Latest / The Trauma Therapist / Guest Host: Christina P. Kantzavelos interviews Rick Doblin, Ph.D

Transcript

Guest Host: Christina P. Kantzavelos interviews Rick Doblin, Ph.D · The Trauma Therapist

• 0:00
  Speaker 1: Welcome to the Trauma Hippis Podcast. My name is gommickperson
• 0:04
  Speaker 1: I interview incredible people who dedicated their lives to helping
• 0:07
  Speaker 1: those who have been impacted by trauma.
• 0:09
  Speaker 2: Here we go, Hey Rik, nice to see you.
• 0:14
  Speaker 1: Oh well, great, great to be here.
• 0:16
  Speaker 2: Thank you, Thank you so much. So we're going to start.
• 0:20
  Speaker 3: We're going to get into it and start with the basics,
• 0:22
  Speaker 3: which is what is NDMA and from your perspective, why
• 0:28
  Speaker 3: is it such a powerful healing tool.
• 0:30
  Speaker 1: Well, let me start by saying that MDMA is not
• 0:33
  Speaker 1: a plant medicine, which MDMA is a synthetic chemical. As
• 0:41
  Speaker 1: far as we know, it does not appear in nature.
• 0:44
  Speaker 1: It was invented by Merk in nineteen twelve, the pharmaceutical company.
• 0:49
  Speaker 1: They found nothing interesting in it in all of their
• 0:52
  Speaker 1: animal studies, so they never did anything in humans. MDMA
• 0:56
  Speaker 1: is more widely known as ecstasy, and it was a
• 1:01
  Speaker 1: therapy drug from the middle seventies to the early eighties
• 1:04
  Speaker 1: before it became the party drug ecstasy, and that's what
• 1:08
  Speaker 1: ended up causing it to be criminalized in nineteen eighty five.
• 1:12
  Speaker 1: But what it does is it helps people to approach
• 1:18
  Speaker 1: difficult conversations, difficult emotional traumatic memories in a less fear
• 1:24
  Speaker 1: based manner. It has oxytocin, which is the hormone of
• 1:29
  Speaker 1: love and connection that it releases, so people feel more empathic,
• 1:33
  Speaker 1: both to others and to themselves. It has a lot
• 1:36
  Speaker 1: to do with self compassion, and it has properties that
• 1:42
  Speaker 1: can be very useful in a therapeutic context when people
• 1:46
  Speaker 1: are facing frightening memories that are overwhelming. It sort of
• 1:52
  Speaker 1: calms the fear centers of the brain, the amigla, so
• 1:56
  Speaker 1: that people can experience and express what's happened in the
• 2:02
  Speaker 1: past that has previously felt overwhelming.
• 2:05
  Speaker 3: Okay, great, and so for those who you know, even myself,
• 2:09
  Speaker 3: right we hear sasafras it being the derivative of sasafras,
• 2:13
  Speaker 3: It doesn't have to do with that, correct when people
• 2:15
  Speaker 3: think of it.
• 2:17
  Speaker 1: Well, you can get from sassafras, you get saffral oil,
• 2:20
  Speaker 1: and then you modify it a bunch of times and
• 2:23
  Speaker 1: then you can get MDMA. People have a romantic attachment
• 2:28
  Speaker 1: to plant medicines, so you know, market it's good marketing
• 2:32
  Speaker 1: to call it sasafras, but it's not in sasafras.
• 2:36
  Speaker 2: Fair enough.
• 2:36
  Speaker 3: Thank you for clarifying that, because I know some people
• 2:38
  Speaker 3: say about there, like it's technically a plant medicine. I'm like, no,
• 2:42
  Speaker 3: not exactly, not exactly. So in terms of your you know,
• 2:47
  Speaker 3: the research you've been a part of, and what you've
• 2:50
  Speaker 3: seen in long term healing, especially with like treatment resistant PTSD,
• 2:55
  Speaker 3: I mean, what can you tell us about what has
• 2:57
  Speaker 3: come out of the clinical trials and everything.
• 3:01
  Speaker 1: Well, MAPS has been doing research. MAPS meaning you know,
• 3:05
  Speaker 1: Multidisplinary Association for Psychedelic Studies are nonprofit which I started
• 3:09
  Speaker 1: in eighty six, and also our sort of public benefit
• 3:13
  Speaker 1: pharma company that is now not ours but most owned
• 3:17
  Speaker 1: by investors. We began work with PTSD in two thousand,
• 3:23
  Speaker 1: so there's been basically twenty five years of research with
• 3:26
  Speaker 1: MDMA assisted therapy for post traumatic stress disorder. And I
• 3:31
  Speaker 1: want to make the first point that it's really therapy
• 3:33
  Speaker 1: more than the drug that loads and loads of people
• 3:37
  Speaker 1: twenty million Americans have taken MDMA or ecstasy, and a
• 3:42
  Speaker 1: lot of them had PTSD and still at PTSD or
• 3:45
  Speaker 1: had some other issues. So what we really think about
• 3:48
  Speaker 1: as the operating principle is the therapeutic relationship, this safe
• 3:52
  Speaker 1: support of trusting relationship called a therapeutic alliance that can
• 3:57
  Speaker 1: be built between a patient and the therapist, and then
• 4:01
  Speaker 1: within that the MDMA makes it easier for these traumas
• 4:05
  Speaker 1: to surface and then to be processed.
