A Promising Treatment

Healing the trauma: MDMA-assisted therapy for Queer PTSD. 

BY COLIN STACK-TROOST, MA, AMFT

It’s been over 30 years since MDMA, known in the club scene as “molly” or “ecstasy,” received an emergency Schedule I classification from the US government. At the time, there were a number of factors contributing to this: tens of thousands of MDMA tablets were being produced outside of the FDA and DEA’s watchful eye and regulatory protocols, and fingers were pointed to MDMA for causing medical emergencies. All of this was in the midst of former First Lady Nancy Reagan’s “War on Drugs” campaign, and as such, the drug was deemed to have “no legitimate medical use.” Though objections came from researchers, psychotherapists and psychiatrists, the study of MDMA’s therapeutic potential came to a screeching halt.

Enter Rick Doblin, who founded the Multidisciplinary Association for Psychedelic Studies (MAPS) in 1986 with the goal of making MDMA an FDA-approved medicine. Today, we are knocking on the door of this being a reality thanks to their patience and efforts. Despite the stigma of MDMA (and other psychedelics) being associated with a culture of partying and nightlife, in November of 2016, MDMA was approved by the FDA for Phase III clinical trials to determine if MDMA-assisted psychotherapy would help patients with a Post-Traumatic Stress Disorder (PTSD) diagnosis who have not responded to traditional forms of therapy and psychopharmacology (MAPS’ comprehensive MDMA-assisted therapy protocol, as well as their preliminary research findings, are available online for the public to review).

PTSD is characterized by a few major hallmarks: exposure to a traumatic event; re-experiencing the event or intrusion symptoms; avoidance of people, places, or things that serve as a reminder of the trauma; negative mood and thoughts associated with the trauma; and chronic hyper-arousal symptoms. Many readers who have trauma or know someone who has are familiar with just how debilitating PTSD can be. It affects not only one’s ability to work or maintain interpersonal relationships, but one’s overall feeling of safety in the world.

In last month’s issue, I explored the connection between PTSD and the Queer experience, where repeated exposure to homophobia and heterosexism have left so many in our community with the feeling that not only is the world unsafe, but that there is something inherently wrong with them because of their sexuality. I believe that MDMA-assisted psychotherapy has the therapeutic potential to help dissolve blocks that prevent us from healing from the wounds of growing up Queer.

While the Phase III Clinical Trials of MDMA-assisted psychotherapy are still in process, the preliminary data is promising: in a pilot study, 83% of participants who received MDMA-assisted psychotherapy showed a significant reduction in PTSD symptoms, and no longer reached the criteria for PTSD. Benefits from MDMA-assisted psychotherapy were maintained by most participants years after treatment.

Acclaimed trauma researcher Bessel van der Kolk, explains how “being traumatized is not just an issue of being stuck in the past; it is just as much a problem of not being fully alive in the present…in order to return to proper functioning…the body needs to be restored to a baseline state of safety and relaxation.” 

Taking MDMA can put someone in a mental state where they are able to access a state of empathy and compassion that may have previously eluded them, and combining that with a Queer-affirmative perspective could have a tremendous impact on the therapy process. Participants are able to stay engaged in the work, revisiting past traumatic experiences without feeling overwhelmed by anxiety or other painful emotions. Could this occasion a new relationship with the self and their Queer identity?

With this shift in consciousness, those who receive MDMA therapy may be able to re-narrate the story of their lives, where they no longer identify with the shame that has been thrust upon them by societal homophobia. As the research and clinical trials progress with the hopes of MDMA-assisted psychotherapy becoming a legal and viable treatment tool, it will be exciting to see what the applications of this are for healing the trauma that so many in the Queer community have faced.