MDMA Psychotherapy Revealed

Article and video How Clinical Trials Are Making the Case for MDMA in Psychotherapy.

Below, excerpts from another article, MDMA Assisted Psychotherapy: How Different is it from Other Psychotherapy?

Caveat: No one knows how any psychiatric treatment, psychotherapy, or psychopharmacology actually works, even when we understand the essential elements or many of the physiologic essential elements or many of the physiologic effects.

MDMA-assisted psychotherapy is especially complicated in this regard because it combines psychotherapy and psychopharmacology.

In the meantime, our observations about possible therapeutic mechanisms are speculative, based on clinical observations.

THE GUIDELINES:

• Establishing a Safe and Supportive Therapeutic Setting and a Mindset Conducive to Healing: The effects of MDMA appear to increase the likelihood that participants will be able to maintain enough trust in the therapists and a broad enough perspective about their own inner experience to process their fears without emotionally or physically withdrawing from the therapeutic alliance.
• Emphasis on FEELING rather than thinking: Anxiety Management Training/Stress Inoculation Training, Prolonged Exposure. and EMDR are used along with methods such as mindful diaphragmatic breathing.
• Exposure Therapy: Revisiting traumatic experiences through "imaginal exposure" is accomplished by asking the participant to repeatedly read or recite an account of their traumatic experience. Therapists can bring up the trauma if it does not come up spontaneously, but in almost 100 research sessions we have never had to.
• Cognitive Restructuring: In MDMA-assisted psychotherapy, cognitive restructuring may result from dialogue with the therapists using elements of CBT, psychodynamic therapy, and other methods according to the individual therapists’ training and experience as allowed for in our research Treatment Manual. Our largely nondirective approach often results in spontaneous cognitive restructuring resulting from qualities engendered by MDMA: increased mental clarity, confidence, and the courage to look honestly at oneself.
• Transference and Countertransference: Becoming aware of often unconscious feelings that arise in the client toward the therapists and vice versa.  We know that participants taking MDMA can be exquisitely sensitive to verbal and nonverbal expression from the therapists, and we encourage honesty and openness about any feelings that arise. The effects of MDMA appear to increase the likelihood that participants will be able to process their fears without emotionally or physically withdrawing from the therapeutic alliance.
• Somatic Manifestations of Trauma: MDMA-assisted psychotherapy often includes focusing attention on body sensations and using breath and movement to facilitate awareness, expression and release of tensions, or pains in the body that may be associated with the trauma.

Possibility of legal Psilocybin in California

It is possible that the California Psilocybin Mushroom Decriminalization Initiative (2018) could be on the ballot in November 2018.

The measure would "decriminalize use, possession, sale, transport, or cultivation of psilocybin (a hallucinogenic compound) by persons at least 21 years of age."

Psilocybin for Depression

Peter Thiel is betting on magic mushrooms to treat depression — and he's not the only one

• A for-profit company that Peter Thiel invests in has plans to start clinical trials of magic mushrooms for depression within the first three months of 2018.
• Psychedelics appear to disrupt the brain's activity patterns in a positive and life-changing way.
• Several research institutions are studying psychedelics for their potential to treat depression, anxiety, addiction, and PTSD.

Mind's Eye Blink

‘Mind’s eye blink’ proves ‘paying attention’ is not just a figure of speech.  The attention gaps being studied are reminiscent of cessations experienced by advanced meditators.

Psilocybin & Meditation Study Making Progress

The researchers at Johns Hopkins have finally accumulated their target of 40 long term meditators not previously exposed to psilocybin.

“There was a participant in the study who had had an extensive, extensive practice, like tens of thousands of hours of meditation, which is an incredibly extreme amount,” said Frederick Barrett, PhD at the Johns Hopkins Department of Psychiatry and Behavioral Sciences. “And she indicated after her psilocybin session that she relived all of the peak experiences she had ever had meditating. Wow.”

Largest Psilocybin Dose in an FDA Study

This is the personal account (i.e. trip report) of a participant in a phase I clinical trial for psilocybin.  If I were to map this onto a Buddhist progress of insight map, it sounded like the person was dealing with the unsatisfactory states in the first two trips and in the 3rd trip described here finally broke through into equanimity.

I was pure awareness, but there was no awareness. I was pure consciousness, but there was no consciousness. There was a sense of pure wisdom and knowledge, but there was no wisdom or knowledge. It was a state of perfection, but there was no perfection. There was no desire. There was no emotion. There was no bliss. No oneness. No unity consciousness. There was nothing. This state was a perfect state. This state, which was not a state, was above all.