• 4:11
  Speaker 2: That's incredible.
• 4:12
  Speaker 3: And what what have the results been from what you
• 4:15
  Speaker 3: guys have researched.
• 4:17
  Speaker 1: Yeah, so there's basically from two thousand to twenty sixteen,
• 4:23
  Speaker 1: we did what are called phase two studies, and that's
• 4:25
  Speaker 1: where you look at what the doses are used, what's
• 4:28
  Speaker 1: your patient population, what are your outcome measures, what's your
• 4:32
  Speaker 1: therapeutic intervention, and so from that, what we learned is
• 4:37
  Speaker 1: that the healing potential of MDMA systic therapy is independent
• 4:42
  Speaker 1: of the cause of the trauma. So if somebody had
• 4:46
  Speaker 1: sexual abuse or you know, violent attack or war related
• 4:50
  Speaker 1: or fires from the you know PTSD from the fires
• 4:54
  Speaker 1: in LA or other things that once you have PTSD,
• 5:01
  Speaker 1: it's sort of this repetitive, fear based emotions that never
• 5:07
  Speaker 1: never really go away. The emotion is that the experiences
• 5:10
  Speaker 1: are never really processed. So once you start to phase
• 5:15
  Speaker 1: three studies, what we found is that we compared therapy
• 5:20
  Speaker 1: with no MDMA versus therapy with MDMA, and so we
• 5:25
  Speaker 1: have three eight hour sessions one month apart, and then
• 5:31
  Speaker 1: twelve ninety minute non drug psychotherapy sessions, three for preparation
• 5:35
  Speaker 1: before the first MDMA session and then three for integration
• 5:40
  Speaker 1: after each MDMA or therapy without any MDMA session, So
• 5:43
  Speaker 1: it's the same forty two hours of therapy whether you
• 5:47
  Speaker 1: get therapy with no MDMA or therapy with MDMA. So
• 5:50
  Speaker 1: the first study was severe PTSD, and what we showed
• 5:54
  Speaker 1: is that thirty two percent of the people that got
• 5:56
  Speaker 1: therapy without any MDMA at all no longer had BED
• 6:01
  Speaker 1: at the two month follow up, which is really pretty good.
• 6:04
  Speaker 1: We had a very low dropout rate. However, when you
• 6:07
  Speaker 1: add MDMA, more than doubles to the sixty seven percent,
• 6:12
  Speaker 1: so that's pretty remarkable. And another twenty one percent had
• 6:16
  Speaker 1: what's called clinically significant reductions of PTSD symptoms, meaning that
• 6:21
  Speaker 1: they still have PTSD but their symptoms have declined enough
• 6:24
  Speaker 1: that it's a noticeable difference in their lives. So those
• 6:27
  Speaker 1: are called responders. So we had eighty eight percent responders
• 6:30
  Speaker 1: and twelve percent where it just didn't work. Then the
• 6:35
  Speaker 1: second study was we expanded it to moderate to severe PTSD,
• 6:41
  Speaker 1: but three quarters of them had severe PTSD, around one
• 6:44
  Speaker 1: quarter had moderate PTSD. And keep in mind, now these
• 6:48
  Speaker 1: are the therapists we had sites in Israel, Canada, in
• 6:51
  Speaker 1: the US. They've had practice. Now they're working in this context.
• 6:54
  Speaker 1: They're getting better and better. So in the second study,
• 6:57
  Speaker 1: forty seven percent no longer had PTSD from the therapy
• 7:02
  Speaker 1: without any MDMA at all, which is better than any
• 7:06
  Speaker 1: other therapy for PTSD, with very very low dropout rate. Also,
• 7:13
  Speaker 1: so studies that were done by the Veterans Administration took
• 7:16
  Speaker 1: them around six years, nine hundred and fourteen veterans comparing
• 7:20
  Speaker 1: cognitive processing therapy versus prolonged exposure. About fifty percent of
• 7:25
  Speaker 1: the people dropped out of the study because the therapy
• 7:28
  Speaker 1: was retraumatizing. They had to go over their therapy, their
• 7:32
  Speaker 1: trauma over and over and over. But it just didn't
• 7:35
  Speaker 1: have the reductions of fear, that sense of self acceptance
• 7:39
  Speaker 1: that comes from the MDMA. So we had very low
• 7:42
  Speaker 1: dropout rate and credible forty seven point six percent no
• 7:46
  Speaker 1: longer had PTSD. But when you add MDMA, now it's
• 7:51
  Speaker 1: about seventy two percent no longer had PTSD and another
• 7:56
  Speaker 1: fifteen percent had clinically significant reductions of PtD. So according
• 8:01
  Speaker 1: to Besilvanderkoch, who wrote the book The Body Keeps the Score,
• 8:04
  Speaker 1: which many people have probably heard about about trauma and
• 8:08
  Speaker 1: all the different treatments. He's published a paper recently that's
• 8:11
  Speaker 1: saying that he thinks this is the most effective approach
• 8:14
  Speaker 1: to treating PTSD is therapy combined with MDMA.
