MDMA and exposure therapy against PTSD

MDMA structure

Table of contents

PTSD symptoms

More than half of the population comes into contact with a traumatic experience that can cause PTSD complaints. This is a very worrying social phenomenon. It is essential to recognize and acknowledge symptoms of post-traumatic stress disorder (PTSD) after a traumatic event. PTSD can be crippling and have serious consequences for a person's daily life, including feelings of anxiety, intense stress and discomfort. Below we list a number of symptoms.

MDMA crystals

Reliving

Re-experiences in the form of images, dreams and thoughts about the trauma. The re-experiences can express themselves as internal dialogue, emotionally or visually.

Negative worldview

An excessive and unrealistic negative image of the world in which everyone and everything feels unsafe. Safe people or situations are more likely to be experienced as threats.

Agitation

Always on and alert, causing sleep problems, poor concentration and anger to occur regularly.

Evasive

Avoiding possible triggers creates a smaller social world, resulting in loneliness and addiction.

MDMA session against PTSD complaints

Exposure therapy is a form of therapy aimed at overcoming anxiety disorders/PTSD. It involves exposing the patient in a safe manner, step by step, to the situations that evoke fears or fear reactions, so that the fear ultimately decreases.

Several older and recent studies show that the use of MDMA during exposure therapy can accelerate and improve treatment. MDMA can strengthen the therapeutic relationship, making the patient more open. In addition, MDMA can ensure that the patient experiences less anxiety and more positive emotions. This can help the patient to process difficult situations better and therefore make faster progress with the therapy.

Assignment as preparation

It is important to map out the trauma and triggers as much as possible before the first MDMA session. A week before the first MDMA session in which exposure therapy plays an important role, a trigger list is independently made.

The triggers can be sounds, situations, people or other things. Consider things that trigger PTSD symptoms such as avoidance, agitation, re-experiencing and reinforcing a negative world view. It is also useful to write down the primary response. By the primary response we mean the automatic response of the body/thoughts, which often has something to do with the fight/flight/freeze response. Furthermore, it can be written down what the secondary response is and by this we mean what kind of conscious choice you make after the trigger and primary response. For convenience, create a table that looks something like this:

TriggersPrimary responseSecondary response
Banging soundAnxious feeling, thinking back to warListen to music to calm down
Smells?  
Images?  

Meditation and exercise can help

If making a trigger list causes too much stress, it can be useful to take a break for something that gives you peace of mind. Exercise and various breathing techniques can help with this. So choose relaxation when necessary.

Other important preparation

People with anxiety complaints often have a disturbed glutamate/GABA ratio in the brain, especially in the hippocampus. GABA is an inhibitory neurotransmitter that helps reduce anxiety and promote relaxation. When levels of GABA are increased in the brain it can have a calming effect. A good balance in these neurotransmitters also increases the chance of a positive effect from a psychedelic session.

During the preparation of psychedelic sessions, we provide advice based on the intake in order to balance the neurotransmitters, including GABA, so that the mood before the session can improve and the session will run better.

GABA glutamate hippocampus-MDMA and exposure therapy against PTSD

The support during MDMA therapy

In addition to ensuring physical safety, it is at least as important to provide a sense of safety to those who use the combination of exposure therapy and a MDMA therapy. Working without judgment and trying to understand that the 'abnormal' behavior is actually quite normal given the circumstances can create a good bond between the therapist and the client. It is always important that both parties see the person with PTSD as someone who has been a victim of the situation and that treatment has the prospect of reducing the symptoms.

For emotional safety, it is important to mention that all feelings and emotions are important and that they can play an important role during the MDMA sessions. Before the effects of MDMA kick in, shame, guilt, fear and avoidance of sadness can get in the way during the first part of the session. However, it is not a major problem with MDMA sessions because as soon as MDMA starts to take effect, these forms of self-protection can disappear. It is important for guidance to give the client time to feel safe to talk about the trauma. All in all it is an unforced approach with understanding of the situation for the person in question.

Indicate the stress level during the session

The SUDS score (Subjective Units of Distress Scale) is used to measure the degree of emotional tension or stress that someone experiences. It is useful to be able to communicate during the session how much stress it causes to talk about certain traumatic experiences or how much fear is generated during exposure. It can indicate on a scale of 0 to 100, with 0 indicating no stress or tension being felt and 100 representing the worst stress or tension experienced during the traumatic experience itself. It is useful for a good MDMA session not to induce a major stress response to triggers and mutual communication can help with this.

After MDMA exposure therapy

After the MDMA session it may be easier to do things that would otherwise be avoided. If stress levels remain low, it is advisable to take advantage of the situation and seek exposure. This can speed up the exposure therapy process. It is recommended not to make it too extreme and to take small steps. Recording the SUDS score can help to gain more insight into the progression of the reduction of anxiety complaints.

Legal MDMA sessions in the Netherlands

In the Netherlands, offering MDMA as psychotherapeutic treatment is not yet legal, but it is possible to offer MDMA sessions. The same effect is achieved by using a legal analogue of MDMA with 95%. This analogue does not fall under the Opium Act or the Medicines Act, which makes it legal. This substance activates the same neurotransmitters as MDMA and therefore has similar effects on the feeling of connection and empathy.

According to the law, our current MDMA sessions do not fall under medical treatments, although we strive to imitate future medical MDMA-assisted psychotherapy as much as possible. It is advisable to read the information below if you are interested in an MDMA session.

Reviews MDMA sessions

Psychedelic therapy can be exciting and that is why it is nice to know how others have experienced an MDMA session and what the results have been. We list some reviews below.

More than a week ago I had an MDMA session under the guidance of Ronald. Without realizing it, I had created an expectation of the session in advance and I noticed that part of me was a bit disappointed after the session. Fortunately, that disappointment was short-lived because afterwards it was much better than what I expected. It was exactly what I needed to take the next steps. After the session the process continued for a few more days and nights, physically and through dreams that addressed exactly my themes. I have come closer to myself and have felt so intensely grateful since that Friday. I look to the future with confidence and I now know that whatever may come... Come on... I am ready for it.

Thank you Ronald for your wonderful guidance. The right person in the right place at the right time. Grateful 🙏

The hours flew by and after six o'clock Janneke got ready to go. Because I felt so connected to her, I had become attached to her and it was difficult for me to see her go. Also during the session when she went to the toilet, I felt loneliness and a slight feeling of abandonment, but the MDMA quickly took me out of these feelings. After the session, a fear of losing that warm feeling surfaced and I had this fear with me for about three days. The “Tuesday dip” was hard for me and I wasn't prepared enough for it. Now two weeks later I feel light, open, calm and clear. I have a better self-image and feel calm in my daily activities. For the first time in years I have felt stable for days; not too happy, not too gloomy, not chaotic but satisfied. Trip therapy has opened a door for me to psychedelics as a healing agent and I am curious about what else it will bring me.

Marcel helped me very well during my session. How scared I was at first! Yet Marcel's calm approach helped me to dare to do it. I still feel an oasis of peace and happiness when I think back to that beautiful session. I suffer less from anxiety and feel more connected. Thanks again and I think I'll come back to you in 3 months!