The trial used three increasing doses, 0.30 mg/kg, 0.45 mg/kg, and 0.60 mg/kg.  For a typical 70 kg person, this would equate to a dried mushroom dose of around 3.5 grams, 5.3 grams, and 7.1 grams.  This person can claim the "highest" dose because they were heavy, around 98 kg.

And this was an FDA study.  There is an unpublished UNM study that Rick Strassman was involved with that used even higher doses of 0.90 mg/kg and 1.10 mg/kg, for reference our 70 kg person would be taking around 11.2 and 13.8 grams of dried mushrooms, some prodigious doses.  It should be noted that at the highest dose they noted that a "confusional state" was induced.

How To Meditate

I've added some material on How To Meditate over at the other blog, also linked here at the top right.  The material is the equivalent of a small pamphlet, and includes the best advice I could come up with for a do-it-yourself-er.

Mushroom Retreats in Jamaica, Costa Rica, Netherlands

Inside the growing world of all-inclusive magic mushroom retreats

For the past decade or so, there have been retreats in South America for ayahuasca, Ibogaine escapes in Africa, and peyote spirit quests in the United States. However, until recently, there’s been nothing similar for magic mushrooms.

But, in places like Jamaica, Costa Rica and Holland, where the fungus was never banned, opportunistic fungus-lovers and entrepreneurs have finally begun to offer mushroom retreats — hallucinogenic trips for everyone from plumbers to psychonauts that allow people to explore the benefits of psilocybin in safe, legal, vacation-like settings.

Psilocybin and Depression

Magic mushrooms may 'reset' the brains of depressed patients.  In a small trial, treatment resistant depression was lifted for several weeks after 2 sessions with psilocybin.

Consciousness and the Self

The Nature of Consciousness: A Conversation with Thomas Metzinger on Sam Harris' Waking Up podcast.

Intellectual discussion on topics relating to consciousness and the self  between two long time meditators, neuroscientist Sam Harris and neurophilosopher Thomas Metzinger.

Enduring Changes with Psilocybin Use

Psilocybin-occasioned mystical-type experience in combination with meditation and other spiritual practices produces enduring positive changes in psychological functioning and in trait measures of prosocial attitudes and behavior.

This is an outcome from the attempt to mix psilocybin use with meditative/spiritual practice.

High-dose groups showed large significant positive changes on longitudinal measures of interpersonal closeness, gratitude, life meaning/purpose, forgiveness, death transcendence, daily spiritual experiences, religious faith and coping, and community observer ratings.

Will Psychedelic Therapy Transform Mental Health Care?

Will Psychedelic Therapy Transform Mental Health Care?

"Unlike almost all other psychiatric medications that have a direct biological effect, these drugs seem to work through biology to open up a psychological opportunity"

During treatment, patients typically don headphones for music and eyeshades and then lie down. They’re encouraged to go as "deep" as possible into the experience. As the session ends and the hallucinogenic effects wear off, patient and therapist discuss the experience. Follow-up psychotherapy sessions facilitate lasting results.

The Psychedelic Experience

Good basic and graphical overview of information about major psychedelic drugs in The Psychedelic Experience.

Psychedelics And Mental Health

Psychedelics And Mental Health: nice overview of research into depression, anxiety and addiction.

Details on MDMA's Phase 3 Clinical Trials

MDMA Advances Another Step As Tool to Treat PTSD.

I found it interesting, and compassionate, that those who end up in the placebo control group will have the option to repeat the therapy process with MDMA.

Results from Phase 2:

• Therapy alone: 23% remission
• Therapy plus 1 MDMA session: 55% remission
• Therapy plus 2 MDMA sessions: 61% remission
• One year out after MDMA sessions: 68% remission

Acceptance is important - some interesting comments:

As a result of both his clinical and imaging work, Nutt has concluded that the common characterization of MDMA as similar to LSD and psilocybin is wrong both in terms of its psychodynamic effects and its effects at the receptor sites. While psilocybin and LSD work through the 5HT2A receptor system, said Nutt, MDMA “dampens down the limbic system—probably through the 5H1A receptor.” MDMA acts so differently that it should not be compared with these other drugs, said Nutt. Rather, it is more accurately characterized as “an empathogenic and anxiolytic.”