• 8:20
  Speaker 3: Wow, that is so incredible to see those numbers laid out.
• 8:25
  Speaker 3: And you know, my other question was, like, so many
• 8:29
  Speaker 3: therapists hit a wall in traditional talk therapy, and especially
• 8:32
  Speaker 3: when it comes to complex trauma, and so like, how
• 8:36
  Speaker 3: do you see therapists, Like what role do you see
• 8:39
  Speaker 3: therapists playing in this new frontier with this?
• 8:42
  Speaker 1: Well, well, again, it's not the drug, it's the therapists.
• 8:45
  Speaker 1: It's the therapeutic relationship. So therapists are going to be
• 8:48
  Speaker 1: key to going forward. You know, according to the Veterans Administration,
• 8:53
  Speaker 1: not just among veterans, but there's thirteen million PTSD patients
• 8:57
  Speaker 1: in America alone, hundred and hundreds and hundreds of millions
• 9:01
  Speaker 1: of PTSD patients all over the world, and so therapists
• 9:05
  Speaker 1: are going to be key. However, when we talk about
• 9:08
  Speaker 1: for example, Rwanda or South Africa or Ukraine for example,
• 9:15
  Speaker 1: you know, war zones things that there's enormous amount of trauma.
• 9:18
  Speaker 1: There's not very many psychiatrists and therapists in these places.
• 9:23
  Speaker 1: So I think we're going to be expanding to looking
• 9:26
  Speaker 1: at nurses, to looking at other kinds of healers in
• 9:29
  Speaker 1: other places. But it's always going to be the case
• 9:32
  Speaker 1: that the context that is created by therapists or nurses
• 9:39
  Speaker 1: or even friends peer support. We do a lot of
• 9:43
  Speaker 1: work on peer support that they're going to be absolutely
• 9:47
  Speaker 1: essential because it's not. It's fundamentally different than the drugs
• 9:52
  Speaker 1: you get from your psychiatrists, which are meant to control
• 9:55
  Speaker 1: the symptoms, and you just take them on your own
• 9:57
  Speaker 1: at home on a daily basis. This is you take
• 10:01
  Speaker 1: them only a few times, the MDMA only a few
• 10:03
  Speaker 1: times with the therapist there the whole time during an
• 10:06
  Speaker 1: eight hour therapy session, and you go to the root
• 10:09
  Speaker 1: causes and try to reprocess. And then there's a whole
• 10:13
  Speaker 1: other new area of neurosciences called neuroplasticity. So what it
• 10:18
  Speaker 1: means is that psychedelics can open up what are called
• 10:22
  Speaker 1: critical periods where you can re format your brain in
• 10:28
  Speaker 1: a way, you process information in a different way, and
• 10:32
  Speaker 1: that's where the integration part comes in where you sort
• 10:34
  Speaker 1: of reinforce what happened during this session with the MDMA
• 10:39
  Speaker 1: and then you can reinforce it. So I think, as
• 10:42
  Speaker 1: we want to really scale this to address the enormous
• 10:46
  Speaker 1: trauma that exists in our world, there's also what's called
• 10:49
  Speaker 1: epigenetic trauma. So what that means is multi generational trauma.
• 10:54
  Speaker 1: There's been research that shows that trauma can be passed
• 10:59
  Speaker 1: down through the generations, so it's more like a set
• 11:02
  Speaker 1: point for anxiety or depression or things or fear. And
• 11:08
  Speaker 1: there's research that Rachel Judah has done at the bronx
• 11:11
  Speaker 1: DA with people who have received mdmasist at therapy, and
• 11:16
  Speaker 1: she's looked at the epigenetics before and after therapy, and
• 11:19
  Speaker 1: there's preliminary suggestions that successful therapy, and it doesn't necessarily
• 11:24
  Speaker 1: need to be through MDMA, but successful therapy can change
• 11:28
  Speaker 1: these epigenetic mechanisms so that we don't need to keep
• 11:32
  Speaker 1: passing this trauma down the generational line.
