Author: Dan Bernitt

Undoing the Tape: Experiencing Trauma Release Through MDMA Therapy

Undoing the Tape: Experiencing Trauma Release Through MDMA Therapy

photo courtesy Alejandro Alvarez

What is it like to participate in an MDMA clinical trial? Lori Tipton shares her experience of undergoing MDMA-assisted psychotherapy for her severe PTSD at a clinical trial in New Orleans. After receiving ‘Breakthrough Therapy’ designation by the FDA in 2017, phase 3 trials have begun for this promising treatment. 

Watch this clip from Lori’s MDMA session.

Video: Session footage from MAPS Phase 2 Clinical trial New Orleans, LA 2018 courtesy MAPS.
For study details and how to participate in the MAPS MDMA trials visit clinicaltrials.gov.

Lori’s Tape

When the tape is playing, we listen to the tape. There is no not playing the tape.

You have to stay vigilant. If you don’t stay vigilant, bad things are going to happen. Lock the doors. Check the window latches. Check to make sure the back door is locked; it can be fussy, and not everyone is as careful as you. You locked the front door, but make sure it’s still locked, too. Make sure you always know where the exit is. If somebody comes in through that exit, look for the next one. If they come in through both exit doors, hide behind a barricade. If they find you behind your barricade, fight them off. You’re brave. You’re vigilant. That’s me, that’s who I am. And if they kill me, so be it.

At work, if someone walks into the bar and they look mad, they’re going to kill you. You can tell from their face; this is the person who has come to kill you. They’ve come to kill everybody. Something bad is going to happen. You can feel it, you know it in your gut. Something terrible. Dying would be good. This is what makes sense. You’re alone anyway. We’re all alone. Nobody’s not alone. But even if you weren’t alone, nobody’s going to understand you. Nobody loves you; how could anybody love you? You’ve been through this thing. Nobody wants to be with someone who’s worthless. Nothing can pull me out of this way of thinking. You can’t go to a therapist and get on drugs, because you don’t need that. You’re strong. You’re vigilant. You’re brave. You can function. Only people who can’t function need that. Besides, even if you took it, it’s not going to work because nothing else has worked. You’re special in this pain, because nobody knows exactly what this feels like.

When the tape is playing, we listen to the tape. There is no not playing the tape.

My husband interrupts: “Lori, in all my life, working as a bartender and living my life, the worst thing I’ve seen is people get in a fistfight. You walked into your mother’s house and found two people dead, and your mother had killed herself. Your idea of the worst thing that can happen is so much further than mine. You can fill that space with so much more violence, because you’ve literally experienced that.”

When the tape is playing, we listen to the tape. There is no not playing the tape. Rewind the tape, and play it again. You have to stay vigilant. If you don’t stay vigilant, bad things are going to happen…

Preparation

“At night before I’d go to bed, I sometimes spend hours looking at session tape.” As part of his psychiatry residency, Dr. Ray Worthy, M.D. worked as an adherence rater for a research program on MDMA-assisted psychotherapy for post-traumatic stress disorder. “It was enthralling. Clearly, people were processing really difficult stuff, and they were doing it in a different way than what we normally see in psychotherapy. What I saw were catharses, insights, and a-ha moments that clearly seemed to be transformative.”

Tempering his enthusiasm, Worthy notes: “If it’s too good to be true, it’s usually not true. We owe it to ourselves with the Phase III trials to see if it can be replicated.”

Investigational Product (MDMA), courtesy of MAPS
Investigational Product (MDMA), courtesy of MAPS

By Worthy’s account, one-year follow-up results have been “unprecedented:” 68% of participants no longer had PTSD. In August 2017, the United States Food and Drug Administration designated MDMA as a “breakthrough therapy” for the treatment of PTSD. The FDA grants this designation when preliminary clinical evidence for treatments of serious or life-threatening diseases or conditions demonstrates substantial improvement over existing therapies.

The impact of the work also fascinated New Orleans-based therapist Dr. Shari Taylor, who first encountered the results through watching the documentary The Spirit Molecule. Her interest led her to work done by the Multidisciplinary Association for Psychedelic Studies (MAPS) and Worthy. “If there’s any way I can be involved in this, I want to,” she said to Worthy.

“In the field of psychiatry, there haven’t been a lot of advances, and working with PTSD can be frustrating,” Taylor said. “In the early trials with MDMA, people were getting better and better as time went on. They didn’t have to continue to take medication, which is huge. The thought of being able to take a medicine just three times, and then to continue to get better, was remarkable to me—and still is.”

If it’s too good to be true, it’s usually not true. We owe it to ourselves with the Phase III trials to see if it can be replicated.

