Study Links MDMA Use and Self-Reported Empathy

Users of the substance ‘MDMA’ are reported to have higher emotional empathy than users of other drugs.

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A recent study, published in the Journal of Psychopharmacology, examined the relationship between MDMA use, self-reported empathy, and general social cognition. The results of the correlational research suggest that long-term MDMA users report higher empathy compared to users of other substances, with no harmful effects on social functioning.

“Investigative studies looking at the acute effects of MDMA on social cognition have reported heightened levels of compassion, trust, generosity, and empathy, mirroring the effects reported by recreational users,” write the team of researchers, led by Dr. Molly Carlyle of the Addiction Research Centre at the University of Exeter.

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A growing movement is suggesting that certain psychedelics and street drugs, such as ‘ecstasy’ or ‘molly,’ should be considered as pharmacological tools for psychological healing. Preliminary research suggests that MDMA-assisted psychotherapy may be an effective intervention for those who have PTSD, given its enhancing effects on trust, openness, and compassion. The researchers explain the proposed rationale:

“[…] the acute effects of MDMA on empathy and openness are thought to help the extinction of traumatic memories as well as overall engagement during psychotherapy, and it is hoped that this will promote long-term changes in reducing distress.”

The research organization MAPS, the Multidisciplinary Association for Psychedelic Studies, is currently sponsoring an effort to win FDA approval for MDMA’s status as a prescription medication by 2021. Similarly, psychiatrist Scott Shannon has argued that MDMA’s legalized prescription status could represent a significant shift in the medical model’s focus on chronic symptom management, in favor of personal transformation, given MDMA’s ability to catalyze therapeutic change.

Phase 2 trials for MDMA-assisted psychotherapy have indicated promising results. After only three sessions, 61% of the 107 participants no longer qualified for the PTSD diagnosis at the two-month follow-up, which rose to 68% at the one-year mark. All participants exhibited treatment-resistant PTSD beforehand, with an average of 17.8 years suffering from the condition.

Research is still in the early stages, but the FDA has granted the substance the Breakthrough Therapy Designation, which means that it shows early promise over existing modes of therapeutic intervention and that its medical status is receiving expedited consideration. Phase 3 trials are currently being conducted in locations across the U.S., as well as internationally.

The current study analyzed empathy and other social cognition factors across three different groups, totaling 67 participants. The groups consisted of poly-drug users, including MDMA, poly-drug users not including MDMA, and a group that only used alcohol. An independent-group, correlational design was used, and participants were measured for emotional empathy, cognitive empathy, and response to social exclusion.

Carlyle and associates targeted chronic users of MDMA and other substances: at least once per month in the past ten months and at least ten times across the lifespan. They hypothesized that chronic use of MDMA would result in reduced empathy and increased sensitivity to social pain, considering some previous research findings on MDMA abuse.

Contrary to expectations, however, the researchers found that the group that included MDMA use scored higher on subjective emotional empathy than the other poly-drug users, but not from alcohol users. The difference between the two drug groups was only noted with a subjective report questionnaire (the Interpersonal Reactivity Index or IRI), and not a computerized test (the Multifaceted Empathy Test or MET). They speculated that the difference might result from the IRI’s emphasis on trait empathy, as opposed to the MET’s focus on state empathy, which is more temporary and fluid.

Cognitive empathy, or mentally taking the perspective of others, did not differ on the IRI. On the MET, MDMA users were found to have increased cognitive empathy from non-MDMA drug users, but not from alcohol users.

All three groups exhibited emotional distress following a computer game-based social exclusion test, but there were no significant differences between them.

The study had several limitations. Reliance on subjective self-report measures can produce unreliable results, both in terms of reported drug use and answers on the questionnaire. In this case, MDMA users reported more empathy than other drug users on the subjective report questionnaire but the empathy test did not support this finding. This study also lacks a non-drug user control group.

