possible,
00:25:27 ►
set aside expectations, not try to have an agenda.
00:25:32 ►
Obviously, they have an overriding intention to heal,
00:25:35 ►
but not to have an agenda about what that should look like.
00:25:38 ►
And so, you know, sometimes we see people
00:25:41 ►
that go straight to processing their trauma,
00:25:44 ►
and that seems to be very helpful for them.
00:25:48 ►
Quite often we see people that have some other kind of experience first,
00:25:53 ►
either a very affirming experience,
00:25:56 ►
kind of really letting it in emotionally for the first time that they survived
00:26:01 ►
and that they have a lot of support in their family, that kind of thing,
00:26:05 ►
that people say, I knew that, but I’d survived. I knew I had support, but I couldn’t feel it.
00:26:12 ►
And then maybe their first experience, we have seen that, their first experience then is
00:26:16 ►
having that get in. And then later they’re in a position to process the trauma.
00:26:22 ►
Or some people have awareness of their own parts suddenly more
00:26:26 ►
and have a very healing experience about their relationship with their own parts
00:26:31 ►
before they actually process the trauma.
00:26:35 ►
And so it seems like this incredibly elegant and reliable process happens
00:26:40 ►
that’s different for each person,
00:26:42 ►
but that really, from the evidence we have,
00:26:46 ►
can be extremely helpful. Yeah, and, you know, Michael always gives the example of working in
00:26:53 ►
the ER when someone comes in with a cut, he would know how to, you know, remove gravel, obstacles, remove dirt, clean it out. But the body has its own innate intelligence of how to heal that wound.
00:27:11 ►
It grows, the wound grows back together as long as you don’t have infection or dirt.
00:27:18 ►
So it’s…
00:27:19 ►
You can sew the edges closer together.
00:27:20 ►
You can sew the edges closer together.
00:27:22 ►
It’s also like you can think about a seed, and a seed grows into a plant, and the sun and water,
00:27:30 ►
and if it has concrete over it, you know, it can’t grow.
00:27:35 ►
So if you remove that concrete, it has a natural ability to grow.
00:27:39 ►
So, you know, PTSD is an interruption of that healing process because everybody has trauma.
00:27:49 ►
And, you know, when you have PTSD, you haven’t gone through that healing that most people do, you know.
00:27:57 ►
So it’s interrupted or there’s obstacles to their healing.
00:28:03 ►
So that’s part of what we do.
00:28:06 ►
But we also, you know, it’s for people to get to know us and to know what our experiences are
00:28:13 ►
and to start to find out things about the participant are part of the things we do in the first three sessions
00:28:21 ►
that are the preparatory sessions.
00:28:25 ►
things we do in the first three sessions that are the preparatory sessions. And then we try to give them a little bit of an idea of like Stan’s cartography of what they might expect to happen.
00:28:32 ►
Not too much, but you know, enough so that they’re not freaked out. We also give them
00:28:38 ►
instructions about how to use their breath to relax if they get scared when the medicine is coming on,
00:28:45 ►
which is really important to have that tool to be able to calm down
00:28:50 ►
if you’re overwhelmed.
00:28:53 ►
And, yeah, there’s more we do, but you want to say some more?
00:28:58 ►
Well, we also talk about, we do talk about using the breath that way
00:29:02 ►
to calm the system if people get afraid when the medicine is first coming on.
00:29:09 ►
But then later we actually aren’t encouraging people to try to relax so much.
00:29:14 ►
There are times when we do, but mostly if anxiety is coming up later in the session,
00:29:21 ►
we’re encouraging people to use their breath to breathe into the experience,
00:29:24 ►
Later in the session, we’re encouraging people to use their breath to breathe into the experience,
00:29:31 ►
to stay with it and move through it rather than trying to settle it down or push it away from it,
00:29:39 ►
to look at everything that arises as something your inner healing intelligence is bringing up for your healing and your growth.
