The Upcoming MDMA Research Will Transform Mental Health Care

By
-
132
5850

For decades I have dreamed of giving MDMA (the recreational form is known as ecstasy or molly) to patients legally. In the early 1980s I prescribed MDMA legally. At the time, the power of this simple molecule to relieve emotional suffering and heal relationships deeply moved and inspired me as a psychiatrist. Then in 1985 the DEA chose to place MDMA in the most restrictive Schedule I category. Now, almost thirty years later, I will again dose a patient with MDMA legally as a member of the upcoming Phase III study sponsored by MAPS as a Site Principle Investigator in Fort Collins, Colorado. My motivations are larger than just helping a handful of folks overcome longstanding PTSD in this international trial.

While MDMA is a wonderful and needed tool that the practice of psychiatry cries out for, I think that MDMA is much more than a tool. We have many reasons to call MDMA a transformational agent. Recently, the FDA awarded the MDMA Assisted Psychotherapy for Severe PTSD Phase III Study with the “Breakthrough Therapy” moniker reserved for those agents with early evidence of substantial improvement over all existing therapies. As such the FDA does all they can to expedite review and analysis.

MDMA also represents a breakthrough in a number of other ways:

  1. It represents the possible movement of a Schedule I substance into an approved medical application.
  2. A donor sponsored Public Benefit Corporation funding the FDA trials.
  3. An episodically administered agent to enhance psychotherapy.
  4. A psychiatric medication that triggers improvement that continues over time without daily ingestion.

Yet in spite of all of the breakthroughs mentioned in the recent flurry of media and press releases, this medication has the potential to do much more. It truly is a transformational agent that will change the face of mental health care as we know it.

Psychiatry and the medical model have dictated mental health care policy and direction in this country for the last 50 years. From the lines of authority in psychiatric hospitals, community mental health centers and NIMH to the pay scales and practice models dictated by insurance companies to non-federal research funding, psychiatry drives the bus. Over the last 35 years as part of this shift to a medication-focused mental health, we have witnessed a remarkable shift in the spending for mental health care. We now spend more for medication and insurance administration than we do for all outpatient therapy (and much more than inpatient therapy). Sadly, the money we spend on psychotherapy per capita falls each year while the dollars spent on things like Abilify and Seroquel increases every year. For example, over 50% of children receiving mental health care now get medication management only. Like it or not, psychiatric philosophy and the practice of medicating symptoms dominates the field of mental health.

Psychiatry sits at an uncomfortable juncture. We are witnessing the fading end of a failing paradigm. Just as Kuhn told us in his landmark book, The Structure of Scientific Revolutions, scientific paradigms or belief systems do not fail step by step as the data reveals itself. Rather, they crash down when the weight of conflicting data shifts the perspective of the scientific community. Kuhn helped many of us to see that scientific paradigms are also socio-cultural phenomena driven and sustained by the inertia of individuals and institutions. So, often this shift to a new paradigm may occur one funeral at a time as the Nobel Prize winner Max Planck famously quipped.

When the theoretical structure that medical or psychiatric practice is built upon clearly outlives its value and validity it creates a time of turmoil, conflict and challenge for a profession. We are witnessing this phenomenon in psychiatry now as therapists, parents, patients and the news media question the prevailing practices. Research has eroded the belief in the safety and efficacy of the core treatments in depression, anxiety and schizophrenia. The number of practicing psychiatrists in the US actually fell over the last 15 years as recruitment and retirement erode those willing to do the work. The reputation of psychiatry both within medicine and by the public has soured.

Psychiatry is always vulnerable to distorted science as the complexity of the human brain and behavior exists orders of magnitude beyond our coherent grasp. As such, my profession can get caught up in harmful ideas that seem at first to be sound and medically based. Witness the frenzy around lobotomies and insulin shock therapy just seventy years ago. Today, these things seem horrific and unsound when viewed through the perspective of time, but if key thought leaders and a few studies point the way we can often lose our bearings in the rush to participate in the next advance of science.

Given its roots in behavior, relationships and the ever-existing cultural milieu, psychiatric illness can best be viewed as a biologically based socio-cultural expression. Over time our prominent illnesses wax and wane in keeping with the changes in society. In Freud’s time it was neurasthenia, vapors and hysteria; in the 1950s we had hebephrenia and neurosis; the 1980s were littered with dissociative identity disorder, cult abuse and borderline personality. Today we have a pandemic of ADHD, bipolar disorder and depression. Psychiatry has always been a specialty that sits just outside of medicine and much closer to sociology and anthropology than any of us might like to admit. As such it reflects the fears and wishes of the culture it is based in.

For the last 60 years, modern psychiatry has gravitated around a medication model that mirrors our cultural zeitgeist that worships quick relief, flashy psychopharmacology and the avoidance of emotional depth. The chemical imbalance theory supplied all of that and a Jetson’s-like aura of science from the future. The marketing mania of SSRIs like Prozac (released in 1987) eroded the enlightened systems-oriented bio-psycho-social perspective of George Engels. By the time we reached the Decade of the Brain in 1990, all of us (myself included) could envision a day when a focused and advanced psychopharmacology would eliminate all psychiatric illness. The excitement was palpable and fueled by the whip-smart marketing of Lilly and the rest of Big Pharma (who now spend more on marketing than on research).

Here is the core of the chemical imbalance theory that was sold to the medical profession and the American people:

  1. Psychiatric illness represents an imbalance of key neurotransmitters.
  2. We are born with this imbalance and it does not change.
  3. Medications prescribed by physicians can correct this disorder.

The second tier implications of this paradigm are also critical but not as widely appreciated:

  1. Diet, lifestyle and to some degree relationships really don’t matter.
  2. Often the medication/chemical balance will shift and you must return to the psychiatrist for your medication management.
  3. These medications and thus the regular management of them are required indefinitely.
  4. Psychotherapy is nice, but not really indicated for serious problems.
  5. You can’t heal yourself.

Interestingly, this philosophy is unspoken and untaught in psychiatry residencies. Psychiatry as taught by all of the core textbooks is actually free of any unifying philosophy. Accordingly, there is no consideration of mental health in these textbooks. Psychiatry is a study of disease and the specific pharmacology that can manage them. Other treatment avenues are given lip service in residencies and academia, but out in the real world of private practice, community mental health centers, psychiatric hospitals and insurance companies, it is all about medication management of the chemical imbalance. We diagnose and then we prescribe. That is the role of psychiatrists in our mental health system. We re-balance the chemical imbalance.

While this overly simplistic and unrealistic theory became an urban myth that drove actual psychiatric practice, the science was never really there. We have no sound science to support the chemical imbalance theory of depression. Period. Never was, really. No reputable neuroscientist now supports the chemical imbalance theory of depression. All antidepressants have the same meager level of effectiveness over a placebo for treating depression (they do much better for anxiety). Researchers such as Irving Kirsch blame this slight advantage on an active placebo response generated by medications that create side effects that make us believe they are working and thus heighten our expectation and resultant healing. Many now doubt that these medications have any fundamental benefit for the depressed patient. We have no idea how these medications work, if they even do.

Now we are witnessing the deep erosion of this chemical imbalance paradigm in the treatment of depression. How do we reconcile the fact that selective serotonin reuptake inhibitors (SSRIs) are about as effective in randomized controlled trials as selective serotonin reuptake enhancers (SSREs)? They work in an opposing manner on neurotransmitters. They do the exact opposite of each other! One increases serotonin and one decreases it. The chemical imbalance theory is dead in the water.

Likewise, we have growing evidence that the long-term use of psychiatric medications offers no real benefit and may in many cases actually deteriorate outcomes for patients. For example, we have growing evidence that antipsychotic medication damages the frontal lobes of the brain and that schizophrenics in the US have better outcomes when they avoid these medications. In Robert Whitaker’s book Anatomy of an Epidemic, he explored the data surrounding the long-term use of psychiatric medications in schizophrenia, ADHD, depression and anxiety. Big Pharma studies typically highlight trials of only 6 to 12 weeks while the brain is still adjusting to the input of medication. The true response occurs over years when the brain begins to adapt to this input. Whitaker’s book documented what many observant and discouraged psychiatrists have seen for years: we don’t cure anybody with these medications and we harm way too many.

Big Pharma and our professional guilds remain unrepentant and surprisingly non curious about these devastating insights. However, more and more psychiatrists have begun to question the model and the paradigm that our modern practice of psychiatry is built upon. The chemical imbalance paradigm dictates a life of medically managed misery that is increasingly unpalatable to patients and doctors alike. As the conflicting evidence and opinion build, the profession is beginning to flee the sinking ship. What other options do we have? Usually in Kuhn’s perspective models don’t crumble as much as they fail from lack of support as interest flows to something more scientifically compelling. Where is it going next? How does the MDMA trial relate to this process?

In line with all these changes, the big research dollars in psychiatry have moved away from neurotransmitter manipulation and toward other models of understanding and intervention such as the connectome. This model postulates that we have networks of activity in the brain that drive behavior and illness. While this is much more reflective of modern science, it has the potential to be just another three-decade-long rabbit hole that we jump into with the hope that salvation is just around the technological corner.

Besides the connectome, a number of other possible successors exist to become the next predominant model in mental health. Epigenetics has overpowered genetics and the genome. It brings nutrition, supplements, health and lifestyle into the conversation, but most suffering Americans are not ready for this level of personal change. Neuroplasticity and neurofeedback tell us that we can retrain any brain, even an aging brain. This has a wow factor and appears to work for ADHD, but a comprehensive approach to a range of psychiatric issues is still decades off. Whole person medicine (often inspired by integrative/functional medicine) with facets like the microbiome, inflammation and autoimmunity offers a more systems-oriented view of mental health, but the indications are mainly for the chronic illness subset of our patients. Psychedelic science has exploded in the last ten years and offers broad hope for transformational interventions, but these interventions still struggle with predictability and narrow indications. Oh, there is that whole ‘illegal’ thing too. Thus, we have some contenders, but nothing that can form a unifying umbrella for mental health.

If MDMA can effectively treat and perhaps even cure PTSD it will create clear documentation that the core premises of the chemical imbalance theory are dead wrong. We can heal ourselves when barriers are removed. Recovery is possible. We can get better. We move from a pessimistic model that denies the responsiveness of the human being to their environment to one that acknowledges that change and improvement can be dramatic even from a serious and longstanding mental disorder.

Holistic/integrative medicine shares this core premise about the inner healer. MDMA can become the entry point to foster a vibrant integrative psychiatry that becomes more than just the supplementation of medication management. The concept of catalyzing personal transformation begins to open the realm of spiritual medicine and pulls us back to our roots in shamanism. Here the power of psychedelics can gain much needed appreciation and cautious application for a range of chronic, often existential maladies.

Once we embrace the power of a living system to heal and adapt, a range of other implications also emerge. The idea of chronic symptom suppression becomes more obviously repellent. Psychiatric medications will become short-term tools to enhance catalytic change but will be avoided as long-term interventions. Psychotherapy will become more focused on providing support and enhancing expectation. The arguments over technique will fall away to a focus on creating a safe container, trust and an open heart. Ignored tools like breath work, somatic therapies and art will gain traction.