Dr. Ray Worthy

MAPS has been training co-therapist teams in leading MDMA-assisted psychotherapy sessions. These differ from other types of psychotherapy in many ways, and Worthy is careful not to sell short traditional psychotherapy, which he’d recommend to anyone as a path to growth. “Don’t get me wrong: Those can be powerful lunch hours. This is a special journey.”

“The boundaries are different than traditional therapy,” Taylor said. “You’re spending eight hours with someone who’s essentially in an altered state, and you become very close to them. There’s this level of trust, and you get in this space of feeling this love for the person and wanting them to heal. We can do things that aren’t allowed in traditional therapy: hold their hand, do bodywork. On one hand, it’s really important to have boundaries. On the other hand, people need to feel like you care.”

As a therapist team, Worthy and Taylor work with the participant to create a setting of trust and rapport in therapy sessions leading up to working with MDMA. “We get the broad brushstrokes of the trauma material out in the open before the medicine sessions so that we’re all on the same page when that comes up in the sessions,” Worthy said. “Inevitably, it comes up. If it doesn’t, we as therapists will take the role of a gentle reminder to check in with folks to see if they want to look at some of that stuff.”

While the therapist team can remind the participant about traumatic material they may want to face, the participant’s experience of taking the medicine guides the session. Both Worthy and Taylor take it upon themselves not to interfere. “As therapists with MDMA, our job in large part would be to get out of the way. Never obstruct that process as natural unfolding. The MDMA is a catalyst for that natural process unfolding,” said Worthy.

The work operates under the notion of an “inner healer” guiding the participant toward addressing their own trauma. “The medicine brings to you what you need to work with,” Taylor said. In her own medicine sessions as part of the therapist training, Taylor’s “inner healer brought things up that I hadn’t even thought about in so long, and didn’t even really recognize were things I was still dealing with.”

The inner healer concept comes from Dr. Stanislav Grof, an early researcher of psychedelic-assisted psychotherapy. MAPS’s MDMA-assisted psychotherapy protocol draws heavily upon Grof’s work. Worthy summarizes the inner healer concept: “If there’s a cut in the skin, there’s a tendency toward healing and wholeness. The theory is, and I certainly ascribe to it, that the same is true of the psyche. We’re looking for healing. We know when there’s a level of wellness.”

When the therapists do interact with the participant, Taylor sees the main objective as “reflecting the client’s truth back to them. You hold space and allow them to feel connected and open while they have their own insights and witness their own healing happen.”

Session

The trials for MDMA-assisted psychotherapy have been for people suffering from PTSD where no other available treatment had been effective. Lori Tipton enrolled in one of the MAPS studies. “I tried all the legal, recommended things for the problems I was having. I went to all the doctors, and I saw all the specialists. I tried all the antidepressants and the antianxieties. I tried all the naturopathic ways. Put a f***ing oil on me, and I’ll sit in meditation for ten hours, and I still had f***ing PTSD.”

Trepidation consumed Lori Tipton leading up to her first MDMA-assisted psychotherapy session. If it did work, she wondered, “What if I don’t like who I am? How do you know you’re going to like who you become?” The fear didn’t win: “I didn’t go into this all rainbows and butterflies, thinking this is going to be the thing. I went into this as open-hearted as I could, open to whatever happens.”

The medicine session began gently, and suddenly she would remember things not even tied to her traumas.

“It was like somebody had opened my brain’s filing cabinet and pulled out beautiful memories for me.

Instead of them becoming just a passing nuance, I was fully engaged, feeling the memory throughout my entire body. In one session, I kept having all these memories of my brother and I as children at water parks and the beach. It was just so beautiful to me, because I don’t even remember the last time I’d thought of those memories.

I tear up thinking about it, because it was so powerful to have moments knowing I had been so joyous then. I could feel that joy, in my heart and radiating from me. That’s the magic of this situation: allowing you to understand that you have at your disposal access to these emotions at all times.”

Liberation comes from the ability to respect and accept the memory without allowing it to create the same reality.

Lori Tipton

How Tipton experienced her emotions was the first of many revolutionary insights from the session. “We are just passing through these situations and emotions. We’re going to feel joy and happiness, as well as terror and anger at some points. Those things don’t have to attach and define us.” Her own skepticism jumped in to verify it: “I am not attached to this? I can feel this, and I can experience it, but then I can know that it’s going to pass, and that’s okay?”

The major insights from MDMA-assisted psychotherapy work because they’re understood on an emotional level, not just intellectually. As Tipton notes, “The drug placed me in the state of wellbeing, where you’re more easily able to open up to those feelings. You can then create the space between your feelings and your ego. It may be the tiniest space, but within it is this perspective shift. You get to see differently the same old story of your life.”