Additionally, because of the correlational design, it is impossible to know whether MDMA use caused increased emotional empathy, or whether individuals with higher empathy were drawn to using MDMA. While the researchers speculate about the application to psychotherapy, the data do not speak to the efficacy or safety of MDMA as a treatment.

“Based on this research it is not possible to identify whether differences in empathic processes precede or are a consequence of MDMA use, nonetheless these data strengthen the argument that MDMA may be used safely in a therapeutic setting without negative repercussions on empathy and sensitivity to social pain.”

This study adds limited and tentative support for the relationship between MDMA and prosocial personality factors such as empathy. The findings contradict previous research which identified an associated decrease in social functioning with long-term MDMA usage. These issues will become increasingly significant if MDMA is approved as a prescription medication by the FDA in the coming years.

 

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Editor’s note: The headline and contents of this article have been edited to better reflect the findings of the study. 

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Carlyle, M., Stevens, T., Fawaz, L., Marsh, B., Kosmider, S., & Morgan, C. J. (2019). Greater empathy in MDMA users. Journal of Psychopharmacology, 33(3), 295-304. https://doi.org/10.1177/0269881119826594 (Link)

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Micah Ingle, PhD
Micah Ingle, PhD
Micah is part-time faculty in psychology at Point Park University. He holds a Ph.D. in Psychology: Consciousness and Society from the University of West Georgia. His interests include humanistic, critical, and liberation psychologies. He has published work on empathy, individualism, group therapy, and critical masculinities. Micah has served on the executive boards of Division 32 of the American Psychological Association (Society for Humanistic Psychology) as well as Division 24 (Society for Theoretical and Philosophical Psychology). His current research focuses on critiques of the western individualizing medical model, as well as cultivating alternatives via humanities-oriented group and community work.

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37 COMMENTS

  1. Why not publish an article on the role that alcohol could play to fight “social phobia”? And the heroine against “melancholia”?

    This propaganda for drugs is repugnant.

    We do not want pro-drug articles here! Get out the Big-Pharma propagandists! Get out the criminals, get out the monks who sanctify them!

    Get out, get out, get out!

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  2. The amphetamines were “wonder drugs” in the 80’s. The antidepressants were “wonder drugs” in the 90’s. The atypical antipsychotics were “wonder drugs” in the 2000’s. The opioids have seemingly always been “wonder drugs” and “safe pain meds” to the doctors.

    We now have an ADHD epidemic, with millions hooked on amphetamines. We now have a depression epidemic, with millions unable to get off the antidepressants. We now have a bipolar epidemic, with millions whose lives are being destroyed with the antipsychotics. We now have an opium epidemic, with millions addicted and dying. When do we stop trusting big Pharma and the doctors?

    I’ve only heard tell about Ecstasy, never tried it myself, so I’m no expert. But this habit of turning street drugs into psych drugs hasn’t really worked out well for the patients.

    But maybe, the psychiatrists should just turn all the street drugs into psych drugs? And we can just make the psychiatrists the legal drug dealers of all the street drugs? But, of course, we would absolutely have to take away the psychiatrists’ right to force drug people, which should be done anyway.

    And, we’d have to take away the right to prescribe any of the psych drugs, from all the other doctors, which we should do anyway also. Because when all the doctors are handing out mind altering drugs, fraudulently calling them “safe meds,” and denying that they’re mind altering drugs, all the doctors lose their credibility.

    And now we have very few doctors left with credibility. Pardon my cynicism, but I’m personally tired of all the hype, that turns into lies, about the pharmaceutical drugs. “Just say no.”

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  3. Many of the drugs in the MDA family give you a sense of empathy with others when you’re under their influence. These other drugs were likely created when MDA, itself, was outlawed back in the 1967 purge to eliminate hallucinogens, in an attempt to get around said statute, because the individual outlawed drugs were all individually named.

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  4. I think that people that are giving each other the freedom to do something that’s not by the book are going to be more empathic, regardless of whether the “medications,” cause that.