• 11:37
  Speaker 3: That is amazing, and you know they say it's seven
• 11:40
  Speaker 3: to fourteen generations back seven to generations or seven to
• 11:43
  Speaker 3: fourteen generations boards, so we can really shift the way
• 11:47
  Speaker 3: our genes are expressed right from day to day and disease,
• 11:52
  Speaker 3: and really people don't realize that it's only ten to
• 11:55
  Speaker 3: twenty percent of the role that our DNA plays in disease.
• 12:00
  Speaker 3: So epigenetics are huge and he so much. So that's
• 12:05
  Speaker 3: that's fantastic. And you know, sometimes when i'm you know,
• 12:10
  Speaker 3: speaking with a client who's interested in sitting with you know,
• 12:13
  Speaker 3: MDMA or any psychedelic but we're discussing MDA specifically, they
• 12:17
  Speaker 3: worry about perhaps losing control or being retraumatized. How is
• 12:22
  Speaker 3: this addressed in preparation?
• 12:26
  Speaker 1: Well, the first part about being re traumatized, that's what
• 12:31
  Speaker 1: I talked about in terms of the research that was
• 12:34
  Speaker 1: done with prolonged exposure and cognitive processing therapy. If you're
• 12:38
  Speaker 1: being asked to just go over and over and over
• 12:40
  Speaker 1: the trauma without even if you have a good therapeutic relationship,
• 12:46
  Speaker 1: that can be re traumatizing because it's been overwhelming before.
• 12:50
  Speaker 1: So the thing that addresses the re traumatization part is
• 12:55
  Speaker 1: this eight hour session because we are not asking people
• 13:00
  Speaker 1: to go to their trauma. We're saying to people, whatever
• 13:04
  Speaker 1: you're concerned about, whatever happens, whatever emerges, you can deal
• 13:08
  Speaker 1: with it in whatever time frame you want, so we
• 13:11
  Speaker 1: support what's emerging. We're not trying to move people to
• 13:15
  Speaker 1: the trauma. So I think when people have to engage
• 13:18
  Speaker 1: with the trauma too quickly, that can be retraumatizing. The
• 13:22
  Speaker 1: other part that makes it so that it's not so
• 13:26
  Speaker 1: retraumatizing is the MDMA itself, is that it reduces this
• 13:30
  Speaker 1: fear response so that these emotions and these memories can
• 13:34
  Speaker 1: be processed. And actually people remember more of the trauma
• 13:39
  Speaker 1: when they're under the influence of MDMA because parts of
• 13:42
  Speaker 1: it they've put out of their mind. And so we
• 13:44
  Speaker 1: have many many stories and people that are under MDMA
• 13:47
  Speaker 1: therapy and they've said, oh, I'm here because I was
• 13:51
  Speaker 1: in a war and this is my trauma. And then
• 13:53
  Speaker 1: you work through that, and then they start talking about
• 13:56
  Speaker 1: how when they were children they had an abusive father
• 13:59
  Speaker 1: and we're beaten up. And so a lot of times
• 14:02
  Speaker 1: people have put certain traumas out of their mind, and
• 14:05
  Speaker 1: so that MDMA can really help them process it in
• 14:09
  Speaker 1: a way so that it's not retraumatizing. The first part
• 14:14
  Speaker 1: of your question, though, was not about re traumatizing. It
• 14:16
  Speaker 1: was about the role the.
• 14:21
  Speaker 3: What was I saying, the role of what therapists, that
• 14:24
  Speaker 3: therapists will play in this.
• 14:26
  Speaker 1: Oh yeah, but it was after that, I'm sorry, it was.
• 14:31
  Speaker 2: Oh, preparation, how do we How is this addressed in preparation?
• 14:35
  Speaker 1: Yeah? Okay, So the key parts of the preparation and
• 14:40
  Speaker 1: usually in the experiment at least we would have three
• 14:42
  Speaker 1: ninety minute sessions roughly once a week. So the preparation
• 14:47
  Speaker 1: is to help people understand what MDMA does, to help
• 14:52
  Speaker 1: them understand that there's a basis of sort of basic
• 14:57
  Speaker 1: information about what their trauma was, what the issues might
• 14:59
  Speaker 1: come up. But it's more really about getting a feel
• 15:04
  Speaker 1: for whether the therapists and the patients are a good mex.
• 15:09
  Speaker 1: So occasionally in this preparation phase, for whatever reasons, either
• 15:14
  Speaker 1: the patient or the therapist will feel like they're not
• 15:16
  Speaker 1: a good match, and then they will find other therapists.