After Tipton’s mother died, she visited a psychic medium who claimed she could communicate with the dead. The medium claimed that her mother’s energy was “locked in a state of unpredictable sickly energy, and she hasn’t moved on past that.” This message resonated with Tipton, feeling that it accurately represented her mother. The claim depressed Tipton, who concluded that when people die they’re stuck in the troubles of their life’s final throes.

In her session an insight broke through to her about this message and her relationship with her mother:

“I sit up, and I’m like, ‘Oh, my God. I’ve figured it out.’ I’m with Shari and Ray, the most lovely human beings ever. We became very close, but I can only imagine it looks like this person being pretty high on drugs shouting for them to listen.”

“I wrote this down: ‘Perhaps the way we hold space for the memories of people keeps them locked in that state of energy. Liberation comes from the ability to respect and accept the memory without allowing it to create the same reality.’ I knew the psychic wasn’t reading my mother’s energy. The psychic was reading the way I was holding my mother’s energy.

Because I had never forgiven her. Inside of me, I was holding her in that state. I needed to work past that, because that wasn’t all she was.

That was really powerful for me. I realized, ‘Oh, once again, I’m doing this.’ Not in a self-defeating way, but in a way of understanding I’m actually in control of how I’m going to feel about this. One glimpse changed everything for me.”

Participants in MDMA-assisted psychotherapy sessions commonly experience these flashes of insight. Tipton said, “I felt like I’ve walked around my whole life with dirty glasses on, and now somebody wiped the lenses clean. I didn’t even know the glasses were dirty.”

Integration

“You can have really great insights,” Dr. Shari Taylor said. “But if you don’t then figure out a way to implement what you’ve learned into your everyday life, then it can be wasted.”

Taylor recommends participants take each insight and ask themselves, “What can I do in my everyday life to facilitate working on that?”

Dr. Ray Worthy notes that the MDMA-assisted psychotherapy sessions can be the beginning of insights unfolding: “Usually these early insights and revelations only got more deeply integrated with the passage of time, as we’ve seen in the Phase II study trials.”

The thought of being able to take a medicine just three times, and then to continue to get better, was remarkable to me—and still is.

Dr. Shari Taylor

[ Dr. Shari Taylor is a therapist the Psychedelic Support Network. ]

One year later, Lori Tipton feels she’s been better able to accomplish important goals in her life, especially with her relationship with her child. Before the therapy, her child saw her as the authoritarian, the enforcer, the worrier. “Now, when my five-year-old says to me, ‘You’re the most fun,’ it’s the best f***ing thing in the world. That is worth whatever. That is priceless.”

She’s also the first to admit that she’s not completely healed and still has sadness. Importantly, “my reactions to things have drastically improved that all my interpersonal relationships have flourished. I have stronger connections with my husband, with my dearest friends, with my co-parents. All of those things are better than they were before. None of them are worse. That is the truth. They have all improved. Even if it’s a minuscule improvement, it’s still an improvement.”

Before this work, whenever an event would trigger Tipton, her reaction had to play through until the end. “If I felt like I was being abandoned, then I’d be spurred to lash out at the person and then prove to them how they’re going to abandon me.” A metaphor she gained from further reflection after her therapy sessions was of a tape. “It wasn’t until doing this work that I realized, ‘Oh, yeah, that’s the tape.’ Somebody pressed play on it, and there was no stopping it.” The insights gained from the therapy showed her how to handle these triggers: “I don’t have to press play, and if play does get pressed, I can press pause. Because the tape does not have to play to the end.”

Coda

Since Tipton completed her participation in the MDMA-assisted psychotherapy study, she’s been dedicating her energy and attention to raising awareness about the medicine’s impact.

Lori Tipton 2018, courtesy of Jill Lafleur
Lori Tipton 2018, courtesy of Jill Lafleur

“The fact that I’m alive right now, and that I love myself, that’s a miracle. This drug should not be illegal. I want this not only decriminalized, I want this accessible for everyone,” Tipton said. “I live in New Orleans, where almost everybody suffers from some form of trauma. I don’t want people to be unable to have the option to do this.”

She remains cautious, though: “I’m trepidatious about saying ‘MDMA will heal everybody,’ because I don’t believe it’ll heal every single person. But I do think that the potential for it to heal most people is so significant that everybody should have access to it.”

After being involved in the MDMA-assisted psychotherapy study, Tipton was in touch with another study participant who had the same MDMA treatment.

“I emailed him, and I said, ‘I just have a simple question: do you regret doing this?’ He called me on the phone, and we had a very brief conversation. He said, ‘Lori, you sound like you’re… What are you? In your 30s?’ I said, ‘Yeah, I’m almost 40.’ He said, ‘I’m almost 60. I would have basically given anything, because I have no idea how much more I would have accomplished in my life, had I had the opportunity to participate in MDMA therapy earlier.”

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