In short, this MDMA study has the far-reaching implications that will transform mental health care and our view of the human psyche. The inner healer will become the new paradigm for mental health. Psychiatrists will move from being managers of medication to healers. Psychotherapists will become more valued and we will focus more on the inner development of the practitioner than merely valuing of specific techniques. We will witness a much-needed expansion of our theories about the healing that underlies mental health that have sat dormant since the time of Jung and Maslow. True, this is only one study, but it stands as a crucial test with massive implications. It can become a nidus around which a new paradigm can form. It is ironic and only fitting that a chemical molecule will finally bury the chemical imbalance theory and allow us to move on. Patients, practitioners, professions and the public as a whole will reap the benefit.

***

Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

***

Mad in America has made some changes to the commenting process. You no longer need to login or create an account on our site to comment. The only information needed is your name, email and comment text. Comments made with an account prior to this change will remain visible on the site.

RELATED ARTICLESMORE FROM AUTHOR

132 COMMENTS

  1. Scott, I applaud your critique of the medical model.At the same time, I am deeply concerned by your celebration of the new FDA trial and the movement to give people who suffer from trauma what is in essence is a few doses of doctor-delivered Ecstasy. While I take in that the hope is that just a few doses will do (and we all know what will happen if they don’t imminently produce the long-term “effect” being sought) here again drugs that interfere with totally normal neurotransmitter levels are involved and being presented as “medical” treatment.
    Let me suggest that this is but a new (read: additional) entry point into the medical model–and not something to celebrate.

    We can hardly defeat a paradigm by slipping into it.

    Report comment

    • Well said, Bonnie. The disconnect between the very relevant critique of the medical model and the absence of ANY kind critique of the view of PTSD as a “treatable disorder” is glaring. The victim is still blamed and the psychosocial origins of PTSD remain obscured behind the “diagnose and treat” model. Far from undermining psychiatry’s medical model view, any success of MDMA will be grabbed upon and trumpeted from the rooftops as proof that PTSD IS a biological problem (because after all, a drug solved it, so it MUST be biological!) Meanwhile, the root causes of PTSD, including parental abuse/neglect, dysfunctional schools and other social institutions, structural poverty and unemployment, domestic abuse, racism, sexism, and other institutional oppression, and the generally oppressive nature of our corporate capitalist social system will all be given yet another free pass.

      Oh, and just for the record – psychiatry doesn’t stand “just outside” of medicine, IMHO. It’s miles away in the area of self-promotional delusion. Admittedly, some other medical specialties spend time in that area, too, but psychiatry is at this point almost completely divorced from any honest effort to comport itself according to the scientific findings of its own researchers. It’s closer to religion than it is to medicine, or even to sociology.

      Report comment

  3. Crikey you couldn’t make it up, they just can not help themselves.

    Here are some questions

    But what if you do not have enough AMPA receptors or there is a problem with mobility, or the phenotype of glutamate decarboxylase isoform GAD65 is poor and there is a problem with GABA synthesis, or the NMDA receptor isn’t moving correctly to generate electrical signals ?

    is it not worth knowing about ?

    https://www.youtube.com/watch?v=87PagkjGz0I

    Report comment

  4. Psychedelics were originally sought for aid in psychotherapy and inducing religious experience, two reasons almost at cross purposes, unless you’re going to cling to that old tripe about mad doctors “healing souls”.

    I can’t imagine the medical use of a recreational drug not extending that recreational (or religious) usage, and having a great potential for getting out of control. The answer, as ever, and with a big fat duh, is not to be found in drugs of any sort.

    Of psychedelics, the use of MDMA in particular should raise some concerns, and send up a few red flags. Why?

    “Most psychedelics are not known to have long-term physical toxicity. However, entactogens such as MDMA that release neurotransmitters may stimulate increased formation of free radicals possibly formed from neurotransmitters released from the synaptic vesicle. Free radicals are associated with cell damage in other contexts, and have been suggested to be involved in many types of mental conditions including Parkinson’s disease, senility, schizophrenia, and Alzheimer’s. Research on this question has not reached a firm conclusion. The same concerns do not apply to psychedelics that do not release neurotransmitters, such as LSD, nor to dissociatives or deliriants.”

    https://en.wikipedia.org/wiki/Hallucinogen

    Part of the problem with that era referred to as the sixties was the religious use of some of these drugs. If religion is the opium of the masses, I have to wonder what that makes opium, and by extension, LSD, mescalin, ecstacy, or you name it. I think it is a decade that left us with, quite literally, many casualties of the search, through chemistry, for the ‘ultimate high’.

    There are more positive things to be said for, say, sex and rock and roll.

    While not learning from history may be very profitable, I would caution against leaping into another decade of worshiping at the altar of the ‘quick fix’ to Godhead in the form of a pill.

    Before the psychiatric drug you had the psychedelic drug, okay, and I imagine that illicit drugs redeemed for medical purposes, in this instance, are only likely to lead to a further development of the psychiatric drug, the two being somewhat intimately connected in time and conception.

    Report comment

  5. Scott and all

    Is this blog not just another attempt to resurrect and repurpose Psychiatry with the focus now on a new form of chemical intervention on the human species? I share Bonnie’s and other commenters’ concerns here.

    While this blog has some positive exposure of what is wrong with the chemical imbalance theory and its’ practice in the dominant paradigm of so-called “treatment,” it fails to escape the philosophical and scientific underpinnings of Biological Psychiatry.

    Scott said:
    “Once we embrace the power of a living system to heal and ADAPT [my emphasis], a range of other implications also emerge…In short, this MDMA study has the far-reaching implications that will transform mental health care and our view of the human psyche. The inner healer will become the new paradigm for mental health. Psychiatrists will move from being managers of medication to healers.”

    The above quote totally leaves out the role of the environment as a central determining factor in human thought and behavior. In order to create a world free of extreme forms of psychological distress, we must move in the direction of creating a material world free from the all the forms of physical and psychological trauma that are rooted in multiple forms of inequalities in the world.

    NO, we don’t want to just learn how to better “ADAPT” to all this madness. What about the necessity to “TRANSFORM” the world and ourselves in the process of identifying and changing those things in our environment that cause and/or trigger thoughts and behaviors that get labeled as “mental illness.”

    Yes, MDMA may have a limited role in helping some people suffering from post traumatic distress. However, we do NOT need new ways to “medicalize” the human condition and essentially preserve the status quo by helping people “adapt” better to an unjust world.

    Richard

    Report comment

      • Steve

        Yes, all of Psychiatry is based on unscientific premises and has a dark history since its inception.

        Biological Psychiatry is just its latest and dominant incarnation, and historically it represents the worst of Psychiatry on steroids.

        While there are a tiny minority of psychiatrists that help people in the world, it is NOT because they are performing “psychiatric” forms of “treatment.”

        If psychiatrists do help some people, it is because they are listening to people and providing some sort of emotional support. This has nothing to do with their medical credentials or medical services.

        Today, the only exception would be those psychiatrists who have done serous research into safe psychiatric drug tapering protocols, and use their medical credential to aid people in their efforts to taper off of, and/or reduce their dependency on psychiatric drugs.

        Richard

        Report comment

      • littleturtle

        I will repeat a comment I made to you in a recent blog; perhaps you missed it:

        “You are looking at the role of “biology” in human behavior in a mechanical way. To promote the standard refrain of “bio/psycho/social,” is to remain stuck in a paradigm of thought that represents everything wrong with the status quo’s version of what actually represents the very fluid concept of human nature.

        After all, every Biological Psychiatrist will gladly parrot the “bio/psycho/social” refrain. And we also have to ask the question, why is “bio” ALWAYS listed first in this particular meaningless refrain? We do know that based on any careful examination of the way modern Psychiatry functions in the world, is that they pretty much all practice a “bio/bio/bio” approach in the real world.

        I suggest you read some of Robert Sapolsky’s (well known neuroscientist and primatologist) writings, including his short article titled “Peace Among Primates.” Here is a quote from that essay:

        “To an overwhelming extent, the age-old “nature versus nurture” debate is silly. The action of genes is completely intertwined with the environment in which they function; in a sense, it is pointless to even discuss what gene X does, and we should consider instead only what gene X does in environment Y. Nonetheless, if one had to predict the behavior of some organism on the basis of only one fact, one might still want to know whether the most useful fact would be about genetics or about the environment.”

        In this essay he clearly shows a real life example where “environment” clearly trumps (sorry for the use of this word) other factors in the ultimate determination of what are the primary behavioral influences within an on going culture of a particular subset of primates.

        All this provides some very important “food for thought” when we ponder what is going on in the world and how we should go about finding the best solutions for the most vexing problems facing humanity.”

        Richard

        Report comment

  6. I will add a few points to my above critical analysis of this blog.

    Scott said: “All antidepressants have the same meager level of effectiveness over a placebo for treating depression (they do much better for anxiety).”

    This blog has left out one of Psychiatry’s and Big Pharma’s biggest crimes to date, and that is the worldwide benzodiazepine disaster. This has harmed millions of people around the world.

    And to suggest that anti-depressants are a successful “treatment” for anxiety is misleading at best, and it fails to show its intimate connection to the benzo disaster.

    Richard

    Report comment

  7. “psychiatric illness can best be viewed as a biologically based socio-cultural expression.”

    Not in my book. First I’m not keen on the term, “Psychiatric illness.” Second, the biologically based bit is a red herring and a dangerous one at that. If this drug don’t work, try that one, etc etc etc. Forget the biology.

    The only thing that is good about ecstasy is that is it about as dangerous as horse riding, according to Proff Nutt, and therefore a whole lot safer than other psyche drugs.

    Personally I’d prefer a good friend to drugs any day.

    Nuff said.

    Report comment

    • I once won a competition and the prize was a ticket to a David Nutt lecture. I remember he was talking about ecstasy and said it had never killed anyone. A member of the audience queried this statement and Nutt said it wasn’t ecstasy that killed but drinking too much water. I didn’t find that very convincing.
      As for Scott’s article, I couldn’t see how MDMA is going to be different from any other drugs. Perhaps, Scott, you could make it a bit clearer?

      Report comment

  8. Sorry Dr. Scott Shannon, another critical comment, as mostly the angry will be motivated to respond, not the happy.

    If everyone (adult) is a willing participant in a MDMA treatment, caveat emptor, obviously that is fine.

    However , Psychiatry is known to jail people and force them against their will to be treated. Though forced MDMA would likely be better for a persons brain function and memories than a session of ten or so Electroshocks prescribed-forced on the severely saddened.

    _________________
    You write ” a chemical molecule will finally bury the chemical imbalance theory” and “we have growing evidence that antipsychotic medication damages the frontal lobes of the brain”

    Without the chemical imbalance theory for schizophrenia the psychiatrist has no justification for “medicating”(poisoning) their ill patients with antipsychotics, so psychiatry can not bury the imbalance theory.
    ___________________________
    There is no police force, no internal affairs for psychiatry.
    With no body of oversight to enforce rules , like the Nuremberg code “Required is the voluntary, well-informed, understanding consent of the human subject in a full legal capacity.” what person has ever been charged? Psychiatry will do whatever it wants as it answers to no one.