• 15:20
  Speaker 1: But the preparation is really very important about helping people
• 15:25
  Speaker 1: to feel that they are safe and supported. Oh also
• 15:30
  Speaker 1: losing control, That was what you think, Okay, So that
• 15:34
  Speaker 1: was the key part. So the preparation is to point
• 15:39
  Speaker 1: out that often the control is the problem because when
• 15:46
  Speaker 1: you keep things in control, but the fear is that
• 15:48
  Speaker 1: you get re traumatized. So it's to say that what
• 15:53
  Speaker 1: we like to say is that difficult is not the
• 15:55
  Speaker 1: same as bad. What's the difference between a difficult experience
• 16:00
  Speaker 1: in a bad experience as usually resistance or control, it's
• 16:04
  Speaker 1: keeping it in control. So both the drug and the therapeutic
• 16:08
  Speaker 1: alliance are there to try to help people feel that
• 16:13
  Speaker 1: there is this idea of losing control, but that you're
• 16:17
  Speaker 1: not out of control, but you're not suppressing feelings that
• 16:21
  Speaker 1: you think are overwhelming. Now you're able to process them.
• 16:25
  Speaker 1: So it's like you've built your capacity to have difficult
• 16:29
  Speaker 1: emotions flow through you. And so that's what the preparation
• 16:33
  Speaker 1: is for, so that the fear is that this is
• 16:36
  Speaker 1: a this is a safe place to quote lose control.
• 16:42
  Speaker 3: So by the time they actually sit with the medicine,
• 16:45
  Speaker 3: they feel resource, they feel like they're in a safe
• 16:48
  Speaker 3: enough container where if they quote unquote lose control, they're
• 16:53
  Speaker 3: with safe people to experience that. And generally speaking, it's
• 16:57
  Speaker 3: too therapists, right.
• 16:58
  Speaker 1: Yes, we often use male female. It's not always that way,
• 17:04
  Speaker 1: but yeah, there's two therapists because a lot of times
• 17:06
  Speaker 1: people who have PTSD have had childhood trauma and they
• 17:11
  Speaker 1: have like a well functioning male female team can be
• 17:14
  Speaker 1: really helpful. Again, we've sometimes to women to men, people
• 17:17
  Speaker 1: who don't identify with either gender in that way. But
• 17:23
  Speaker 1: we want it so that if one of the therapists
• 17:25
  Speaker 1: goes to the bathroom and somebody had this abandonment and
• 17:28
  Speaker 1: then they open their eyes and there's nobody there, that's
• 17:31
  Speaker 1: not so good. So we always want somebody to be there.
• 17:36
  Speaker 3: And for someone who hasn't sat with this medicine before,
• 17:41
  Speaker 3: eight hours probably seems like such a long time. For
• 17:43
  Speaker 3: those of us who have, it feels like it goes
• 17:46
  Speaker 3: it goes by like that.
• 17:47
  Speaker 2: Can you speak to that at all?
• 17:50
  Speaker 1: Yeah, Well, what we do is an initial dose. We
• 17:55
  Speaker 1: use the first MDMA session as eighty milligrams. The second
• 17:59
  Speaker 1: and third people can go up to one hundred and
• 18:01
  Speaker 1: twenty milligrams, but after two hours we add half the
• 18:04
  Speaker 1: initial amount, and that is precisely to make it longer,
• 18:08
  Speaker 1: to make the experience go longer. So again, this eight
• 18:12
  Speaker 1: hours is really protective. So if somebody feels like they're
• 18:15
  Speaker 1: approaching something and they feel like they're losing control. You know,
• 18:19
  Speaker 1: if you have an hour therapy session once a week
• 18:22
  Speaker 1: and you're thinking, oh, I got to make use of
• 18:24
  Speaker 1: all this time. But when you have an eight hour session,
• 18:27
  Speaker 1: you can approach something and you say I'm not ready
• 18:29
  Speaker 1: to deal with that, or I want to hold off
• 18:32
  Speaker 1: for a bit. You can do that and then you
• 18:34
  Speaker 1: come back around it at a later time. So it
• 18:38
  Speaker 1: has that kind of built in safeguard. And what people
• 18:42
  Speaker 1: feel is once it's like grief, you know, when people
• 18:45
  Speaker 1: are really someone that they love has died or something.
• 18:49
  Speaker 1: When you try to hold the grief in, you know,
• 18:52
  Speaker 1: it persists, but when you can cry and let it out,
• 18:57
  Speaker 1: you're processing the grief and then it moves from round
• 19:00
  Speaker 1: to background. So I think that's the way to say it. Now.
• 19:04
  Speaker 1: Actually I'll just tell one super fast story about one
• 19:07
  Speaker 1: of them.
• 19:07
  Speaker 2: Take your time, you know.