 “Unlike the classical psychedelics, which appear to work on depression “by breaking down persistent ruminations, MDMA helps those suffering from PTSD break down their trauma by confronting it,” Nutt commented. “What we think is that under MDMA, the emotions are not so powerful, so people can endure them better.”

Jim Carrey seems to Get It

"There's just a relative manifestation of consciousness appearing" (Youtube, 2 minutes)

He gets a little crazy in some other videos, but this one is pretty spot on.  And, BTW, he is not playing Terence McKenna in an upcoming movie.

The Importance of Acceptance

Carnegie Mellon Study Shows Mindfulness Meditation App Works—But Acceptance Training Component Is Crucial.

"Rather than fighting to get rid of unpleasant feelings, welcoming and accepting these feelings during stressful moments is key."

4 Rituals for Happiness

Advice on happiness from neuroscientist Alex Korb.

Summary:

• Ask “What am I grateful for?” No answers? Doesn’t matter. Just searching helps.
• Label those negative emotions. Give it a name and your brain isn’t so bothered by it.
• Decide. Go for “good enough” instead of “best decision ever made on Earth.”
• Hugs, hugs, hugs. Don’t text — touch.

Notice the noting style instruction to label your felt experience.

Do Nothing For 2 Minutes

Do Nothing For 2 Minutes.  An opportunity to meditate?  A challenge?  A break?  Betcha can't.  If you last it out, it takes you to a book and app called Calm.

On the Construction of a Self

Nice video on the construction of the Self.

Western psychology holds that humans are not born with a sense of self, but rather that the self is constructed over time, gradually emerging within the first two years of life. Further, much scientific research says that everything that exists in human awareness – sight, sound, even time itself – is all a construction of the mind. So what are the pitfalls of treating these constructs as objective truths? According to Mahāmudrā Buddhist teaching, explored here by the clinical psychologist Daniel Brown at Harvard University, the more enamoured we are of our selves, the more fixed we are in our own ‘realities’, limiting the possibilities of our awareness. Playing with these reflections on the self and awareness, the San Francisco-based animator Claudia Biçen uses a series of ink-and-pencil portraits of Brown to bring him into being and then let him disappear.

Research Identifies 27 Emotional Categories

In the wake of research that tended to reduce the number of basic emotions down to sometimes four (mad, glad, sad, afraid), a recent study found 27 unique categories of emotions.  Probably useful from the standpoint of noting meditation.  From the study:

Talking to Yourself in 3rd Person & Emotions

The study "talking to yourself in the third person can help you control emotions" reveals that this form of distancing oneself from emotions can alleviate emotional suffering.  This is not particularly surprising given that this is a very literal form of de-identifying and detaching, similar to the goals of meditation.  It also reminds me of one of my recommended practices, thinking out loud, which in itself is related to noting practice (link at right).

Part of the study included an inquiry type practice of "what is [Participants’ Name] feeling right now?"

Emotions may be more changeable than we thought

Radical Theory Overturns Old Model of How Emotions are Made.

According to Barrett, emotions aren’t reactions to the world. Rather, emotions actually construct our world.

Meditation continues to show benefits

General article on recent research showing reductions in stress, etc.

Ecstasy now FDA Breakthrough Drug for PTSD

Ecstasy Was Just Labelled a 'Breakthrough Therapy' For PTSD by The FDA.  We are now that much closer to stage 3 clinical trials for MDMA.

This on the heels of recent research showing that MDMA facilitates changes in basic personality traits such as openness and neuroticism, traits that were previously thought to be fixed in adults until psilocybin was shown to make people more open.

Testing Psychedelic Microdosing

Small amounts of psychedelics, often below a threshold that would make the user feel significantly altered, are said to be a useful cognitive and mood enhancer.  The Plan to Prove Microdosing Makes You Smarter describes the Beckley Foundation's plan to test how well people do on the task of playing the game Go while using microdoses of LSD.

I have one data point for this.  Back in the day, several decades ago, during my one and only experience with LSD, I played the arcade game Asteroids.  It was a strange experience because it didn't seem like "I" was playing.  I was looking at the screen, my hands were touching the controls and moving, but it was as if "I" had no part in it.  It was just happening as I watched, there was no conscious intent, cognition, planning, or strategy.  It was just happening.  And I got my highest score ever, before or since, by about 30%.  I think sometimes it can be helpful to get the conscious mind out of the way and just let the underlying mind do what it does without interference.