    Dr. Jeffrey Lieberman broke the Nuremberg code and no one charges him, just like when Bernard Madoff was allowed to continue his scheme with Harry Markopolos’s criticism. http://content.time.com/time/business/article/0,8599,1877181,00.html

    From Wikipedia article on Lieberman.
    “Methylphenidate challenge as a predictor of relapse in schizophrenia.” Authors Jeffrey Lieberman, Kane JM, Gadaleta D, Brenner R, Lesser MS, Kinon B. Am J Psychiatry. 1984 May,141(5):633-8

    “Prediction of relapse in schizophrenia.” Authors Jeffrey Lieberman,Kane JM, Sarantakos S, Gadaleta D, Woerner M, Alvir J, Ramos-Lorenzi J. Arch Gen Psychiatry. 1987 Jul 44(7):597-603

    “Behavioral response to methylphenidate and treatment outcome in first episode schizophrenia”. Authors Jody D, Jeffrey Lieberman, Geisler S, Szymanski S, Alvir JM. Psychopharmacol Bull. 1990;26(2):224-30

    Mood responses of remitted schizophrenics to methylphenidate infusion”]. Authors Robinson D, Mayerhoff D, Alvir J, Cooper T, Jeffrey Lieberman. Psychopharmacology 1991;105(2):247-52

    “Methylphenidate response, psychopathology and tardive dyskinesia as predictors of relapse in schizophrenia.”Authors Jeffrey Lieberman,Alvir J, Geisler S, Ramos-Lorenzi J, Woerner M, Novacenko H, Cooper T, Kane JM. Neuropsychopharmacology. 1994 Oct,11

    The behavioral effect of m-chlorophenylpiperazine (mCPP) and methylphenidate in first-episode schizophrenia and normal controls.” Authors Koreen , Jeffrey Lieberman, Alvir J, Chakos M. Neuropsychopharmacology. 1997 Jan;16(1):61-8

    Report comment

  10. My sense is that Scott is mostly making sense here, and the criticisms are overblown!

    I see a huge difference between using a drug to essentially show someone that their brain can operate differently, and to get them to have an experience that helps them make constructive changes in a future that doesn’t involve taking the drug, compared with standard psychiatry which attempts to alter brain functioning every day.

    Of course, not all use of a drug like MDMA is likely to be transformative – but the combination of the drug with the right set and setting could I think have the potential to be truly healing. And healing, rather than daily drug suppression of the brain, would be a nice future focus for psychiatry. (Of course, if this was applied by force, it would be a disaster, and there are probably other ways to make this into a disaster, but I think Scott’s argument is just that we could take this in a good direction.

    Report comment

    • It’s interesting, to be sure.

      I think one of the problems I have with this protocol (and many of the MAPS studies, though I suppose it is a step away from this totalitarian war on drugs, er, racial war on poverty) – is the therapist’s office.

      Let’s take someone, for example, who has trauma from psych treatment (Monica Cassani talks about “Psych Drugs as Agents of Trauma” http://beyondmeds.com/2012/04/25/psychdrugsagentoftrauma/) That person goes to the therapist’s office, and in this office, even if it has been set up like a hippie haven with a painted parachute on the ceiling, tea lights all around, and Enya playing calming, emotive music, this office represents a room of control.

      In that place of control, the “client” (whatever word you want here) takes this drug which will cause them to lose their inhibitions and get in touch with their emotional self. Except their emotional self is traumatised. And there is a huge power variance between the “client” going into this altered state, and the therapist, who is not going with them. This is similar to my objections of the medical uses of psilocybin.

      In my experience, psychedelics/entheogens are best experienced in nature with a group of like minded, caring individuals, preferably friends. There are always people around to help coddle you through the rough bits, and there is not this power variance, nor is there a reliving of the therapist’s office in trauma. And even though it’s not “therapeutic,” in my experience it has always been beneficial and transformative, when handled with care and respect, as a sacrament should be, and if the intent to transform and connect was clearly pursued.

      When I heard in the 80’s that it was being used in relationship therapy – I did try it in my own marriage, the two of us together. That day is still memorable to me, spent in a public park – talking, opening to new hope. There were glimpses, moments of opening and sharing – but – and here’s the other caveat – when the drug wore off, the gates slammed shut, and I was left with a very distressed, repressed and locked-down husband again. And we don’t know what it did to his neurotransmitters in the long run. (He committed suicide in 2008, another polypharmacy case.)

      Of course, my experience was illegal, horribly illegal, and currently the state of “Molly” on the streets does not even resemble the pharmaceutical drug. It’s terrifying – so terrifying that the smart kids take test kits to their raves to make sure they don’t get the bad ones, which are cheap and plentiful, and so terrifying that I advise all to not take anything without a test kit.

      So on the one hand I applaud that MAPS is getting the government to release the better entheogens, I’m not sure that the therapist’s office is where I want these things to end up. (and yes. the change in neurotransmitters is a strong issue, and why I only tried it a few times in the 80’s. The last attempt was a “bad dose” – the beginnings of what is available on the streets today, and that, coupled with the reports of brain damage which didn’t seem like propaganda at all, ended my experiment in “freer emotions and communication.”

      Report comment

      • Jan, thank you for this thoughtful post. You are moving into a realm of helpful discussion and healthy, constructive skepticism. I have a few thoughts.

        As someone who was deeply traumatized by prescription psych drugs, I’m not sure that there is always the problem with power relationship that you describe; I certainly have not felt that way myself, as I’ve found a range of relationships and power dynamics in different psychotherapy contexts, and suspect others have, also. (I do realize there are always questions of power at play, I just haven’t found it to always be a problem.) I also think it has more to do with the actual therapist and the personal relationship than with the decor of the office; there are good, careful people doing this work, and not good, not careful people, and it can make all the difference.

        I also do not see nearly as clear a differentiation between power-laden individual relationships and supportive group work as you do. Group work with psychedelics can be really very problematic and needs to be done with just as much care and attention to power dynamics as individual work.

        I also think you’re right about the problem of people shutting down, or at least snapping back to base-line, after the experience. It’s just not a silver bullet, doesn’t work for everyone or at any time, and I think there’s a real danger of people not realizing this. One thing that I think is very helpful about the MAPS protocol is the way they embed the experience in traditional therapy. That really helps establish trust and help people go deeper and integrate the experience, and minimize the problem you describe, and I think their research is helping us to understand how best to use the substance.

        Thanks again,

        Daniel

        Report comment

    • Ron, I think there are a couple of points you are missing. This is not a critique of MDMA or the possibility that it might catalyze healing for some. I’m critiquing the idea that finding a drug-based solution will somehow lead to the dismantling of the DSM-diagnosis-based and drug-based “treatment” paradigm we’ve all come to despise. Until and unless we do away with the idea that the “patient” is “ill” based on some arbitrary criteria, a drug-based solution, however well-intended, will lead instead to an INCREASE in drug-based arguments and interventions and a further deflection away from looking at root causes for these “disorders” and a continued and redoubled effort to blame the client’s brain for his/her difficulties. There will, as there always are, be practitioners who use this information and possible intervention responsibly and in an empowering way that respects the social context of a person’s suffering. But the industry, with the help of Big Pharma, will be saying, “MDMA is the new miracle drug! Psychiatry’s big breakthrough proves that they CAN heal the brain with new and better medications!” MDMA being successful will not alter the current power dynamics. In my view, it would make them worse, no matter how effective MDMA might be if used in the right context.

      — Steve

      Report comment

      • Steve, to my ear, this is not at all about looking away from root causes, but rather is about recognizing them and asking how injury to a once-healthy system can be healed. That doesn’t at all preclude working also on changing the social context and root causes embedded in it. If a child is being hit and having his bones broken, should we not both address the family and social context AND set those bones so they can heal? That seems to me very different from saying (to perhaps strain the metaphor), oh, my, that child has weak bones! He is diseased. Give him a daily dose of bone strengthener…that has not actually been shown to strengthen bones and has a host of nasty side effects. Just to be extra clear for anyone skimming, I’m not suggesting MDMA works as simply and clearly as setting bones! 😉

        Perhaps it has also to do with how this is theorized and described. No doubt big pharma could spin it the way you suggest, but I’m not sure they have enough interest, since it’s not patented or making money for them. No? But either way, I think it’s up to us to make sure it doesn’t get hijacked that way.

        Report comment

        • If there’s a way to hijack it, they will do so. And it’s very possible they CAN get a patent for a form of MDMA if it’s used for a new purpose. Drug companies do this all the time. My point is, whether or not this pans out as a helpful intervention, it doesn’t change the power dynamics of the Big Pharma/APA juggernaut as the author suggests it might, and I see a good chance, even if they can’t patent it, that it gets used to further their context-free agenda that’s worked so well for them since 1980 and the DSM III. That’s the central problem we face, and MDMA will do nothing to create sudden “enlightenment” of an industry which has made billions by denying known scientific facts such as those Whitaker so thoroughly outlines in his work. Why would they change what’s been so profitable, just because a few inconvenient facts suggest they are wrong? The general public still believes in them and their marketing, and that’s not going to change as a result of MDMA’s projected successful use.

          Report comment

        • And of course, I’ve made the “Weak bones” argument myself, and it makes total sense, but it doesn’t stop the psychiatric mainstream from telling those with PTSD diagnoses that their reaction is a disease because not everyone acts that way. Apparently, the only acceptable response to trauma is to shake it off and get back to work. We get a whole two weeks now to grieve the loss of a loved one, why should being sexually abused or seeing a friend blown up by a bomb require a longer recovery period?

          Report comment

          • Shoot, I thought weak bones was original!

            I’m always uncomfortable with absolute certainty in dynamic situations. This seems dynamic to me. I don’t think they can patent it, and I’m much more hopeful than you that people are starting to see through the emperor’s clothes on this and other fronts. And that’s coming from someone who’s academic work was both Marxist and Foucaultian; I totally hear you on power. Keep in mind that this is also related to the true psychedelics (MDMS is a sort-of psychedelic). Those come with their own pros and cons, but I think there is something important afoot outside the realm of patents that has the potential to help break the power relationships you’re concerned about. (Help, I said…only help.)

            I don’t assume it! I once heard a prominent physician with ties to big-philanthropy (and who, in my opinion, is stuck in a psychedelic quasi-cult) suggest the hashtag “psychedelics, the cure for poverty!” She was serious. I think she meant that they can help people self-actualize, and I suppose become the go-getters capitalism wants. (Needless to say, capitalism actually needs them to stay poor; gotta have that reserve army of labor.) So it was utter bulllshit. As some Indian guru apparently once said “A fool going in, a fool going out.”

            Still, I think it’s dynamic, the world is coming apart at the seams, things are not as predictable as they once were. And people who are suffering need help.

            Report comment

      • I agree with Daniel’s metaphor. We have to attend both to the system and the individual.

        Trauma is to some extent like a lie that gets told. If someone tells me a lie, the problem is initially the liar, but once I believe the lie, then the problem is inside me and I will also need to go through some changes to “get better.” If MDMA can help people reject lies that have become deeply embedded into them, that can be a good thing even if the person helping them is called a “psychiatrist.”