00:29:42 ►
So talking about that ahead of time is really helpful,
00:29:45 ►
just kind of introducing that approach that we take during the sessions. And what are some of the most important lessons you learned in
00:29:51 ►
these many years of holding space for MDMA sessions with severe PTSD?
00:29:57 ►
I mean, it seems to work for everybody. I mean, that, nobody was harmed by being in our studies. You know, we did
00:30:08 ►
a long-term follow-up questionnaire at the end, and nobody indicated that they had been harmed at
00:30:15 ►
all. And, you know, there were some people that maybe didn’t do as well with the, some of the
00:30:22 ►
testing that we were looking at, but overall the, their life was
00:30:27 ►
changing in dramatic ways. Um, so, you know, I think one of the, one of the, um, sad things is
00:30:37 ►
some of the people with PTSD go back to, um, you know, no job, um,, the way our society works, we don’t really have places for those
00:30:50 ►
people, you know, to have support.
00:30:52 ►
And so that can be somebody that doesn’t have the economic means or support, family support.
00:31:00 ►
That can be one of the challenges for doing this work because you can help people heal,
00:31:05 ►
but then they go back to maybe a situation that’s not a positive situation,
00:31:12 ►
and that can be a real challenge.
00:31:17 ►
Yeah.
00:31:18 ►
I think for me one of the maybe the deepest lessons is that trusting that the process can keep unfolding in a useful way.
00:31:29 ►
Because we have seen people with very severe PTSD that have been radically better by the end of two months after their second or third MDMA session.
00:31:41 ►
But we’ve never seen anybody that wasn’t somewhat better, as Annie
00:31:45 ►
said. But we’ve seen people that were still struggling quite a lot. It’s not the majority,
00:31:53 ►
but a significant minority of people were still struggling quite a lot at the end of the study.
00:31:59 ►
But we’ve seen repeatedly that, you know, if they keep doing some inner work, sometimes with a therapist, sometimes without a therapist, and stay with it and have the encouragement and the perspective that it can keep unfolding.
00:32:18 ►
We’ve seen dramatic changes, you know, a year or more later.
00:32:23 ►
dramatic changes, you know, a year or more later.
00:32:26 ►
So it’s a really interesting thing, you know,
00:32:32 ►
that most medication treatments, certainly,
00:32:36 ►
people don’t tend to keep getting better once you stop the medicine,
00:32:40 ►
especially if you’ve only taken it two or three times a month apart.
00:32:45 ►
But it’s very clear that this healing process just keeps unfolding.
00:32:48 ►
And wound.
00:32:49 ►
And yeah.
00:32:55 ►
And trusting also, you know, we’ve had the sense, obviously the research protocols are very strict and people can only have X number of sessions.
00:33:00 ►
Usually it’s three.
00:33:08 ►
number of sessions. Usually it’s three. And we’ve seen situations in which, again, somebody was improved but still struggling quite a bit. And we’ve wished we could have done more MDMA sessions,
00:33:14 ►
which I think probably could have been useful. But also it’s been a good lesson for us and for
00:33:21 ►
them in terms of trusting themselves to find that, well, yeah, we wish we could give
00:33:28 ►
you another MDMA session, but we can’t, but we’re confident you can keep working with this and keep
00:33:34 ►
healing. And we’ve seen, yeah, that happens. So that’s a really important, important lesson for
00:33:40 ►
me. And I think it’s, you know, I i i think sometimes maybe it would have been better if we
00:33:45 ►
could have done more mdma sessions but then again maybe people wouldn’t have gotten such a powerful
00:33:50 ►
message that the process was could keep going without the mdma too so more trust and in
00:33:59 ►
themselves and their inner healing intelligence once the MDMA helped the process start moving
00:34:05 ►
and helped get some of the obstacles out of the way.
00:34:09 ►
They didn’t really need the MDMA in the same way anymore.