    And I’m sorry, but I’m not convinced that the authorities that be are able to measure water empathy really would be.

    I don’t think you create healthy emotional states by fooling around with natural brain functions.

    Am I allowed to think this, or is it going against someone’s rules?

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    • that was supposed to be:

      And I’m sorry, but I’m not convinced that the authorities that be are able to measure what empathy really would be.”

      I typed water rather than what. Somehow my brain new there was a “w” an “a” and a “t” and concocted that really quickly into water, without me knowing it, and being convinced I typed something (I think my mind knows water is a word), it was convinced that was enough. Task accomplished. It’s weird, because I sometimes find myself, in thinking about words, how to define or react to something, that in thinking of the word I’m typing it out in my imagination. Without keyboard or computer.

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  6. Promoting chemical mood alterants gives people the idea that such chemicals are the best response to their experience of injustice. And this is always wrong.

    Locally I have acted to get narcotics dealers arrested and incarcerated in the state prison.

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  7. “No harmful effects on social functioning.” Well that is how the mental health system defines mental illness, as that which is harmful to “social functioning”. We must not go along with that.

    Street and prescription drugs make it harder for people to feel their feelings. This alone is enough reason to never ever use them.

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  8. “The research organization MAPS, the Multidisciplinary Association for Psychedelic Studies, is currently sponsoring an effort to win FDA approval for MDMA’s status as a prescription medication by 2021. Similarly, psychiatrist Scott Shannon has argued that MDMA’s legalized prescription status could represent a significant shift in the medical model’s focus on chronic symptom management, in favor of personal transformation, given MDMA’s ability to catalyze therapeutic change.”

    That is a long-winded way of saying it is all about selling drugs and making money and using phrases like “personal transformation” and “catalyse therapeutic change” is to deflect from that

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    • We don’t want Psychiatrists or Psychotherapists to be able to proscribe mood altering chemicals. These things exist on the black market and they are hard to regulate already. We don’t want White Coats to be contributing to this.

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  9. “No harmful effects on social functioning”

    I suspect the patient who was repeated sexually assaulted by her therapists during the Phase II clinical trial might beg to differ. The full statement is available on MAPS’ website, here: https://bit.ly/2VZuJOC

    Any drug that increases empathy, enhances trust and extinguishes fear is not benign. To its own financial benefit, MAPS is marketing MDMA through both general media and peer-reviewed journals. Publications-written and researched by MAPS-are overwhelmingly positive. There is little to no truly objective outside analysis; and no mention of the overwhelming evidence that sexual abuse was, is and remains a serious concern in the mind-altering realities of psychedelic psychotherapy. This article is not unbiased research; rather a repeat of what Big Pharma drug companies have been doing for years… selling a drug before it has been fully clinically tested and highlighting just how concerning that “clinical testing” truly is.

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  10. I interviewed an ex-MDMA user I know very well. Here’s how he described the effects:

    “A few hours of intense pleasure for two days of intense displeasure. Although the pleasure at the beginning of the intake is high, the balance of pleasure/displeasure is very negative because of the withdrawal syndrome. It is also an ultra-fast addition drug: if, after a few hours you take a second dose to prolong the effects, it will be much less effective, and the third or fourth dose will probably have no effect. In this case, you know that the withdrawal effets will be extremely harsh.

    During the two days of weaning, you just feel extremely bad, you have no possibility of feeling pleasure, and it is only because you know, intellectually, that it will not last that you do not commit suicide. At the emotional level, however, you have the impression that the suffering will be eternal and you want to end it by any means, typically taking heroin. The consumption of MDMA can therefore be a gateway to opioid consumption, in order to reduce the withdrawal syndrome.

    Finally, what they call “improving empathy” translates concretely into the desire to touch everyone and to be touched by anyone. More prosaically, a person under MDMA can commit non-solicities touching, that is to say, sexual assault, or conversely be touched by anyone, which can lead them to be victims of aggression.