• 19:10
  Speaker 1: This was his first of three MDMA sessions, and what
• 19:13
  Speaker 1: he realized was under the influence of MDMA, he came
• 19:16
  Speaker 1: up with this insight that the PTSD was had something
• 19:21
  Speaker 1: good about it. It was the way that he showed
• 19:23
  Speaker 1: loyalty to their friends that had died. As long as
• 19:27
  Speaker 1: he was suffering, he had them in their mind, he
• 19:31
  Speaker 1: had them in his mind, I mean. And then what
• 19:34
  Speaker 1: he was able to do under the MDMA is see
• 19:38
  Speaker 1: himself from the eyes of his dead friends, and he
• 19:42
  Speaker 1: saw them saying to him, we cannot live. We don't
• 19:45
  Speaker 1: want you to honor us by being traumatized and not
• 19:49
  Speaker 1: able to do anything. You can honor us by living.
• 19:53
  Speaker 1: That would be better. And then he said, okay, what
• 19:57
  Speaker 1: am I going to do with the rest of my life?
• 20:00
  Speaker 1: And in that moment, he cured himself a PTSD because
• 20:03
  Speaker 1: he found a different way to honor his dead friends.
• 20:06
  Speaker 1: They could live through him rather than him suffering in
• 20:10
  Speaker 1: that way to show that he was connected to them.
• 20:12
  Speaker 1: And then he said, you know, I'm on opiates for pain,
• 20:16
  Speaker 1: but I don't really think I'm taking them for pain.
• 20:19
  Speaker 1: I don't need the opiates anymore. And then he said,
• 20:22
  Speaker 1: you know what, I don't even need the MDMA anymore.
• 20:24
  Speaker 1: I'm done. I want to drop out of the study.
• 20:27
  Speaker 1: And the researcher said, you can drop out anytime you want,
• 20:30
  Speaker 1: but would you do the two month and one year
• 20:32
  Speaker 1: follow up, which he did, and he did not have
• 20:35
  Speaker 1: PTSD at the two month, he didn't have it at
• 20:38
  Speaker 1: the one year, and that was about fifteen years ago
• 20:41
  Speaker 1: and he's still fine.
• 20:43
  Speaker 3: Oh, that's an incredible story. And you know I've said
• 20:48
  Speaker 3: this before, which is that grief. Feeling your grief won't
• 20:52
  Speaker 3: kill you. Not feeling it might because it festers.
• 20:55
  Speaker 1: Yes, that's exactly the point. That's exactly it.
• 20:58
  Speaker 3: It festers and ex our autonomic nervous system and our
• 21:01
  Speaker 3: immune system function, and our hormones.
• 21:04
  Speaker 2: And so much more.
• 21:05
  Speaker 3: And there's also I've noticed this this pattern sometimes where
• 21:10
  Speaker 3: you know, someone in our life has has passed away
• 21:13
  Speaker 3: and we have a lot of trauma around it, and
• 21:15
  Speaker 3: it's almost as though us suffering with that trauma is
• 21:18
  Speaker 3: how we stay connected to them. Yeah, like in this
• 21:23
  Speaker 3: in this case, and when in fact it's the other
• 21:25
  Speaker 3: way around. It's it's living in our joy, it's following
• 21:30
  Speaker 3: our joy, it's being in our joy and our healings.
• 21:32
  Speaker 3: So yes, thank you for that amazing story. That's that
• 21:37
  Speaker 3: tells you so much. And and I like what you said,
• 21:40
  Speaker 3: he healed himself like he healed his own pts. The
• 21:44
  Speaker 3: medicine just kind of you know, we say, the medicine
• 21:46
  Speaker 3: just kind of guides us to healing ourselves.
• 21:49
  Speaker 2: It doesn't it doesn't do it for us.
• 21:50
  Speaker 3: Of course, it sets things up in a really great
• 21:53
  Speaker 3: powerful way, especially with neuroplasticity and all of that.
• 21:55
  Speaker 2: But we do the work well.
• 21:57
  Speaker 1: And that's also true for the therapists. So the essence
• 22:00
  Speaker 1: of our method is that we are trying to help
• 22:02
  Speaker 1: people to heal themselves. Are there to provide a safe space.
• 22:07
  Speaker 1: The MDMA is there to help them process, but people
• 22:11
  Speaker 1: have to do the hard work. And then once you've
• 22:13
  Speaker 1: learned that you can process difficult things, then you can
• 22:17
  Speaker 1: do that on your own without the drug. So that's
• 22:20
  Speaker 1: where it's again different than classic pharmaceutical drugs where they
• 22:24
  Speaker 1: you take them every day for years. Sometimes we have
• 22:27
  Speaker 1: an intervention that several times is to teach people enough
• 22:31
  Speaker 1: skills and to feel self efficacy that they can process
• 22:35
  Speaker 1: and heal themselves. That then when they got out into
• 22:38
  Speaker 1: their life when new traumas happen, they won't be overwhelming,
• 22:43
  Speaker 1: they'll process them.
• 22:46
  Speaker 3: I love how empowering it is. And ultimately, whoever's listening
• 22:50
  Speaker 3: to this, you are the medicine. Sometimes we just need
• 22:52
  Speaker 3: that reminder and here's this, here's MDMA and here's therapy,
• 22:56
  Speaker 3: and both combined can totally be that reminder for you.