        I agree it will take more than just one thing to correct our messed up mental health system, and our messed up society, but going from a “daily drugging” model, to “use a drug at a strategic time to help create a transformative experience” model, would be a huge step in the right direction, and would be a substantial paradigm shift. (And it’s hard to see Big Pharma having much of a role, as the quantity of drugs required is minute, and already off patent.)

        Report comment

        • Again, not arguing against (and I never have) the strategic use of a short-term drug intervention (with proper informed consent) as long as it has an established positive effect that outweighs the risks involved. I’m arguing against the idea that MDMA being successful in this context would have the slightest positive impact on the demise of the medical model. At best, it will allow a few lucky souls to slip through psychiatry’s net if they manage to connect with the right provider. At worst, it will be trumpeted as proof that the victims of trauma who react poorly are at fault for their negative reactions, which is all the diagnose-and-drug model needs to continue to function. The fact that this argument holds no water is not relevant – NONE of the arguments for arbitrary diagnosis and drugging hold any water. It will provide a PR opportunity for the greedy and malfeasant industry, but even if they miss that, it won’t even make a tiny chink in their armor. And if it does, they’ll find a way to blackball anyone using it by relegating it to a permanent “experimental” status, as they have with neurofeedback and other promising interventions.

          It is hard to overestimate the venality and ruthlessness of the psychiatric juggernaut. I think it is a big delusion to think that this kind of intervention will knock some kind of hole in their boat.

          Report comment

  11. These kinds of articles are useful because they demonstrate with great clarity the delusional thinking that drives modern psychiatry. Why would someone dream of giving ecstasy to people? Is this really what people are learning in medical school? There are high school stoners who are smarter than that.

    First, there is the delusion that a drug like ecstasy will relieve emotional suffering. Absolute poppycock! True healing is painful. It takes time and patience. A person may suffer through the process of healing, but the healing will be real and complete. We don’t need some Rolling Stones “Mothers Little Helper” distortion of medicine. That clearly didn’t work.

    The second delusion is that PTSD represents a real illness. Balderdash! Of course people suffer from a wide variety of painful symptoms from trauma or abuse (much of which is directly cause by psychiatric force or interventions), but there is no such thing as PTSD. The atrocious acronyms of the DSM-V need to be relegated to the garbage dump of history.

    The third delusion is that psychiatry is some sort of a profession that requires saving or refurbishing. Hogwash! If the innocent people who are abused and tortured by psychiatrists meant anything to anyone, no one in the so-called “profession” of psychiatry would be trying to finagle some new conception of psychiatry in order to save the “profession.” Who cares about the reputation of psychiatry? Psychiatry has been torturing, abusing, incarcerating and murdering innocent people since its inception. It’s time to abolish this evil, and to eradicate it from off the face of the earth.

    The fourth delusion is that psychiatry is in any way a form of medicine or healing. Malarkey! Psychiatry is, as Szasz so eloquently demonstrated, the science of lies. It is at best a pseudo-science, and it certainly has nothing to do with healing. It is a system of iatrogenic harm and coercion that preys upon the most vulnerable in our society, including children, the homeless, and the elderly. Even worse, as Szasz has also pointed out, it is a false religion whose false priests endorse false rituals that inflict untold harm on untold numbers of innocent people.

    The fifth delusion is that advancements in our understanding of the human brain are helping us to understand the nature and causes of so-called psychiatric illnesses. Rubbish! The human brain is so much more intricate and complex than anyone has even begun to fathom, and yet those who appoint themselves as brain scientists believe that they can tinker with this infinitely complex organ of inestimable worth as if it were nothing more than a lump of curdled cheese.

    The sixth delusion is that if a person recognizes the inherent mendacity involved in the development of the “chemical imbalance” hypothesis of so-called “mental illness,” psychiatry somehow has a free pass to come up with other explanations and fake cures for fictitious diseases. Hooey! Just because the myth of mental illness has been laid bare by Szasz, and the chemical imbalance hoax has been exposed doesn’t mean that psychiatry will provide better answers in the future. In fact, the attempt to reform or rethink psychiatry produces an endless variety of hoaxes and charades that will continue to cause harm in the future.

    The seventh delusion relates to the false theories that have been propounded in the name of genetics, or epigenetics. Baloney! Doesn’t anyone read books anymore? Isn’t it abundantly clear by now that all of this drivel can be traced back to the eugenics projects that gained traction in Nazi Germany?

    The eighth delusion is that psychotropic drugs can be effective as a short term remedy for so-called “mental illness” or “psychiatric disorders.” Nonsense! Good luck on administering brain altering, neuro-toxic chemicals to people in small doses as if addictions will not develop, and as if these harmful substances are “medicine” and not dangerous drugs.

    The ninth delusion is that psychiatrists will move from managers to healers. This is perhaps the most pernicious of all the delusions. What a lot of twaddle! The word “psychiatry” is derived from Greek terms that mean “the medical treatment of the soul.” Since psychiatrists don’t know the first thing about what a human soul is, nor do they understand a thing about medicine or the practice thereof, it is crystal clear that psychiatry is in its very definition a fraudulent endeavor.

    The tenth delusion is contained in the following sentence: “Patients, practitioners, professions and the public as a whole will reap the benefit.” This one takes the cake. Who will really benefit from the mass distribution of ecstasy or any other psychotropic drug? Pharmaceutical companies and psychiatry will profit off of the increased suffering that will be caused by any of these fraudulent innovations. As Big Pharma and psychiatry team up to coerce and oppress more and more innocent people, who will really benefit? Again, it won’t be those who are falsely labeled with fictitious diseases and force-fed any variety of psycho-active substances, including ecstasy.

    In short, this article is useful because it shows us with great clarity the delusional thinking that drives modern psychiatry. Perhaps for this reason we can be grateful for articles like this one. Thank you.

    Report comment

  12. MDMA and Street Drugs and Prescription Drugs and Talk Therapy cannot treat PTSD because their is no such thing. There is no disorder, just as there is no such thing as mental illness.

    People may well be experiencing stress and danger, and may take a long time to work through such. But there is no “disorder”.

    Saying that MDMA or anything else fixes it is very dangerous.

    People may benefit from supportive environments, but not Talk Therapy or Psychotherapy or anything else pitched at fixing people.

    Report comment

    • I would agree that what is called PTSD is actually a normal human response to something horribly overwhelming both psychologically and emotionally to a person. It should not be referred to as a disease or an illness and, along with everything else in the DSM, should not be a label or diagnosis. Once it’s a diagnosis then something which is absolutely normal becomes pathologized. This is the wrong approach to all of this, which is as usual for psychiatry.

      Report comment

      • Slaying and Stephen Gilbert,
        PTSD may not be a disorder, but can’t we agree that the cluster of symptoms signify there is trauma, stress, imbalance, pain, etc in a person similar to what a broken leg causes? And in a similar way, if that broken leg is not properly set and physical therapy occurs to help re-strengthen the muscles, etc, the damage/dysfunction can become nearly permanent?

        So maybe we change PTSD to PEMT(post emotional/mental trauma) symptoms, or whatever you prefer, and move the focus from the ‘disorder’ to the trauma where it should have been all along. But a weakness that the anti-psychiatry faction seems to have is separating their hatred of the bio-medical model and its complete reliance upon the useless and harmful drugging of people (often because of their personal trauma as a result of that paradigm), from the fact that there is REAL mental distress from trauma which causes REAL emotional/mental damage/dysfunction in the person if it becomes overwhelming enough, and hence, we throw the baby out with the bathwater.
        Sam

        Report comment

        • I would agree with you totally. Trauma is the real culprit here and of course psychiatry does absolutely nothing about a person’s trauma. They know the source of the problem and it’s biological, a broken brain and a chemical imbalance, so they don’t have to waste any time on listening to people’s trauma stories. All they have to do is force a pill down someone’s throat and that will take care of everything. Yes, put the focus on trauma where it should have been all along.

          I would never say that there isn’t real mental distress from trauma. I know for a fact in my own life that there is tremendous stress that causes great dysfunction . We are in agreement in what you state here.

          Report comment

          • LavenderSage,

            I’m honestly not sure how you get around the use of the word symptom. Even though these are ‘natural reactions’ to trauma they are still symptoms of trauma. And I would argue that a symptom of trauma does NOT put it in the category of disease/disorder. It all depends on the paradigm one is using what the word symptom means. That is why so many of these discussions are fruitless because we don’t define our words or explicitly state our ‘a priori’ beliefs.

            I believe you are basing your statement on the ‘bio-medical model of mental health’, but my use of ‘symptoms’ is based upon the ‘trauma-model of mental health’.
            Sam

            Report comment

        • No samruck2. Perhaps we haven’t explained ourselves well enough. These responses do not emerge from a hatred of the biomedical model of psychiatry. They are an expression of the love of truth and of liberty. Furthermore, I’m sure that most everyone here firmly agrees that people suffer from a wide variety of symptoms and traumas that require time and love for healing. What we decisively and adamantly reject is the notion that when some acronym from the DSM-V is attached to one of these suffering souls that it will somehow aid in the process of healing. The opposite is the case, especially since much of the trauma is caused by psychiatry, and its atrocious alphabet soup, in the first place. No one is trying to argue that trauma isn’t real or painful. Besides, psychiatry is not a baby. It is more like a venomous serpent in the bath with the baby. If we throw out the venomous serpent, the baby will be much safer.

          Report comment

          • DragonSlayer,
            I’m very clear on what you and others believe, and I stand by my statement. There is such hatred for psychiatry that you can’t see past it. The baby I was talking about is the trauma, not psychiatry. And though I’m sure some people were victimized solely and ONLY by ‘the mental health system’ as we’ve had at least one writer who said her initial incarceration was vindictive, I’m guessing most people who entered the system did so for a reason as many do so willingly.

            When my wife was diagnosed with d.i.d., it was my eureka moment. Our 20-year marriage had been struggling that whole time and we had NO clue why. Once I understood what was going on, and it took a couple years for me to truly understand d.i.d. as I carried her thru the healing process, then I was able to help her in ways that I never could have before.

            Psychiatry did NOT cause most people’s mental health issues. It may have exacerbated the mental distress by its ignorance of basic humanity and also because of its legalized drug pushing, but you and others have simply gone to the other, far end of the spectrum. That’s your choice, but I respectfully disagree, and I’m glad my wife did too when she decided to work on her trauma and all the issues it brought into our marriage.
            Sam

            Report comment

        • Again, samruck2, I’m afraid that we’re at an impasse since you think that those with whom you disagree are motivated by hatred, whilst you are motivated only by good will. I don’t even attribute such base motives to psychiatrists who cause so much harm, although there are certainly psychiatrists with base motives, just as there are others with base motives. However, it would be well to address interlocutors in such a way as to understand their arguments without impugning their motives.