In my own experience, which is maybe unique in a way, I don't particularly care for microdosing.  Once I became "good" at meditation I became much more sensitive to psychedelics.  My standard dose became on average a tenth of what it was before.  And when I microdosed, even down to as little as 1/200 of my previous standard dose, I noticed it.  In my case I'd just as soon do without it, or go to my "full" dose rather than go halfway.

Buddhist Geeks - Meditating on Psychedelics

I was interested to see this podcast show up, both because of the subject matter (Meditating on Psychedelics), and the fact that for me it marked the return of Buddhist Geeks, a podcast that had been more or less pronounced dead.

Apparently this was an introductory podcast to usher in a series of episodes on the topic, which in theory I look forward to.  This was a fairly lukewarm, delicate, kind of "make sure we're not stepping on anyone's toes" kind of thing, mainly focusing on the need to be flexible and open about what is for some a controversial topic.  It is what it is.  The last 20 percent of the podcast was a plea for funding, which I understand, but sheesh.

A survey had been sent out to followers to gauge where people are on the subject of Buddhism and psychedelics.  For myself, I didn't feel like I fit into any of the categories and it's not as if I have no views on the subject.  To me it's kind of like anything else - psychedelics are neither "good" nor "bad".  There is an entire spectrum of experiences.  After listening to the podcast and decoding the thrust of the survey I would have to pick the "Psychedelic Buddhist" category, which is essentially a "maybe" category, saying “yes to the mixing of the Psychedelics and Buddhism and at the same time acknowledging that there are downsides, things to watch out for, and much that is still not well understood about the pairing."

I do sincerely wish that every person could get to the point where they could feel good about themselves, become familiar with their psychological makeup, maybe do a bit of meditation, and slowly work up to a psychedelic experience starting from low/medium doses in a safe setting, keeping in mind the advice from any number of reasonable Psychedelic Trip Guides.

My view might be something like Sam Harris', who when thinking about his daughter growing older and experimenting with substances, felt that his greatest fear was that his daughter wouldn't try a psychedelic at some point.  Of course Sam is perhaps being strong in making a point, but the fear is that to live a human life, and to not experience what is possible, and perhaps even probable given the considerations above, the unimaginable power, glory, and freedom of a genuine mystical experience, that would indeed be a tragedy.  Your mileage may vary.

As to the Buddhist or spiritual direction, I would say the psychedelic experience is indeed conducive to these kind of insights, and more generally insights of any kind.  The other side of that is that the mind may be presented with so many ideas and connections that it may tend to run off into those and lose itself in them.  Keeping the mind in a meditative mode while under the influence of a psychedelic is actually the best way to raise the odds for an amazing experience.

As far as the BG podcast, a bit more "meat" in the form of some surprising views from Vince Horn on the subject of Buddhism can be found in the previous episode Stirrings from the Bardo.

Your Brain Hallucinates Your Reality

No human being has ever experienced anything other than their own consciousness.  The universe we experience is a map of what may or may not be "out there".  This is the insight being pointed at in Your Brain Hallucinates Your Reality on YouTube.

Ketamine produces anti-anxiety effects

 

Ketamine, the dissociative anesthetic with psychedelic properties,

"can reduce symptoms of treatment–resistant anxiety disorders.

Previous research had found that ketamine produced an antidepressant effect in patients with treatment-resistant major depressive disorder. The new study provides the first evidence that ketamine improves symptoms of anxiety in patients with treatment-resistant anxiety who are not currently depressed."

Psilocybin helps depressed patients ‘re-connect’ to the world

Study: Psychedelic drug psilocybin helps depressed patients ‘re-connect’ to the world

“The reset switch had been pressed so everything could run properly, thoughts could run more freely, all these networks could work again. It unlocked certain parts which were restricted before,” one participant explained.

“I got a wider perspective, I stepped back. It helped me appreciate that the world is a big place that there’s a lot more going on than just the minor things that were going on in my head,” another participant told the researchers.

A third remarked: “My previous treatments, talking therapy and meds, were next to useless, utterly useless. My experience of psilocybin has been very positive. I believe there is an unknown physiological and neurochemical change in me, I am absolutely convinced of that.”

Talks

I seem to be posting meditation type writing/ranting over at the other blog, so for those who are interested, here are some thoughts:

What Is Spiritual Enlightenment?