00:34:13 ►
Yeah, I think what Michael said, that’s also part of what, you know,
00:34:18 ►
we really talk about in the beginning in those preparatory sessions
00:34:22 ►
is what the integration is going to look like and what
00:34:26 ►
are the tools that they have you know do they have a practice do they have a yoga practice or art or
00:34:33 ►
singing or you know whatever it is um it’s really good to have to help people start to have a
00:34:41 ►
practice walking walking in nature um because all of those things come into play once they start to have a practice walking walking in nature because all of those things come into
00:34:47 ►
play once they start to feel better and they those things writing you know those things keep
00:34:52 ►
the process moving and it’s over and over again it’s been things like that
00:34:58 ►
yeah you know the other thing is the people that we’ve seen in these studies, you know, wouldn’t have access to psychedelics, I don’t think, a majority.
00:35:12 ►
I mean, there are some, obviously, that would.
00:35:15 ►
But they come from, they’ve been naive in a way to psychedelics, and being able to offer it to people like that has been so rewarding too
00:35:29 ►
because you know you you tend to it’s the same with breathwork there breathwork you you don’t
00:35:36 ►
see the people that are underprivileged at breathwork groups and bringing these things to
00:35:42 ►
people that don’t have the privilege that so many of us do is really important.
00:35:50 ►
It does seem like it’s going to be one of the difficult questions as this moves forward is accessibility and the ability for any country to afford two therapists and one person for a very long period of time who has severe trauma.
00:36:05 ►
Yeah, it’ll be fascinating to see how this rolls out.
00:36:09 ►
Yeah, it will be.
00:36:10 ►
I mean, we’re making efforts already in our Phase 3 design to collect data
00:36:15 ►
that might be relevant to insurance companies about West medical utilization
00:36:21 ►
because there are a lot of data about how much, how many health consequences go with PTSD beyond the PTSD.
00:36:31 ►
So, and if you look at how much it costs for somebody to have PTSD for decades, it’s very, you know, even though our treatment, the way we’re doing it now, is more expensive up front,
00:36:45 ►
it probably is very cost-effective in the long run.
00:36:48 ►
When you have the kind of results we’ve been having,
00:36:51 ►
it would have cost a lot more to treat these people
00:36:54 ►
and not have them really getting much better.
00:36:57 ►
But also, I think once it’s approved, there’ll be a lot more flexibility.
00:37:03 ►
And for some people, they probably don’t need two therapists. And for some people, they probably don’t need
00:37:05 ►
two therapists. And for some people, they could do it in groups. For others, they might need more
00:37:10 ►
intensive stuff. So I think there’ll be lots of ways to look into research and develop ways to do
00:37:17 ►
it more cost effectively once there’s more flexibility too. So in the academic community,
00:37:33 ►
was there a lot of pushback as you started releasing these findings that were so powerful that they almost seemed unbelievable for PTSD remissions?
00:37:39 ►
Well, I’d say there was more pushback in the academic community before we released the data.
00:37:44 ►
You know, there was quite a lot of pushback.
00:37:49 ►
Most universities didn’t want anything to do with us at that point.
00:37:56 ►
I would say once we published data in a reputable journal, things really began to shift. I think we still ran into situations where people, I don’t think, gave the data a very fair look.
00:38:03 ►
Maybe it did seem too good to be true.
00:38:05 ►
But in general, I’d say the attitudes started shifting,
00:38:08 ►
and they’ve shifted radically now.
00:38:11 ►
You know, for Phase III, we’re going to,
00:38:13 ►
it looks like we’re going to have affiliations with two major universities at sites there.
00:38:19 ►
In our last study with the veterans,
00:38:21 ►
we were collaborating with imaging researchers at the Medical University of South Carolina, which, you know, when we got our first study approved in
00:38:29 ►
2001, they were distancing themselves from us as fast as possible. And now, you know, that’s
00:38:38 ►
come around. So it’s really gratifying to see. The other thing that’s helped is that all the studies with psilocybin at Hopkins and in New York and UCLA
00:38:51 ►
and having those results be positive and be published and in the news a lot at the same time
00:39:00 ►
has been, I think, really helpful for all of the psychedelics, you know, and for
00:39:08 ►
people understanding more about what we’re doing. And another aspect of your work I’m curious about
00:39:14 ►
is a training program that you help other therapists experience this. What’s it like to
00:39:20 ►
be running that for people who are so in tune with the other therapy modalities but maybe not as used to the medicine?