    From an outside point of view, a person under MDMA is obviously in a second state, gesturing and gurning like a dement. He is in a state of obvious vulnerability and can easily be abused. It only remains to rely on the “benevolence” of street dealers to “help” partygoers to withstand weaning with heroin…”

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  11. MDMA assisted psychotherapy. I wonder how that works? Is it the therapist that’s on the ecstasy? To come across as more empathic and trustworthy?

    Come to think of it, every psychiatrist that offers neuroleptics as a treatment and claims the effects are that you feel a bit indifferent when on them, should undergo a mandatory 6 month trial of taking 5mg haldol daily (which is still considered a low dose), and if it affects their performance, should be diagnosed as mentally inferior (for life). They should also have to take all their exams whilst on an anti-psychotic (to help them concentrate).

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  12. I read various testimonials on a forum of French drug users.

    A consumer of MDMA happily explains that he gave lots of hugs to many people during his trip, and that everyone loved him, and that he loved everyone … That he was able to get lots of free drug, and give it to everyone …

    Another worries that he has been accused of theft. He does not understand: in his memory, he thought that his friend had given him his things, not that he had stolen them … Another did a bad trip, and his girlfriend, who was also under MDMA, is panicked: she did not know what to do and was very agitated.

    It seems that MDMA increases the feeling of empathy, while it decreases the real empathy.

    MDMA consumers are more likely to associate with positive emotions, but have a hard time understanding negative emotions. During weaning, it is the opposite: there is no longer any capacity to feel pleasure, and negative emotions are felt violently, caricatured. A weaning consumer explained that he had burst into tears and felt hopelessly desperate because he had dropped his fork on the floor.

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  13. It is probably necessary to talk about the use of MDMA as a means of social domination, because this is the main issue of legal or illegal drugs.

    Many drug dealers are highly degraded, both morally and physically. They are often violent people, ready for all the baseness, all the ignominies to make money. They are also very marginalized, under the constant threat of being arrested by the police and spending many years in prison.

    In these conditions, it is almost impossible for them to find a companion in the normal way.

    But there is one solution: MDMA and heroin. You can be the worst junk, the worst criminal, you can create artificial emotions and sensations with MDMA and heroin, you can chemically force a little junkie to fall in love with you. She will probably not realize that her emotions have been chemically forged, and you can mistreat her as much as you want, she will not defend herself.

    Here is an inspiring testimony:

    “I tested the ecstazy and it was great, especially with my sweetheart, it was like we was one. […]

    Then he made me test the heroine. And then, I totally loved it. I felt so reassured, so protected and all the more so because I was in his arms.

    […]

    In short, my love has become my dealer, so to speak. He would bring some and I was entitled to my share. I never buy it.

    Then from year to year I became a real rag, depressed at will. I did not do anything but put my ass on the couch. I had my subutex [Buprenorphine] prescribed by my doctor. But that never replaced the heroine. […]

    And now I see my man continue to take heroin because he knows how to manage it. He has already stopped a whole year all products without any harm. And I am beside him like a shit, who has no taste for anything, no more desire, no more passion.

    I do not know if the cam made me become depressive or if I was already but since I am, I do not taste anything and it will be now 5 years. [She met her dealer 6 years ago]

    Life is a bitch.”

    L’amour et la came. Pas tous égaux.

    Some psychiatrists and pharmacists want to get the legal monopoly of MDMA, as a way to quickly hook their customers, because the effect is intense and short. Similarly, the withdrawal syndrome is intense and short: it is in this window of sulfur that psychiatrists and pharmacists can seek to “relieve” their clients with more durable addictive drugs, for example, benzodiazepines (since heroine is still reserved to street dealers).

    MDMA should not be considered in isolation: MDMA is a special weapon in a global strategy of alienation.