          In any case, if trauma is the baby, I’m afraid that that is a strange metaphor that is difficult to understand. Perhaps the baby has trauma? In which case, it is certainly true that not all trauma is caused directly by psychiatry, but I consider that you grossly underestimate the harm that is being caused in the name of psychiatry. In fact, you have brought to our attention yet another case of harm that is being caused in the name of psychiatry, harm that presents itself as a cure. The fictional diagnosis of Dissociative Identity Disorder may prove comforting for a time in that it gives a name to some inexplicable symptoms of suffering, but when you take the time to investigate the origin of the DSM-V from which the fake diagnosis originates, it will become clear that it is all a hoax. I’m glad that, at least from your perspective, your marriage has improved and that you have been able to help your wife through the healing process. I have no desire to meddle in any of that, but it would be interesting to understand things from your wife’s perspective. Peter Breggin, in his book “Toxic Psychiatry,” has written extensively about the fact that most psychiatric “success” stories are recounted from the outside, rather from the individuals whose lives are most directly affected.

          I agree with your claim that psychiatry does not cause mental health issues, because the concept of “mental health” is preposterous. It is the mythical corollary to “mental illness,” which is even more preposterous. However, psychiatry causes severe iatrogenic harm to untold numbers of innocent people, including children, the homeless, and the elderly. Those who enter the system willingly, as it seems that you and your wife have done, rarely understand the history of psychiatry. Many enter the system willingly because they haven’t read Robert Whitaker’s books.

          Thus, I respectfully disagree with you as well samruck2, and decent people can disagree without impugning motives. Besides, it is reasonable to detest detestable things such as Naziism, slavery, and the system that reflects both of these ideologies, namely psychiatry.

          Report comment

          • DragonSlayer,
            You are correct that my correlating trauma with ‘the baby’ didn’t make sense, lol. That’s what I get for making a reply from work when I’m too busy to think about it!

            And you may also be correct that the reason that I am NOT anti-psychiatry is because when my wife first got the d.i.d. diagnosis, the first thing she asked me to do was to NOT read any of the popular literature out there because she liked what I was doing with her and the others. So she and I kind of developed our own system of doing things. A couple of years later when I was very comfortable with the way we were doing things, I started reading the literature out there from ISSTD, the trauma and dissociation ‘experts’. Oy Vey! We were doing nearly everything ‘wrong’ and yet getting better results than any of their patients. And so I was summarily blacklisted from almost every d.i.d. site because I wouldn’t affirm ISSTD’s recommended ways of ‘helping (cough, cough) someone with d.i.d.

            A little later as I was reading more, I realized I was doing attachment theory principles without knowing it. And so I became more purposeful once I knew some of the basic tenets of that theory and those have NEVER let us down at all.

            All that to say, I will give you some of your arguments. If you find ‘hatred’ offensive, I will rescind the charge, but if you read your comments, I do think they come pretty close to it.

            I guess one last chance to try to unmuddy my ‘baby with the bathwater’ comments. I’m one of the ‘critical psychiatry’ people on this website. And thus I have a very difficult time any of you in the anti-psychiatry camp make your broad, sweeping generalizations. Maybe I have that luxury since I kept my wife 100% out of the ‘system’.

            Wishing you a good new years,
            Sam

            Report comment

          • All the best to you too samruck2. I don’t find ‘hatred’ offensive, just inaccurate. In any case, there is nothing wrong with loving what is good and loathing that which is evil. Those of us who oppose psychiatry find it hard to stomach critical psychiatry because it attempts to preserve a system of coercion in other forms. But reasonable and civil people can and do disagree. Civil debate can help us to draw closer to the truth. Happy new year to you as well.

            Report comment

          • DragonSlayer,
            I’m unequivocally against ALL forms of coercion, too. Maybe that will make ‘critical psychiatry’ untenable in the end, idk… Fortunately, for my wife and I, that’s more a mental exercise, and I do understand why it has much greater implications to those have been abused by our ‘mental health system.’
            Sam

            Report comment

        • I couldn’t find any other place to ask this question so I’m going to ask it here. Critical psychiatry advocates want to save psychiatry and anti-psychiatry advocates want to do away with psychiatry totally, if I understand the debate that’s been going on across MIA lately.

          My question is this. If you took the pills away from psychiatrists and they couldn’t prescribe drugs, what is it that they’d be able to do that would justify keeping them around? The older ones, and I mean older, could still do psychotherapy. The younger ones, unless they’ve spent their own money for training outside of their psychiatric training, don’t know how to do any form of talk therapy. How to do therapy is not taught in medical school for the specialty of psychiatry. So, what would justify keeping them around? The majority of them do not know how to titrate people down on the drugs that they prescribe. If they knew how to titrate they could help people get off the toxic drugs. I had to go and ask my pharmacist at the drug store how to get off the damned antidepressant that I was on.

          All they seem to know about is how to shove pills at people. I once went to a psychiatrist to get talk therapy arranged for myself. She sat there and asked if I wanted the drugs and I said absolutely not. She sat there with a puzzled look on her face and said that she had no idea how to help me if I didn’t want any drugs!!!!!!! What is wrong with this picture?

          So, what is it that psychiatrists can do, other than pushing pills, that would justify keeping them around as a medical specialty? This is the reason that I find myself moving closer and closer to the anti-psychiatry group. I can’t find anything that you can use to justify keeping psychiatry around once you take the pills away.

          Report comment

          • Stephen Gilbert,

            Well…I went onto Wikipedia and tried to figure out the differences between psychiatry and psychology…hmm…maybe I’ll have to rethink my ‘critical psychiatry’ stance.

            I tried to have a similar conversation, but didn’t get much response over on the recent Freud thread over Christmas. Maybe I was so far off base and that’s why only Nancy99 responded…not sure.

            Stephen, how do you see the BRAIN’S reaction to trauma and how that affects healing the trauma, the personality, and so many other things? I tried to lay it out at the end of that blog if you want to reference it. But maybe it would/could still be covered by psychology…idk…Certainly a medicalized approach wouldn’t fix the brain’s response to trauma. Again I tried to explain the things I’ve had to face and how we took a non-medicalized approach to deal with all the ‘brain/mind issues’ that result from trauma and the resultant dissociation…so maybe that’s psychology not psychiatry…

            Seriously, so much of the stuff that MIA debates I had never even cared about or heard of since the healing journey my wife and I have been on has been in a little cocoon outside of the mainstream of mental health stuff…I’m really more a champion of attachment theory and the place of SO’s and family in the healing process, but since the MIA staff has shut that perspective out of the larger conversation on this site [unless you stick your loved one into the system and then they die and then you realize AFTERWARDS ‘this wasn’t a good idea…’] But I digress…

            Anyway, maybe I’ll have to rethink my position. Thank you for asking.
            Sam

            Report comment

  14. It’s very late and I’m beat but I feel I really must take a minute and come to the defense of both Scott and the research and emerging field of practice he describes. I have done this work myself, so speak from both that experience, and my prior, truly awful, experience with prescription antidepressants (I lost a decade of my life to those goddamed things, so don’t think I’m not as skeptical as anyone else), and as an enthusiastic reader and supporter of this website. The suggestion others have offered that MDMA marks a continuation or simple reconfiguration of chemically-based psychiatry is, frankly, nuts. I don’t think you guys are actually reading what he wrote, and I know for sure you have not had any direct experience with this work. The suggestion that this is simply a matter of “taking ecstasy” to avoid the hard work of healing is also far off the mark–frankly, it strikes-me as fear-based, reactionary, and unthinking. If you have serious trauma to heal, work with MDMA is anything but easy. It can be, however, life affirming and insight inducing and overall profoundly healing. It doesn’t work for everyone and it is not a silver bullet for anyone, but it can be an enormously helpful way of facilitating the inherent self-healing nature of the psyche. I’m really sorry so many people have been hurt by dependence-inducing and harmful psychiatric drugs (and I am one of them, and remain, five years out, mad as hell about it), but I really, really, REALLY, think we need, unlike the corrupt field of psychiatry, to keep our minds open long enough to discern what actually works to help alleviate suffering, rather than rest on our comfortable knee-jerk reactions. As much as I respect this community and the members that make it up, I see an awful lot of that last here and hope it will change.

    Report comment

    • My reaction is not knee-jerk “all drugs are bad.” It is a rational expectation, given history, that any successful drug intervention will be taken out of context and promoted as the “new miracle pill” and promoted to make billions while undermining any chance of it being used in its proper role. Psychotherapists all over the nation will be recommending MDMA use to “cure” PTSD without any understanding of the subtleties you mention, and those who don’t improve, rather than having the therapeutic approach looked at, will be labeled “treatment resistant” and re-routed to the same old, same old list of psych drugs for further “treatment.” Meanwhile, psychiatry will be revitalized because they finally have a drug that “works on mental illness,” proving that it really WAS all in your brain all the time, and providing continued cover for the fiction that environmental impacts are of secondary or no importance in the “treatment of mental illness.”

      Just as an example, a fairly recent qualitative study sent student volunteers into residential treatment facilities for youth with a list of questions. Something over 80% of the residents reported to a TOTAL STRANGER that they had significant childhood trauma that impacted their mood and behavior. Only 20% of the kids had any traumatic past documented in their charts!!! So either the staff is so unsafe that at least 60% of the kids felt more comfortable disclosing to a total stranger, or more likely, trauma is so low on their radar that they don’t ask about it, and even if it’s mentioned, it is not considered relevant enough to write down.

      So it’s not that psychiatry hasn’t found a way to help trauma victims – psychiatry doesn’t WANT to help trauma victims and has a vested interest in MINIMIZING the role of trauma in creating adverse emotional/mental experiences – they don’t even consider it worth noting as a factor! They want to blame the trauma victim for their failure to “adjust” and any biological intervention, no matter how helpful it can be in the proper context, will be used to further their agenda of minimizing any discussion of psychosocial causation so that they can promote the much more profitable “chemical cure.” This situation will pertain until and unless the DSM concept of “diagnosis by committee” is dead and buried and pharmaceutical company influence over the profession is deleted.

      You can’t cure corruption with science. It’s about power.

      Report comment

      • Thank you, Steve, for this helpful clarification. I share your concern about what will happen when this comes to be seen as the new silver bullet. Absolutely. I’m less convinced that this can be used to keep trauma out of the picture. MDMA therapy is all about working with trauma and, for many, making it clear that there is no underlying biochemical problem. Talk to anyone who’s worked with it, read any of the accounts now circulating from the MAPS research, and trauma, along with it’s social causes, is almost always front and center. Can you explain how you see this getting sidelined? What am I missing?

        Report comment

      • Steve,

        Our particular concerns and expectations aside, this may be an interesting test case for the juggernaut you describe. Psych drugs always seem very similar to international development to me in their trajectory. Like “mental illness,” there never was such a thing as “development” until Truman put it on the map, a “solution” to a newly constructed “problem” of “underdevelopment.” Since then, about once a decade, there’s always been a new, shiny, better solution–either technological or institutional or both–and every time, the new solution fails, only to be replaced by another new one, and so on.

        There always comes a point, however, when a regime or paradigm falls. Can I ask what you think it would take in this case? Can you imagine any positive role that non-patentable substances can play in that? (I realize you’ve already answered that second question, but pushing a little harder to see if you think there’s any circumstance in which it could happen.) That’s not meant to be argumentative, I’m honestly curious.