00:39:27 ►
Yeah, so we’re doing two different.
00:39:29 ►
So one training is to be able to give MDMA to therapists.
00:39:33 ►
Is that what you’re talking about?
00:39:34 ►
Yeah, that’s been really, really fun and interesting to give people that opportunity.
00:39:44 ►
to give people that opportunity.
00:39:52 ►
It’s been surprising because I think people haven’t realized,
00:39:55 ►
not all of them, but I think there have been some of them that haven’t realized what’s actually going to happen
00:39:57 ►
and that they’re actually going to have two therapists
00:40:00 ►
and all that time and attention.
00:40:03 ►
And so I think some of them have been very surprised
00:40:06 ►
at um what has happened and how beautiful it is and yeah it’s that’s been that’s been wonderful
00:40:13 ►
do you want to add anything michael well the other thing about that is nice is there’s a placebo
00:40:17 ►
session too so the therapists get to have their own all-day placebo session just like in the
00:40:23 ►
studies and they also get to see,
00:40:25 ►
well, that can be very useful too, you know,
00:40:27 ►
because we did see a good effect with just the therapy,
00:40:31 ►
but then it was much, much larger with the MDMA.
00:40:35 ►
But I’d say just to say something more about the training program,
00:40:39 ►
it’s been a lot of fun, but, you know, before people do their,
00:40:43 ►
before the therapists are eligible for their own MDMA session,
00:40:47 ►
they have to go through our other non-drug training,
00:40:50 ►
which is there’s an online segment first,
00:40:54 ►
and then there’s a six-day in-person training,
00:40:58 ►
and then there’s a second one of those later.
00:41:00 ►
And in the first one especially, it’s mostly watching videos
00:41:04 ►
and discussing videos from our sessions.
00:41:08 ►
So it’s a very rich process.
00:41:10 ►
And, yeah, sometimes it’s very interesting to see that people are taught a lot of things in other therapy methods, some of which are very important.
00:41:23 ►
I mean, we’re not training therapists from the ground up.
00:41:26 ►
We’re just training therapists to use the same approach that we’ve been using for the purposes
00:41:30 ►
of research. But a lot of it is kind of unlearning old habits because it is a much less directive
00:41:38 ►
approach most of the time. And so if you had a broad spectrum, what other applications of MDMA therapy would
00:41:49 ►
be most of interest to you? Well, couples therapy is, I think, one of the most exciting areas. And
00:41:55 ►
we are doing a small study now, collaborating with Candace Monson and Ann Wagner in Toronto,
00:42:02 ►
two psychologists there, using the method that Dr.
00:42:06 ►
Monson developed, cognitive behavioral conjoined therapy for couples, one of whom has PTSD,
00:42:13 ►
and combining that with two MDMA sessions two or three weeks apart. So that’s been, we’ve done
00:42:21 ►
three couples so far, and that’s been very exciting.
00:42:26 ►
And it really, you know, there was a lot written before, you know, anecdotal reports about how useful MDMA was with couples.
00:42:33 ►
And this is certainly bearing that out so far.
00:42:39 ►
I think it would be really wonderful to use it with families who are having trouble communicating about issues,
00:42:49 ►
like especially after the death of someone and then also before someone dies,
00:42:55 ►
like the study that’s going on in Marin right now.
00:43:01 ►
I think it could be incredibly useful for those two.