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  16. There are plenty of reasons to be either in favor of or against MDMA-assisted psychotherapy. Personally, I believe it has a lot of promise, as a remarkagle drug that is on your system for only a matter of hours–no daily dosing or bathing the nervous system for years in powerful chemicals–promise to shift us actually OUT of the drug-dependent paradigm and practice of psychiatry. It’s just a very different animal that, at it’s best, opens up the internal, self-healing abilities of the psyche in a profound way. It also has some pitfalls, especially when not done carefully, and my feeling is that the power of the experience–again, when it’s not done carefully–has the potential to convince people they are “healed” when actually they are not. So it’s complicated. But the main thing I wanted to say is that the level of misinformation and flat out ignorance in the comments here is staggering. I mean, at least bother to look into it, people, before you trash it. What’s the point of trashing something you haven’t learned about, aside from, what, bolstering your own prejudices and presuppositions and ego? Those of course are precisely the things that psychiatry does; why not chose to be unlike them and actually consider it carefully with an open mind? Also, please note that MAPS is a non-profit organization, and MDMA is not pattentable. This is really not about greed or profit. These people may turn out to be wrong, but they are not part of the pharma-industrial complex, far from it.

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    • Daniel-

      Thank you for your open-minded reply. I agree with you that MDMA has potential-and strongly continue to believe it has overhwhelmingly unresolved risks requiring address for it to ever, truly, be an evidence-based and safe option. You wrote, “Also, please note that MAPS is a non-profit organization, and MDMA is not pattentable. This is really not about greed or profit. These people may turn out to be wrong, but they are not part of the pharma-industrial complex, far from it.”

      With respect, while MAPS is indeed a non-profit, the organization has set up a for-profit B-corp strictly for the purposes of marketing and monetizing MDMA. In doing so, while optically continuing to appear (and benefit from public opinion) as a not-for-profit, they have indeed become a pharmaceutical corporation.

      The FDA’s approval provided MAPS with a binding agreement guaranteeing the therapeutic legalization of MDMA should Phase 3 trials obtain two statistically significant results with no emergent safety concerns (NOTE: A sexual assault in the Phase 2 clinical trial-the LAST place it should have occurred, with both MAPS and MDMA under far more scrutiny than either will ever face again-should most definitely be considered a safety concern, in my opinion).

      Upon legalization, MAPS will be granted drug exclusivity, making the company the sole source of therapeutic MDMA for at least the first five years after legalization. Granted, as you pointed out, MDMA is already widely available: It’s not patentable. But only MDMA produced by MAPS’ for-profit B-corp-the sales arm of MAPS i.e. MAPS-as-Big-Pharma-will be legalized for prescription use. In addition to actual drug sales, MAPS stands to benefit through the training and certification of therapists. All future therapists and clinics will require MAPS’ approval. Finally, MAPS anticipates rolling out “thousands of psychedelic centres” of its own over the next decade. (Again, can I mention that MAPS is doing nothing of significance to mitigate the risk of sexual abuse, and is instead actively setting the lowest-not highest-possible bar in the certification of its “psychedelic therapists”) With the company recently valued at $100 million, MAPS’ CEO, Rick Doblin estimates profits over first five years post legalization will be around $36 million.

      While I remain hopeful for the future and use of MDMA, in the absence of any external oversight; positing of MDMA as benign cure; MAPS’ calculated marketing initiatives; and multiple examples of MAPS placing profit over patients, I am deeply concerned on many fronts by its impending legalization within the current framework.

      Where I am wholeheartedly in agreement with you (if I may paraphrase what I understood from your comments) however is in the need for continued, informed and thoughtful dialogue. That’s the only way safe, viable, evidence-based options will ever truly be part of mental health care-giving individuals the opportunity to choose what’s best for them, knowing the options are evidence-based and backed by objective research, not for-profit corporations or non-profit organizations masquerading as the same.

      Thanks for your comments.

      Meaghan

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      • Meaghan Buisson’s pro-MDMA commentary is just great because it’s the most honest thing a MDMA promoter can write.

        Yes, MDMA is a drug used to commit sexual assault and rape, such as GHB. Even a therapist of the most holy and very serious MAPS could not resist sleeping with a patient using MDMA. Currently, the patient has sued her therapist.