        Report comment

        • I think it’s a bigger problem, and that the corruption at the top has to be attacked. My more conservative friends will hate me for saying this, but I don’t think it happens without specific government action to forbid a) DTC marketing, b) any kind of kickbacks, gifts, honoraria, etc. for any doctor hawking a drug for a drug company c) colleges and universities using public research dollars to parlay professors into big business opportunities d) the revolving door at the FDA (and other regulatory agencies) where industry insiders “regulate” their old bosses, and so on. This set of events will only happen when a larger movement of citizens demands that government corruption by lobbyists and big business campaign contributions come to an end. It will take a lot of people getting together and demanding change. People in power generally don’t give it up voluntarily, Nelson Mandela notwithstanding. Unless corruption is addressed, Big Pharma will continue to run the show and the APA will continue to Emcee their performances. That’s how I see it. Dissident action inside the system is important, but it’s too easy for them to be silenced or minimized by those in control. I know this from personal experience. It’s gonna take a revolt, starting with the clients themselves and their family members, friends and supporters (and whatever dissident professionals have managed to survive in the system) saying NO, we are not going to play this game. What it takes to create that is beyond my personal imagination and planning skills. Any ideas from your end?

          Report comment

          • Hmm. I have to be tentative, because I really haven’t looked at the system in detail. I need to read Whitaker’s latest book on institutional corruption.

            I do hear you on the need for an uprising of sorts and for the confrontation of power. But I’m wary of my own adrenaline with such things and how it’s triggered by our heroic mythology around uprising and revolution. I think what you suggest could work and would be certainly the best thing, but if it doesn’t happen I also think smaller scale change, including the availability of alternative forms of care and healing–as you know, I think this is an important one–can be very important. Sometimes the time is right for revolution. Sometimes it’s right for incremental change. I think a large part of being attentive to power involves carefully gauging what is possible in a given historical moment–and also what might come after major upheaval, as we all know how traditional political revolutions have tended to go.

            I see a lot happening on both fronts but don’t know enough about specific leverage points and what it would take to bring the system down. So, personally, I’d start with (snore!) institutional and movement analysis. I realize that may be old hat for you and some others.

            But I also don’t think the two forms of action are mutually exclusive, so I would also focus on discerning which incremental changes will support the larger goals and focus on those.

            Richard Rockefeller, who was involved with trauma as a board member of Doctors Without Borders, gave a very nice talk on trauma and MDMA therapy at the Carnegie Council a few years ago. At the very end, he spoke to the larger social significance of healing trauma and asked something like “how in the world can we address our most pressing social problems when trauma is so widespread and so many people are suffering from it on a daily basis.” It’s a simple point but I think a very important one. Even beyond acute trauma (I think we’re swimming in more subtle or at least more accepted kinds of trauma that keep us shut up in little boxes of the mind) I think MDMA, and also true psychedelics, have the potential, if used with intention and respect, to help people open to the world and to become less conventional and more loving and more activist. The people I know who have done this work tend to have a very clear understanding of and strong feelings about what’s wrong with psychiatry and prescription psych drugs. I think they can be among your (our) strongest allies in building the movement.

            Report comment

          • A thoughtful reply. I agree that incremental inside change is happening and is very important. I’m just very doubtful that this by itself can really bring about the necessary change. The financial and psychological/social benefits of the current system are way too large for this model to die easily. After all, the models let EVERYONE off the hook, even the clients, who never have to do any of the hard work to change their lives. But of course, the main benefit is it allows the current neoliberal system to continue unreflective about its destructive aspects. It’s a tough nut to crack!

            Again, I totally believe that inside evolution is relevant and should occur. I just don’t see MDMA being successful as catalyzing some sudden and dramatic realization that the DSM should be scrapped and that clinicians should start viewing client trauma as central to their work. System change is slow, and as the quote goes, “It’s hard for someone to understand something when their livelihood depends on them not understanding it.”

            Thanks for the thoughtful exchange!

            Report comment

          • I was just looking over Scott’s article again–I came to it late last night after a long drive, and then mostly read the comments today–and am seeing anew the emphasis he put on the idea that this will “transform the face of mental health care.” (I do realize it’s in the title; mea culpa…and mea was pooped, too.) I think he’s right about the potential for paradigm change, but that you (Steve) are also right to emphasize the importance of power and question whether it will happen so easily as Scott suggests.

            I really do believe the paradigm is fundamentally different here (and that has been my personal experience), that it’s the difference between essentially anesthitizing people (oh, right: “fixing a chemical imbalance”) and trusting the psyche to reorganize and heal itself and facilitating that. Please stop and really consider that difference, and if it seems mysterious and whacked, look up some of the accounts from people who’ve done this work. IF the initial research results hold up, I do think it opens the possibility of major change, and I’m quite sure the substance itself is paradigmatically different from the drugs in use now.

            However! Notice the reliance in the article on Thomas Kuhn, who’s work on scientific revolutions (paradigm change) is, if memory serves, very much under-theorized in terms of power. (It’s been many years, but I think that’s right.) So that’s where I think the uncertainty is, and why the movement represented on this site, and the wider recognition that the modernist-imperialist-capitalist emperor is wearing pretty shabby clothes, is so important.

            I suggested before that people who have done work with MDMA and psychedelics can be some of our best allies. But it can work the other way, too. By pushing back against big pharma and psychiatry, we can help make sure there is room for alternative therapies and hopefully a new paradigm. What exactly the paradigm is, I’m not sure, but it’ll probably involve a lot more than MDMA and it’s gonna be an awful lot better that what we’ve got now, that’s for sure! Here’s hoping soon.

            Report comment

      • At the state “hospital” where I work the psychiatrists admit that trauma is rampant among the people on the units. The response of probably the best of all the psychiatrists in the place told me to my face, after I gave a presentation on trauma and how it’s related to psychosis and so-called schizophrenia, was: “Oh Stephen, we don’t have time to fool with any of that, we’re an acute “hospital!”.

        Report comment

  15. scott—every good doctor needs to present the good and the bad…
    what are the side effects and problems with using mdma..
    I need to hear it from you…you have some experience with it…
    I am sure that it isn’t all good…I hear it works on the gaba genes….
    thank you

    Report comment

    • I’m not Scott, but I can help you with some of this, as I do know the some of the general rules about hallucinogen safety: (A!) you don’t give hallucinogens to those individuals with unstable perceptions (the pre-psychotics of the old literature); (B) you don’t give them to individuals with liver disease, particularly amphetamine related ones like mescaline (found in peyote) and what I call the MDA’s as there’s actually a whole family of them- MDMA came into existence when its MDA ancestor was declared illegal by the feds; and you don’t give hallucinogens to people who have or have had first order relatives with schizophrenia syndrome. The probability of bad and/or prolonged reactions to hallucinogens is high in the abovementioned folks.

      Report comment

  16. Once someone goes along with the idea that drugs cure ‘mental illness’ and ‘disorders’, then they are always going to be approaching life from an escapist perspective.

    Those distributing or promoting unlawful drugs for these uses should be handcuffed, jailed and prosecuted.

    On this forum we have listened now to people promoting MDMA, LSD, Methamphetamine, and Marijuana for their supposed healing benefits.

    We have also listened to people promoting prescription psychiatric medications for recreational use, these having some supposed benefit. The author declined to give specific info as to how her group of people were getting their drugs. Again though, the remedy to a situation like this is obvious.

    Regulating the uses of drugs and alcohol will always be very difficult. And Prohibition did not work. But this does not mean that we should be promoting the same kinds of fallacies which already operate among users. The idea that the drugs the doctor prescribes are good for you and will cure your ‘mental illness’, is as ridiculous as the idea that street drugs will cure such illness, or are in some other way good for you.

    This is really disturbing, this Jamie Lowe really believes in mental illness, and in the need for drugs. That is a serious abuse that people were able to convince her of this.
    https://www.democracynow.org/2017/12/28/lithium_love_and_losing_my_mind#transcript

    Back before the 1950’s, homosexuals tended to believe that they were defective. And so they believed in things like Recovery, Psychotherapy, and Psychiatry.

    Then when the Mattachine Society and the Daughters of Bilitis started having meetings, homosexuals came just to bask in the acceptance, and see that there were other people just like them, and that they did not see themselves as defective. From that came legal and political activism.

    Well today it seems that it is the scapegoats of the middle-class family who see themselves as defective, and fall prey to Psychiatry, Psychotherapy, Recovery, and prescription and street drugs. Seeing themselves as defective they go along with this. And mostly it seems to be about the ‘self-reliance ethic’, a completely bogus over coding.

    So the remedy is political consciousness raising, and legal and political action, but never Psychiatry, Psychotherapy, Recovery, or Drugs.

    https://sites.google.com/site/stompingthecockroach/

    Report comment

      • Oldhead, are you replying to me?

        Are you again taking the view that drugs have some benefit? If you do that, besides simply being a partisan for a reckless view, you are then also leading people to the inescapable conclusion that there must be some efficacy to psychiatric drugs.

        Spiritual advancement does not depend on drugs.

        It is you Oldhead who speak from ignorance and seem to be an example of the fallacy of drugs.

        Report comment

        • I’m not leading anyone anywhere, just pointing a few things out.

          People who haven’t experienced psychedelics are simply unqualified to make informed judgements about these things; all they can do is view them within the framework of “drugs.” Is marijuana a “drug”? If you agree then we have different definitions. I remember a legalize marijuana rally in the 80’s where the prevailing chant was “Pot is an herb, Reagan is a dope!” Likewise, mushrooms and peyote are the natural prototypes for LSD and similar synthetic substances, which unlock and sharpen one’s focus of attention to deeper levels of consciousness which have been correlated by Leary and others with the higher chakras. In this sense they are more tools than “drugs,” the latter generally referring to chemicals which depress or accelerate normal functions of the body.

          Report comment

          • But first – have you ever been Experienced?

            Have you ever really been Experienced?

            I go back to my description of psychedelics as an event, not a chemical.

            How do you manage an event to make it transformative? This, too, is an art, and there are protocols which could be called science or even Ritual or Ceremony.

            But yes. This is spiritual work, as LavenderSage states.

            Report comment

    • I just want to be sure you want to shackle, restrain, and imprison people who are assisting adults who have sought them out for assistance in exploring their own minds in a way that poses no threat at all to anyone else but that does diverge from your own ideas of what is an acceptable state of mind.

      If so, should we not also shackle and imprison the people choosing to have experiences of alternative consciousness? Note that in the early days psychedelics were sometimes referred to as “psychotomimetic” because they can induce temporary states that resemble “psychosis.”

      So if we’re going to shackle and imprison people who chose to do that, can you explain how that’s so different from psychiatry?

      Are you hoping for a diagnostic manual that can categorize these people? An army of specially trained doctors to “treat” them? Or are you looking more for old-school imprisonment where you just toss them in jail?

      Report comment

  17. Scott wrote, “In short, this MDMA study has the far-reaching implications that will transform mental health care and our view of the human psyche.”

    That would be a truly incredible development. But as we all know, near-identical statements have been offered time and again about novel somatic “treatments” in the history of psychiatry (e.g., lobotomy, insulin coma therapy, ECT, neuroleptics, benzos, SSRIs, etc.) Near-identical statements are now being offered regarding ketamine for depression. Given the 100% historical failure rate for such statements to come to fruition, Scott, you can surely understand skepticism of your expansive claims about MDMA and trauma.