00:43:08 ►
And if you had free legal access to all the medicines, what medicines would be the most
00:43:15 ►
intriguing to both of you that you might want to incorporate or other modalities if it was wide
00:43:20 ►
open? When I first had my first conversation with Rick Dalvin in 2000 about
00:43:25 ►
would it be possible to do this research and he said you can do it here and we’ll help you because
00:43:30 ►
I thought I’d have to go offshore or something. He said what do you want to study and I said MDMA,
00:43:37 ►
LSD, psilocybin and ayahuasca. Basically he said me, but we have to start someplace.
00:43:45 ►
So we decided on MDMA for PTSD.
00:43:49 ►
And now I’m realizing in one lifetime I’m not going to get to all that, but that’s okay.
00:43:56 ►
But I think those are maybe the four that I’m most interested in.
00:44:01 ►
And, you know, there’s research in all those areas so far, psilocybin
00:44:07 ►
and MDMA having the most research, but I think they’re all very, very promising. And, you know,
00:44:14 ►
it’s great to see the research developing for these other compounds too, because I think,
00:44:19 ►
I think this is, you know, part of a, quite a transformation in,
00:44:23 ►
in psychiatry and psychology
00:44:25 ►
that’s much needed if you were put in charge of how these medicines actually were rolled out to
00:44:31 ►
the people what kind of system would you put in place would you like to see for healing well i’d
00:44:40 ►
like to see a clinic setting which was would have some nature um some availability to be outside
00:44:48 ►
but also you know have a nice comfortable um place with i mean i think the male and female
00:44:57 ►
model is a really beautiful model i mean like mich, you know, maybe someday it won’t be necessary
00:45:05 ►
for, for that, but I think having a mom and dad is just ideal if, if it was a perfect world,
00:45:13 ►
you know, to be able to work out all of your issues around your mom and dad and your growing up.
00:45:20 ►
So I, I feel like it, you know, our setting has been really a beautiful setting that we’ve done it in.
00:45:27 ►
And, yeah, having support, other people that could help, you know, to make food and have art.
00:45:40 ►
Well, we have music, but I mean, yeah. Yeah, and that’s largely what we’re envisaging
00:45:48 ►
and really suggesting to FDA that when it is approved,
00:45:54 ►
if it is approved, which I prefer to say when it is approved,
00:45:58 ►
but of course we don’t know how Phase III is going to come out,
00:46:01 ►
but that it should be in, you know, licensed clinics
00:46:06 ►
or places where people have the proper training
00:46:09 ►
about how to support people
00:46:10 ►
and have the proper setting to do it.
00:46:14 ►
Because I think all these medicines
00:46:15 ►
need to be treated with a great deal of respect, you know.
00:46:20 ►
And if you, although I think, you know,
00:46:22 ►
some of these ideas about researching the way it could help with creativity and other non-medical things, I think I’d like to see those move forward too.
00:46:35 ►
But so it doesn’t have to be necessarily so medicalized for everybody perhaps, but if you look at the cultures that have long experience
00:46:47 ►
with psychedelic compounds, like, you know, I’ve been to the Amazon, people don’t just
00:46:54 ►
go take them, you know, willy-nilly.
00:46:58 ►
It’s part of a very respected and structured way of having proper support and using them with respect and
00:47:08 ►
and with safety you know so i think a system that that honors those things is a good idea i don’t
00:47:17 ►
think to have any physician able to write a prescription and send people home with these
00:47:22 ►
would be such a good idea, actually.
00:47:25 ►
Hopefully soon enough we’ll be seeing psychedelic hospices and all kinds of healing centers
00:47:30 ►
around the country and one of them being yours.
00:47:33 ►
Let’s hope so.
00:47:34 ►
I’ve been feeling pretty confident about it.
00:47:37 ►
Thank you.
00:47:38 ►
Thanks so much for your work and thanks for taking the time to talk to us.
00:47:41 ►
Well, thanks for helping to inform people about it.
00:47:41 ►
and thanks for taking the time to talk to us.
00:47:44 ►
Well, thanks for helping to inform people about it.
00:47:51 ►
Thanks for listening to the Psychedelic Salon 2.0.
00:47:55 ►
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