        Yes, MAPS has negotiated an agreement with FDA & co to obtain a monopoly on the distribution of MDMA. Will MAPS participate in clinical trials that will allow the FDA to grant this monopoly? It would not even be surprising.

        Yes, MDMA weaning syndrome is brief, but it is also extremely intense. This is the reason why many MDMA consumers take heroin for the descent. In psychiatry, it is benzodiazepines that are used, with the same objective and the same result.

        One of MDMA’s problems is that consumers no longer perceive negative emotions, and perceive positive emotions that are unrelated to reality:

        _ Oh, that’s weird! Whoever gave me MDMA is sodomizing me. However, before taking MDMA, I had the impression that he was a big lecherous pig, dishonest and malicious. It must be a conincidence: love is blind. In addition, he has benzodiazepines/opioids for later, if I feel bad!

        _ Curious! MAPS has created a for-profit company to monopolize the sale of MDMA. They will make billions with that. I thought it was distributing it for the good of humanity, so that everyone would be happy! I am very surprised.

        And 6 years later:

        _ I became a real shit, addicted to benzodiazepines and/or opioids. My serotinergic system is screwed up: MDMA don’t work any more. I have no taste for anything. However, I am still in love with my prescriber, who has done very well in life. He became a millionaire: proof that MDMA is not bad for everyone, especially for those who sell it and do not take it.

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        • Stephen-

          Please refrain from identifying me as “pro MDMA”.

          My exact comment was “MDMA has potential-and… overwhelmingly unresolved risks”

          That is not a pro-MDMA. That is a balanced perspective.

          I feel troubled by your fictitious sequelae of MDMA clinical trial assault. The inference that individuals assaulted after taking psychedelics are blind to the influence of psychedelics and in fact continue to support their use is an extremely broad statement.

          Putting vulnerable individuals in overwhelmingly vulnerable situations is not a good idea. Psychedelics highlight the power schema inherent to any patient/therapist dyad… and in that circumstance, acts of abuse can and do occur.

          That someone turns to a given modality for healing and is assaulted by his/her therapist however, is an indictment upon the therapists and the institution allowing such perpetrations to occur. Inferring anything less is an extremely shallow reduction of the egregious acts of abusers and thinly veiled victim-blaming. I trust that is not what you intended.

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        • When you mention “weaning,” this indicates regular use. Yeah, that’s a no-go.

          It is true that there is a “come down” time, as there is after any “peak experience.”

          Those who are experienced in these matters for entheogentic, noetic and consciousness expanding purposes call this time, “Integration,” and it may be the most important part of the experience. This is where the therapist might be invaluable, because after the amazing feelings, comes all the ruminations and problems, right back at you full force. It is an opportunity. That’s why they call it “Integration.”

          MAPS purposes are not about regular use, but about experiential use – a few sessions, then never again, or maybe occasional use.

          Your drug users forums talk about regular use, and any drug is bad for that. I seem to recall dangers of dehydration with “molly,” and there is also the issue that street “molly” or “E” is only about 30% likely that it is actual MDMA. I’ve also heard about MDMA causing DNA damage to the brain, but that was in the 80’s. and may have been a “reefer madness” scare tactic.

          Comparing street / party / rave use with clinical trials isn’t a very clear comparison.

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  17. Most of the people writing here are writing about what they have read, not about what they know.

    MDMA can open gateways to expression of feeling, and explore traumas safely.

    However, I’m reluctant to give any tool like this to psychiatrists.

    MAPS has done some good work, however, they are still buying into the “psychiatry is the way to go” model.

    I do not trust that model.

    There is a power variance if I am on a drug, and the practitioner is not on the “trip” with me.

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  18. Anything which says that survivors should have drugs, or need to “heal”, or need therapy is just more abuse. And so it has to be resisted.

    And we should not have our federal gov’t authorizing any of this. Put an end to it.

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