• 23:00
  Speaker 3: So for those listening right, accessibility is huge, Like you know,
• 23:05
  Speaker 3: how can I get this? How soon can I start
• 23:07
  Speaker 3: this type of therapy and work with this. I mean,
• 23:11
  Speaker 3: what can you tell folks who are listening, who you know,
• 23:14
  Speaker 3: don't know much about MDMA and where it is legally
• 23:17
  Speaker 3: at this point.
• 23:19
  Speaker 1: Well, it's it's unclear exactly what the FDA wants to
• 23:26
  Speaker 1: see in terms of additional information before they make it
• 23:29
  Speaker 1: available as a prescription medicine. So it could be six months,
• 23:32
  Speaker 1: it could be three years, it's not really clear. But
• 23:36
  Speaker 1: I do feel that it's important to say that the
• 23:39
  Speaker 1: drug war itself is counterproductive and I think it's a
• 23:44
  Speaker 1: fundamental violation of people's human rights to explore their consciousness. So,
• 23:49
  Speaker 1: you know, you put in the word legal, and so
• 23:53
  Speaker 1: unfortunately there is no place in the world where MDMA
• 23:58
  Speaker 1: is legal outs side of a research context. So you
• 24:01
  Speaker 1: can go to Oregon for psilocybin, you can soon go
• 24:04
  Speaker 1: to Colorado for psilocybin. You can go to Jamaica, you
• 24:07
  Speaker 1: can go to Costa Rica for psilocybin. You can go
• 24:09
  Speaker 1: to South America for ayahuasca. There's no place that people
• 24:12
  Speaker 1: can go for a legal MDMA experience unless it's in
• 24:16
  Speaker 1: a clinical trial, and so I think that that's really sad.
• 24:22
  Speaker 1: And what MAPS is about is sort of these two
• 24:25
  Speaker 1: parallel paths one is drug development to make mdmaint medicine
• 24:29
  Speaker 1: through the FDA and then have insurance coverage to cover
• 24:32
  Speaker 1: the cost of the drug and the therapy. But then
• 24:35
  Speaker 1: the other is to legalize drug policy reform so people
• 24:38
  Speaker 1: could do it on their own or with friends, or
• 24:40
  Speaker 1: you know, without all of this. So I think right
• 24:44
  Speaker 1: now people have to really decide for themselves. You know,
• 24:51
  Speaker 1: is the legal status critical to you. If so, you're
• 24:54
  Speaker 1: going to have to wait for a bunch of years
• 24:57
  Speaker 1: or six months or we don't know exactly how long,
• 24:59
  Speaker 1: but it's going to be wait unless you're in a
• 25:01
  Speaker 1: research project. But if you can think about the laws
• 25:06
  Speaker 1: as some are good laws, some are bad laws. The
• 25:08
  Speaker 1: drug war is a bad law, it's counterproductive, then the
• 25:12
  Speaker 1: question is finding a good MDMA. So there are test
• 25:17
  Speaker 1: kits you can go to, dance safe things like that
• 25:19
  Speaker 1: to find that out.
• 25:21
  Speaker 3: Yeah, harm reduction model definitely ensure that if you are
• 25:24
  Speaker 3: going to take anything that it isn't mixed with something
• 25:28
  Speaker 3: you wouldn't want in your body.
• 25:30
  Speaker 1: Yeah, and also, sorry to interrupt, but there's the treatment Manual,
• 25:34
  Speaker 1: which is what describes our therapeutic approach. So it's up
• 25:39
  Speaker 1: for free on the maths website. It's called the Treatment Manual,
• 25:43
  Speaker 1: and that gives you a sense of these are sort
• 25:45
  Speaker 1: of the instructions to the therapists of how to work
• 25:48
  Speaker 1: with someone through the study, and that would be helpful
• 25:51
  Speaker 1: for people to read.
• 25:52
  Speaker 2: Thank you for that.
• 25:53
  Speaker 3: That is amazing, you guys, You guys are amazing in general,
• 25:56
  Speaker 3: but that you have that out for public knowledge and use,
• 25:59
  Speaker 3: I appreciate that. And speaking of therapists, so well, let
• 26:03
  Speaker 3: me go back. So for someone who wants to be
• 26:05
  Speaker 3: a part of a clinical trial, how do they do that?
• 26:07
  Speaker 2: How do they go about that?
• 26:08
  Speaker 1: Well, that part it's easy to figure out. So clinicaltrials
• 26:12
  Speaker 1: dot gov. Clinical trials dot gov. So it used to
• 26:17
  Speaker 1: be that pharmaceutical companies, well, pharmaceutical companies have to have
• 26:22
  Speaker 1: two Phase three studies that are proof safety and efficacy.