    As a scientist, you of all people should know not to make statements about the revolutionary, transformational effects of a treatment until one has data to support such an assertion. Such data do not exist in the case of MDMA and PTSD. Some promising data has been published from small sample size, uncontrolled pilot studies. I agree with you these data are encouraging and warrant a larger randomised controlled trial. I look forward to seeing the results.

    Until the results are available and properly vetted by the scientific community, I will have an attitude of open-minded skepticism toward MDMA for PTSD. I remain open to the possibility that MDMA will “transform mental health care and our view of the human psyche.” But I am extremely skeptical of this claim, and rightly so, and I am under no obligation to take your claims seriously until you have data to back them up. This is how scientists are meant to think – the burden of proof rests on the claimant.

    By the way, how will you possibly conduct an adequately blinded trial of a drug whose effects are immediately and extremely obvious to those who take it? Will you be measuring the blind by asking clients and assessors to guess which pill the client is taking? If not, how is this methodological choice justifiable? If you do assess the blind and fail to show your study is adequately blinded, isn’t this a fatal confound that renders the results uninterpretable?

    Report comment

    • ” far-reaching implications that will transform mental health care and our view of the human psyche”

      No, that would not be an incredible development because it is total bullshit. Some people believe drugs are good for people. It is hard to convince them otherwise.

      But for someone to be trying to say that behind a medical license, that person has to be put out of action.

      Report comment

  18. I think a lot of these voices here stridently opposed to this – and other psychedelic research – are thinking of MDMA as more of a *drug* and less of an *event.*

    MDMA, psilocybin, LSD – these are events. Yes, they are chemically induced events, and can be extremely useful for starting the process of healing. They do not replace the hard work, and they may not even make it easier, once a shift takes place – often that shift causes the “client” (insert your favourite word here) to have a more realistic perspective of the scope of the work and what needs to happen, and hopefully an open, eager heart to engage in the work. 20 years ago, I would have said, “Right on, man!”

    I do not want this “event” in the hands of psychiatrists. Unlike the neuroleptics which can be used to torture, psychedelics can be used to re-form the mind. If it were coupled with, say, light/sound/neurofeedback and brainwave therapy (I almost regret saying that, because someone might pick it up and do it) it can be a form of mind control. Remember MK-Ultra’s use of LSD. Remember – that we don’t really own the country right now, and rabid dogs can be “put down.”

    It is unlikely to wind up in the hands of therapists – psychedelic therapists I might trust more, but there is still a power gradient there. (the group event I mentioned – because it is a group – a caring group of friends – if someone gets power mad, the rest of the group can steer things away). And the office IS important, it’s called “set and setting.” If the only time I can legally explore “inner spaces” is on someone’s couch – even with sweet music, or a beautiful window opening onto trees and birds – I’m not sure that’s helpful to me.

    I can think of a few friends whose traumas are so “carved in stone,” that the event of MDMA might loosen things up a bit. There are breathing techniques which do this more slowly and under control. BUT – some of those friends are drugged.

    OMG – what about that? Is it wise to perterb neurotransmitters for someone who is already on a cocktail of mind drugs?

    Even the ones who are not drugged would be terrified of the prospect of “losing their mind” for a few hours, especially at the hands of a therapist. There is stigma involved here, too. MAPS is working on that arena.

    MDMA is not exactly a “chemical solution” like drugs are a chemical solution. Because there is only money to be made in paying for the event, the sessions – I don’t think it will have a long life, or, at best will be a fringe practice.

    The prospect of getting it rescheduled is expensive. If this is not beneficial to someone’s balance sheets – it is extremely unlikely to happen.

    Report comment

    • Jan, your point about it being an event is very important; thank you for so nicely articulating that, and also that it is spiritual work.

      I didn’t mean to suggest the setting isn’t important (it is, absolutely), just that the therapeutic relationship isn’t necesSARilly a big problem in terms of power dynamics. I agree that it’s always something to be careful with, and in a sense always problematic. But I would be wary of putting too much confidence in group work. As with a therapist, it depends greatly on the nature of the group. But even in the most supportive of groups it can be a dicey business to rely for support on someone else who also is in a deep state of consciousness exploration. One of the lesser appreciated problems with this work, in the circles where it happens, is that there can be retraumatization when one is in that deep state. In a group that is not carefully set up and, ideally (in my view) supervised, you never quite know who might come along and drop their own shit on you. I think it’s really too much to expect someone in that state to be the primary support.

      That’s my take; I’d be interested in you have further thoughts on this.

      The way I think of it is that power dynamics will always be an issue and always bear the closest consideration in all relationships, whether a group or a dyad. But in a group it’s dispersed and a lot can be happening out of plain sight. Of course, that can also happen with a dyad! But personally, I would rather have the power relationship clear and up front with one trusted and experienced therapist or healer or even a really good friend (and yes, not a psychiatrist!) who’s sober than dispersed in a group, especially where people are doing their own deep work.

      Report comment

      • Hey Daniel,

        The group dynamic – among friends – has an equilibrium, or a homeostasis that prevents the worst, and protects from extremes. I don’t have any reference other than my special group of friends, a nature based organisation. I’ve heard about the Healer’s Tent at Burning Man, and it involves a sober companion, like you mention. In our group, we would go out into the woods together in love and trust, and what happened was meant to. Like has been said before: it was spiritual.

        There was ceremony, rituals to ensure that all were kept safe. Set and setting. Keeping good company. When someone had an extreme state – many of us were capable of functioning in the moment. It wasn’t about “sobriety.” It is about functioning, caring, opening to another. Trust. Of putting personal trip aside and holding a person in safety until they came to a place of well-being again. There was always a place to go if things got frightening. There was scary stuff – but experience taught how to deal with it, and if you couldn’t deal with it alone – there were always friends around to offer you tea, a hug, a blanket, and a listening ear.

        I remember someone who thought the planet had fallen away, that if she left the nature sanctuary, she would find nothingness, void. Surely it was frightening! She was held in a circle of friends who reassured her that all was well – “See? None of us are worried,” and, “We’re your friends.” That circle of friends brought her back to equilibrium. She had experienced some sort of trauma, but it was unclear what (it still is unclear). Now, over 30 years on, I ought to ask her how she feels about that night – if she learned something, if it helped her to grow in any way.

        I can think of individuals that I would – with ceremony – choose to experience an event like this with as a dyad (though I’m much older now, and less likely to pursue any events). I cannot think of a single therapist that I would want to dyad with, however. Especially not if they were “sober.” And I like nearly all of the therapists I’ve ever had.

        Additionally, while I can think of lightning bolt insights I have had (mostly while psychonavigating alone or with one other), most of the gains were made with training through multiple experiences. The more you went, the more skilled you became at manipulating your being, your experience. With that skill, you can become aware of just how vital perception is to reality.

        And there’s a thing called “synchronicity” which clarifies what is right and wrong. In a group, this synchronicity is far more obvious, because it comes from a more random place. When someone you barely know walks up and addresses something you were just thinking about – it’s stunning and affirming.

        I feel my words here are falling far short of the event. It’s like explaining G-d to someone who has never met Him/Her. Or describing a colour to someone who is blind. A lot of this awareness happens in non verbal space, and it takes special skill to describe the non-verbal in words. I feel I am falling far short of that skill.

        But to me, the sober healer of any stripe – is less likely to hit that synchronicity, and will find themselves left out of the discussion, no matter how empathic they are. Go with me, show me the way. Don’t sit in your chair and listen to me while I go. That, right there, is the power differential. If you won’t go with me, then I don’t want to go with you.

        And if you are not skilled enough in the event to go with me – and put your own trip aside as needed – then I don’t want to go with you.

        Report comment

        • Jan,

          This is really helpful, thanks for taking the time and offering the detail. I know one cannot fully describe such things, but I think I get the gist.

          It actually sounds very much like what I was hoping for and led to expect with a group I worked with a few years ago. In my case, it went badly. I think I was somewhat desperate for community and got pulled in with the false-promise of that. It was also a group with very prominent and “respectable” people–doctors, lawyers, philanthropists, Ivy League professors, etc., and I’m chagrined to look back and realize I really suspended my own better judgement because of that, despite a longstanding proclivity to discount or even shy away from conventional markers and titles. (Of course, sometimes what we reject is exactly what we crave on a deeper level.)

          It was not until nearly a year in that someone who had a lot of careful experience working in other contexts pointed out to me that, in such a deep state, one could essentially be re-traumatized when interactions in that space come with impatience, disrespect, hostility, etc.–and given the gestalt of the whole thing, they tend to be relatively subtle, insidious…slippery. It took me the better part of a year to tease out the ways that had, indeed, happened to me. I have now heard of others who’ve left that community in a very troubled state, although I know many others who would describe in much the way you did your experience.

          This brings two thoughts to mind. First is that surely there is a continuum, from the very good and safe group you worked with, to the not-good one I was a part of. The second is that such groups can be very different for different members. I don’t assume it, but wonder if there may have been some in your group who did not have quite as good or safe an experience as you did. I know for my part that I did not give voice to the problems at the time. I was both very invested and trying to make it work, and also there was too much shame involved to even admit it to myself, much less others. What was wrong with me, I wondered, that I could not be a part of this wonderful, supportive, sharing experience that others seemed to be having?

          I should say that I am a very big believer in dispersed power–and not just on faith, but on the evidence, in many situations. But I’m still not convinced this is a situation where it’s best, or at least always so. I doubt these things can ever be regular or predictable enough to know for sure, and because it’s had to be kept so under wraps and quiet, I think we all have still a lot to learn.

          Report comment

  19. Excellent post. And your point about combining psychedelic experience with psychiatric drugging is extremely important.

    I do not want this “event” in the hands of psychiatrists.

    God no!!! Nothing worse than tripping around a control freak!

    Report comment

  20. I am hopeful that shrinks using actual street drugs will prove to the gullible sheeple around me that these “medicines” are just mind altering drugs. A drug is a drug is a drug!

    Sick of hearing my preacher condemn medicinal use of marijuana from the pulpit while his wife is force feeding their grandson speed. 😛 She has no idea I’m a non-compliant “mental patient.” I’m not about to tell her either. It helps that I don’t fit her stereotypical preconceptions.

    Report comment

    • Hi Feelin, I want to ask a question that could seem argumentative but I’m honestly interested and curious and wondering if there could be unseen common ground. So the question is: If you’ve read this article, and perhaps also my comments in the thread, what accounts for your insistence that a drug is a drug is a drug? Do you assume the research is part of the pharma-industrial complex? Do you assume what I’ve written is untrue or that I’m deluded? Do you assume something else?

      Report comment

    • If we can discredit this idea that street drugs heal and show that the psych meds are the same thing, then yes, maybe we can stop it.

      A Prohibition approach to drugs and alcohol will never really work that well. But when it comes to the medically licensed pushers, I say just throw them into a prison cell and the problem is solved.