Upping Your Game

It's Not About Thinking With Your Eyes Closed

2017 Psychedelic Science videos

Apparently the entire 2017 Psychedelic Science Conference has been uploaded in video form, a staggering amount of video.

Higher Consciousness on Bicycle Day

Evidence for a so-called "higher" (or different) state of consciousness was published today, on the 74th anniversary of the first human LSD experience.

The entropy or diversity of EEG signals has successfully been used as a measure of consciousness, with lower levels indicating sleep or anesthesia and higher levels indicating wakefulness.  Experimenters found that this measure of entropy was higher under the influence of several psychedelics.

Finders Course Techniques and Protocol

This Finders Course Techniques and Protocol post on Reddit contains some of the best estimates about what constitutes the Finders Course.  I have been interested in the course due to both the unusual and specific research efforts and the results of the participants.  The post also contains a reasonable amount of information about the controversial background of the course founder.

I found the group awareness exercise where a small group (over video chat) attempts to discuss awareness itself, to be very interesting, kind of a participatory direct pointing exercise that I felt could be very useful, if a bit difficult.  The videos of this exercise are being rapidly taken down apparently as a result of the post.  2 out of 6 are still available as of this writing.

I had spent a lot of time attempting to suss out the contents of the course myself, and had stumbled onto most of the same material.  In part, it inspired me to provide a bare bones guide to these greatest hits of the meditation world in the Basic Meditation Styles post on the other blog, also linked at the upper right.

Again, what I saw happening in the group awareness exercise, that's a very interesting exercise and it's something that I imagine helps keep people motivated and on track, because it gets people to address the key "direction" of meditation in a very direct way and it provides some social pressure to really delve into it.

I suspect the group activities as well as the weekly accountability and the cost of the program to be vital in motivating people to commit to a substantial amount of daily practice.

Dan Harris interviews Shinzen Young

Dan Harris, author of 10% Happier, interviews Shinzen Young. One of the better interviews with Shinzen, an American who became fascinated with Japanese culture at an early age, leading him eventually to Japan and the study of Zen and Shingon. Within Buddhism, Shinzen would be considered one of the pragmatic crowd.

Dan Harris interviews Vince Horn

Dan Harris, author of 10% Happier, interviews Vince Horn, founder of Buddhist Geeks and Meditate.io.  Vince offers up some good content from a pragmatic perspective while describing his experience on the path.

Roland Griffiths on Psilocybin, Psychedelic Therapies & Mystical Experiences

Roland Griffiths on Psilocybin, Psychedelic Therapies & Mystical Experiences (Youtube, 75 minutes) is probably one of the more wide ranging interviews with Griffiths, covering a large breadth of material.  Perhaps a few new scraps in addition to the usual information.  I'm kind of amazed at how prolific Griffiths is with these outreach interviews and talks.

Mind not confined to body

Scientists say your “mind” isn’t confined to your brain, or even your body.

After much discussion, they decided that a key component of the mind is: “the emergent self-organizing process, both embodied and relational, that regulates energy and information flow within and among us.” It’s not catchy. But it is interesting, and with meaningful implications.

The most immediately shocking element of this definition is that our mind extends beyond our physical selves. In other words, our mind is not simply our perception of experiences, but those experiences themselves. Siegel argues that it’s impossible to completely disentangle our subjective view of the world from our interactions.

Tabloid reporting of EEG + Psychedelics

The article "brains of stoned scientists challenge old stereotypes about drugs" reports on several intrepid travelers, including myself, who experimented with various combinations of drugs and EEG biofeedback.  I am slightly dismayed with the spin and slight misquotes, but I guess that's the way it works.  Close enough, I suppose.

Brains of stoned scientists challenge old stereotypes about drugs - See more at: http://www.therooster.com/blog/brains-stoned-scientists-challenge-old-stereotypes-about-drugs#sthash.Zze9ZTYn.dpuf

Brains of stoned scientists challenge old stereotypes about drugs - See more at: http://www.therooster.com/blog/brains-stoned-scientists-challenge-old-stereotypes-about-drugs#sthash.Zze9ZTYn.dpuf

Mapping the Mindful Path

Mapping the Mindful Path is Vincent and Emily Horn's version of the stages of mindfulness practice first outlined in the Theravada Progress of Insight.

They see it as:

• Seeking
• Breakthrough
• Disillusionment
• Resilience
• Completion

This material is presented as part of an apparently free course.  If you click on the top video at the link it will play through 5 short videos describing the stages, about 10 minutes total.