• 26:26
  Speaker 1: But you just need two of them, and a lot
• 26:28
  Speaker 1: of them. Companies used to like do five or six
• 26:30
  Speaker 1: studies and you'd never hear about the ones that failed,
• 26:34
  Speaker 1: never publish them, but you'd only hear about the ones
• 26:36
  Speaker 1: that succeeded. And that's all that they would submit to
• 26:38
  Speaker 1: the FDA as a response. Because people felt they weren't
• 26:42
  Speaker 1: getting the right information. Clinical trials dot gov was set
• 26:45
  Speaker 1: up so that when you're doing an FDA approved trial,
• 26:48
  Speaker 1: it has to be listed under Trials dot gov. So
• 26:51
  Speaker 1: if you go there, you can put in your MDMA
• 26:56
  Speaker 1: or LSD, or psilocybin or depression or PTSD and it
• 26:59
  Speaker 1: will and you will find all the clinical trials that
• 27:03
  Speaker 1: are being conducted with that condition or with those drugs,
• 27:07
  Speaker 1: or that condition with this drug in this state, so
• 27:11
  Speaker 1: that you can use clinical Trials dot gov as a
• 27:13
  Speaker 1: major resource.
• 27:15
  Speaker 3: Great and for therapists psychologists who want to learn more
• 27:21
  Speaker 3: about psychedelic assist A therapy. MAPS does offer trainings. How
• 27:26
  Speaker 3: can they get involved in that if they're interested in
• 27:29
  Speaker 3: being properly trained?
• 27:31
  Speaker 1: Yeah, well we've got you can go to the map's website.
• 27:35
  Speaker 1: I'm leaving in a couple weeks for Ukraine. We're training
• 27:40
  Speaker 1: Ukrainian therapists. Wow, we've got trainings all over the way.
• 27:45
  Speaker 1: We've had trainings in Sarajevo, in Iceland and Australia and Israel.
• 27:50
  Speaker 1: We're planning one in Poland in Switzerland. So you can
• 27:54
  Speaker 1: go to the map's website and look at training. But
• 28:00
  Speaker 1: there's not that many opportunities. We haven't had trainings in
• 28:06
  Speaker 1: the United States for a while. One of the best
• 28:08
  Speaker 1: things they could do is to consider coming to Psychedelic
• 28:11
  Speaker 1: Science twenty twenty five. So this is June sixteenth to
• 28:14
  Speaker 1: twentieth in Denver, and we're going to have workshops from
• 28:18
  Speaker 1: our leading therapists so you can get a short version
• 28:21
  Speaker 1: of the training. The basic training is six days and
• 28:25
  Speaker 1: it's for fifty or fifty five people at a time,
• 28:28
  Speaker 1: and it goes over the treatment manual what we call
• 28:31
  Speaker 1: adherence criteria, core competencies, watch videotapes of therapy sessions, do
• 28:37
  Speaker 1: role play a lot of different exercises and discussions. Then
• 28:44
  Speaker 1: the second part is optional will always be optional, but
• 28:48
  Speaker 1: it's for therapists to take the medicine themselves in a
• 28:51
  Speaker 1: therapeutic setting as if they're the patient, and that's one
• 28:54
  Speaker 1: of the best ways to learn. It's like you would
• 28:56
  Speaker 1: never go to an ayahuasca shaman that had never done ayahuasca. Well, yeah,
• 29:02
  Speaker 1: so we have had FDA PREW protocols. That's again only
• 29:06
  Speaker 1: in a protocol and it will never be required, only encouraged,
• 29:11
  Speaker 1: strongly recommended, but never required. And then the third part
• 29:15
  Speaker 1: is once people work with their first PTSD patients, ideally
• 29:19
  Speaker 1: it gets at least in our research, it's all videotaped,
• 29:22
  Speaker 1: and then we have supervisors review the videotapes and give
• 29:26
  Speaker 1: the feedback to the therapist to see to help them
• 29:29
  Speaker 1: really fine tune the treatment manual, and then they're free
• 29:34
  Speaker 1: to practice however they want, you know, to add different
• 29:37
  Speaker 1: things like that. So I think the treatment. I will
• 29:42
  Speaker 1: recommend a video called Trip of Compassion. Trip of Compassion.
• 29:47
  Speaker 1: It's on vimeo. It's the most patient centered video ever
• 29:51
  Speaker 1: made about mdmasis At therapy. So it's about three of
• 29:54
  Speaker 1: the Israeli patients. It's mostly in English, the parts of
• 29:58
  Speaker 1: the Hebrew have English subtitle else and it's gonna be
• 30:03
  Speaker 1: a really good education and how the therapy actually works.
• 30:07
  Speaker 2: Okay, great, I didn't even know that existence. So I
• 30:10
  Speaker 2: appreciate that, yeah, for you know, for when this