      Report comment

  21. Scott,

    You never mentioned in this piece whether you yourself have ever taken MDMA. In my spiritual tradition, substances (usually natural/herbal, sometimes chemical) can be used to journey and gain very deep insights and connections, personal as well as universal. But one cannot be a guide on another’s journey unless they themselves have been down that road. Personally, I cannot even fathom handing that level of trust over to someone in a medical-paradigm context. This is spiritual work.

    Report comment

  22. I can see from this comments section that it’s really impossible to discuss psychedelics with those who haven’t experienced them, as there’s nothing in the experience of most people to even compare them to. (Those who have seen the movie “Contact” should think about the scenes where Jodie Foster tries to describe her experience to a tribunal of scientists, who consider her “voyage” to have been a total failure.)

    Psychedelics certainly are not relevant to any form of psychiatry or psychotherapy, and should never be used in conjunction with such. They could maybe best be described as adjuncts to meditation (and then some). But as John Lennon said, there’s no guru who can see through your eyes.

    So, I’ll peruse some of the above verbosity but I think I’ll emerge with basically the same reaction.

    Report comment

  23. Here is a thought. Trauma begets trauma, abuse begets abuse, disprespect begets disrespect. It is my sense that the wilful ignorance and violence of psychiatric “care” has been internalized by some of those who have been most harmed by it, and further compounded by their suffering. How else to explain the disregard shown by many here for the views and experiences of others that fall outside their own framework of assumptions. How else to explain the unwillingness to even consider alternate views and experiences? Please note that I said “consider.” Not agree with or accept. Simply consider, and perhaps engage in dialogue.

    Fire away.

    Report comment

  24. Oldhead wrote, “I can see from this comments section that it’s really impossible to discuss psychedelics with those who haven’t experienced them, as there’s nothing in the experience of most people to even compare them to.”

    Oldhead, you are wrong. The Zen teacher Alan Watts used to talk about his pertaining to LSD all the time. It is a one upsmanship game. First it is that you have to had taken LSD to know. Then it is you have to had taken more than some does threshold or you don’t really know.

    Well, there are people who believe that their consciousness is raised by booring a hole in the top of their skull. It could be anything, putting out an eye, cutting of an arm.

    Simple fact is, people who have learned deep meditation skills have more control over their experiences than do people who depend on drugs.

    I know there are people who swear by drugs, or seem to have changed from just one LSD experience, like the cartoonist Robert Crumb. They can believe that if they want. But the fact is that the drug never gave them anything which was not otherwise available.

    And then once you say that drugs help with healing, you are compounding the lie that survivors are in especial need of healing. And that lie is only a way to marginalize them until they are ready to engage in denial.

    You promote drugs, you promote psychiatric medications, and you promote involuntary medication. You feed the whole delusion that some people need to be fixed.

    Report comment

    • I agree that it is problematic at best to promote psychedelics. I don’t agree with Szasz regarding every aspect of his take on drugs, but he does has some very interesting criticisms that ought to be discussed, in particular concerning the so-called “war on drugs.” Now excuse me. The purple haze in this room is so thick that inspiration may strike at any moment.

      Report comment

    • You promote drugs, you promote psychiatric medications, and you promote involuntary medication. You feed the whole delusion that some people need to be fixed.

      Tireless (or Nomadic) — Stop putting words in my mouth, dude. Or go ahead if you feel like it. You are basically confirming my statements when you speak on matters of which you have zero knowledge. Have you noticed my comment that psychedelic experience and psychiatry are incompatible?

      And what sort of “deep meditation” do YOU practice?

      Report comment

        • Tireless, it’s pretty clear already that you believe that. I thought one of the things most of us were against on this site was the presumption to know and judge the interior states of those we might deem less aware or enlightened than ourselves. Why not, instead, speak from your own experience and leave the judgemental presumptions to the psychiatrists? Why not be okay with the way others chose to work with their own consciousness? So what if they’re deluded and escapist? Why not just wish them well and hope they wake up to your superior view?

          Report comment

          • Daniel, you are missing something big time. I have been around people who use drugs and swear by them for my entire life.

            You judge the tree by the fruit it bears. That idea that you have to use drugs to see this fruit is an absurdity. You could try to argue for anything if you allow such fallacy.

            People who use drugs are not better at vanquishing foes than people who do not use them.

            Vanquishing foes is how survivors restore their honor, so that they can again have a biography again.

            So lets say I am helping to write the briefs for a civil suit for a law suit against a psychotherapist. Do I want the guy who uses drugs and believes in them on my team? No way. I want the guy who is committed to staying clean and intense and kicking ass.

            So professional process servers say that divorce cases are the most dangerous. Well once we can get people to start suing their parents, that will be even more dangerous. Do I want the druggie as my backup? Hell no, I want the guy who is committed to feeling his feelings and staying straight.

            And how about capturing a Psychiatrist who has jumped bail? The druggie as my backup? No, the guy who is 100% committed to staying straight.

            And how about if I am on the barricades? The druggie who talks and talks like oldhead? No, I want the guy at my side to be the guy who stays straight, because I know that he will be more effective.

            Right now it is just words, but soon it should be going to lawyers, and we need ones who are straight at all times and committed to kicking ass.

            I helped a DA get a conviction on a Pentecostal daughter molester. I am glad that she did not use drugs. But the defendant did.

            Report comment

  25. Some thrilling soap-boxes, again. Here’s me, clambering onto mine…

    MDMA is a love-drug. Love. sex and togetherness. You remember all those raves you never attended? That’s what happened. Love, sex and togetherness.

    Critique number one: but drug-induced love is not ‘real love’. What then is ‘real love’? Please don’t attempt to answer.

    What is most frightening to me is the idea of a psychiatrist taking on the role of “drug sitter”, a person that accompanies someone on drugs to ensure their safety and so on, and does not take the drugs themselves. The surges of love and connectedness, the overwhelming ecstatic union of being. With a psychiatrist? Forgive me, but, why spoil the fun? Unless the psychiatrist also pops one… but then the most likely progression is some kind of sexual union.

    Ewww. Shivers.

    You remember all those love-drug heads from the 90s? Where are they now? What world did their love revolution contribute to?

    This one. This one of fakery and social isolation. Of narcissism and insincerity. Of fundamental disappointment.

    There are many people that just don’t get it; so drugging them into euphoric alienation is the way to go. Better than sitting back and watching them suffer with the realities of their world and the world they live in.

    I fear the advance of MDMA into mainstream life because of how boring it makes people. The utter tedium of a fakey positivity. The selfsame fakey positivity that renders the world a dank, homogenous shithole. Bright colours and bullshit sentiments. Smiley faces and faked personas.

    Having stated all that, I’m all for any new comedy in life and MDMA’s crazy moon laughter is something to hope and wish for. Much better to laugh oneself to death than morosely humbug through the days. And if that means popping summat, then go for it. Just remember that no amount of stimulants can transform a boring person into a non-boring person. The best you can hope and wish for is to not stand out so much as a curmudgeonly party-pooper. Even if that is your natural state.

    Report comment

  26. If we are going to fight back against Psychiatry and Psychotherapy, and the Recovery Movement, we need Women and Men of Action, not people who want healing and therapy, and altered states of consciousness achieved via chemicals. Such persons are useless at best.

    We need people who are willing to jump into the middle of situations and instigate conflict. Otherwise they don’t deserve to be considered as Resistance.

    Report comment

      • No herbs for me oldhead. And who is this we? That is a very good question. Seems that there is no more anti-psychiatry movement, just a bunch of Psychotherapists and Recoveryists trying to promote themselves and their only very slightly different version of the same thing.

        So the ‘we’ starts when people start taking action. Once you realize that Psychiatry and Psychotherapy are the systematic persecution of both children and adults, and that this is not just some minor error, but that it is war, then you start looking for places to attack.

        So oldhead, if you want to seek nirvana via psychedelic drugs, and you really believe that this is the best response, absolutely, it will be better if you stay away.

        I for one want to go after:

        1. Government run mental health, like in County Hospitals.

        2. Government run Recovery Programs, like through the prison system and county public health

        3. Government licensing of Psychotherapists, and focus on private practice psychotherapists, the sorts that offer a fix-my-kid service.

        Try and put people out of business, try to get lawsuits going, try to get criminal prosecutions, and follow the way of virtually every other industrialized nation and prohibit disinheritance, as not having done this is one of the major reasons for the present sorry state of affairs.

        Report comment

  28. ^^^^^ Does not matter, as drugs are not any kind of a solution. Instead, political consciousness raising and political action.

    You show me a case where someone has been convinced that they have a ~mental illness~, and I’ll show you a case where some people need to be seriously punished.

    Report comment

  29. Oldhead, It’s not too many decades ago that Germany got itself handed a new constitution. One of the provisions is the enforcement of Crimes Against Humanity in the International Court. Even NGO’s can make indictments, and they don’t expire. Donald Rumsfeld and George W. Bush, each indicted for war crimes, and this does not ever expire. Won’t be seeing them at Oktober Fest anytime soon.

    It was a Spanish judge who indicted Pinochet, and in the UK they debated whether or not they could arrest Benedict the 16th for his role in covering up child sexual molestation when he was Archbishop for Munich.

    We should try Germany first.

    But also, we should be protesting at County Hospitals, because that is where poor people are kept on drugs.

    And we should be protesting at some suburban Psychotherapist Offices, because that is where the Fix My Kid doctors work, and some of these still advertise on MIA.

    Very few would be able to stand up to vigorous street protests, with large signs and names and pictures.

    Oldhead, your so called anti-psychiatry is just grumblings.

    It is time instead for people who want to take action. Gandhi’s satyagraha means applying pressure. It is not pacifism. The practitioners take the same sorts of risks as do armed guerillas.

    Report comment

  30. Daniel Smith, if I wanted your well wishing I would have asked for it. I don’t.

    The last thing we need are people who want to use drugs and go off and contemplate their navels, or try and claim that drugs gives them some privileged POV.

    This treatise, written decades ago, expresses my view about drugs:
    https://www.marxists.org/history/usa/workers/black-panthers/1970/dope.htm

    Something I just sent to a friend in email which may be of interest:

    I have no objection to disability money being paid out. I think such payouts should be expanded in scope and quantity. We are in the latest stage of industrialization. But our politics is completely driven by scapgoating the poor, plus minorities and immigrants. We are dividing into a two tier society. Psychiatry, Psychotherapy, and the Recovery Movement are simply resurgences of the bogus sciences of Social Darwinism and Eugenics. If we expect our democracy to continue, then we absolutely have to move to Social Democracy.

    But I am very critical of disability identities. And generally I feel that access to disability payments is being used to coerce people who are already marginalized into accepting a disability identity. No one should be subjected to such coercion. And in my observation the disability identities are usually flimsy and more the product of abuse, injustice, and social marginalization. Accepting such an identity merely exonerates perpetrators.

    It will never change so long as people ask for pity. Psychiatry, Psychotherapy, The Recovery Movement, and Born Again Christianity are all based on pity seeking. Things will only change when people organize and start fighting back.

    There is one thing and one thing only which ended slavery in this country, the fact that 180,000 black men refused to be Uncle Tom’s, and instead trained with rifles and bayonets and served in federal uniform. If this had not been so, we would still be practicing slavery today.

    Report comment

LEAVE A REPLY