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The Guardian - US
The Guardian - US
Katherine Rowland

Thanks to this man, MDMA could soon be legal for therapy

Commanding the stage in an all-white suit and looking like a Graham Greene character or a televangelist, Rick Doblin, an unlikely guru months shy of his 70th birthday, welcomed a roaring crowd to “the psychedelic twenties”.

Doblin is the founder and president of the Multidisciplinary Association for Psychedelic Studies (Maps), which sponsored last summer’s Psychedelic Science conference in Denver, Colorado, where more than 12,000 people gathered for the event.

Since first experimenting with LSD as a college student in Sarasota, Florida, Doblin has been convinced that psychedelics are an antidote to the world’s greatest threat: the capacity for evil, greed and plunder that lies in the heart of man. He created Maps in 1986 as a way to advance “mass mental health” and “spiritualized humanity”.

In practical terms, that has meant advocating for the legal use of mind-bending compounds for recreational, mystical and psychotherapeutic purposes.

From the start, Maps has focused in particular on mainstreaming MDMA, known in the party scene as ecstasy and in segments of the therapeutic community as “penicillin for the soul”.

What once seemed improbable is now coming into view. In December, Maps and its spin-off pharmaceutical company Lykos submitted a new drug application for MDMA-assisted therapy to the FDA, making it the first psychedelic to be considered as a therapeutic product. If approved and successfully rescheduled, it could be legally available later this year. In January, the company received $100m in private equity funding to help support the task of bringing psychedelics into the mental healthcare market.

I spoke with Doblin over Zoom. Our conversation has been edited and condensed for clarity.

What first drew you to work in this field?

Rick Doblin: Let me start by saying that I am the oldest of four kids, Jewish family, and I was deeply disappointed by my bar mitzvah. When you’re 13 years old you think, OK, I’m going to do this ritual and somehow I’m going to be different at the other end of it. And I wasn’t. I was exactly the same.

When I first tried LSD at 17, I was like, this is what my bar mitzvah should have been. It brought up all these existential questions: who am I? Where do I fit in? How do I deal with my emotions?

I felt that psychedelics are the rites of passage that we need.

What happened next?

Rick Doblin: I was immature and wasn’t emotionally evolved and I had all these difficult [psychedelic] trips. But I had an intuition that this process could be helpful.

My guidance counselor at college gave me a book by Dr Stanislav Grof, Realms of the Unconscious: Observations from LSD Research and that changed my life. I thought, OK, I’m going to be a therapist. But first, I had to work on myself. I wasn’t capable of helping other people because I was such a mess. I dropped out of school at age 18, but knew that I would come back.

When I started school again 10 years later in 1982, I went to Esalen [a spiritual retreat center in Big Sur, California] and spent a month with Stan Grof. That’s where I learned about MDMA. I had learned about LSD after the backlash [the US government made LSD illegal in 1968]. Now I was learning about MDMA before the backlash and I thought, OK, I can get involved.

On the weekends, those of us who were interested would do psychedelics, secretly. It wasn’t part of the official program, but we would sit for each other. We were learning to be psychedelic therapists.

I imagine that a lot of people don’t know that MDMA was used in psychotherapy before it was banned in 1985.

Rick Doblin: From the middle of the 1970s to the early 1980s, it was used by around half a million patients. Therapists and psychiatrists were working with it in a quiet way under the name “Adam”, which was the code name developed for it. It sounds like a scramble of MDMA, but it was also meant to evoke images of the Garden of Eden and the state of innocence, openness and honesty.

Near the end of that period, it escaped from those contexts and became marketed as ecstasy. That’s what attracted the attention of the federal government and led to the crackdown.

MDMA was a therapy drug before it became a party drug. And so it’s helpful to say we’re trying to restore it to what it was. At the same time, and what’s complicated for us, is that we want it to be a party drug that’s legal.

As I understand it, you were involved with the Spiritual Emergence Network, started by Stan and Christina Grof as a way to help mental health professionals understand psycho-spiritual growth.

Rick Doblin: In early 1984, I went to a month-long workshop as part of my training to become a therapist.

I had sold a friend of mine some MDMA and he had done it with a girlfriend – this was back when MDMA was legal. During their experience, past trauma came up that his girlfriend had buried.

She’d almost been killed. Raped. Terrible situation. She had found some sort of balance, but under MDMA, the trauma came back to her and she was unable to process it. She was so distraught she checked herself into the emergency room in order to not kill herself. They stabilized her, but they gave her the same drugs that had never worked before. When she got out, she was more suicidal than before.

So my friend calls me and says, can you help? And I’m like, I’m not qualified. I’m learning. This woman is suicidal. This is super serious.

But I’d just come back from the Spiritual Emergence training to do exactly this. I had a bit of a responsibility because I sold them the MDMA. More importantly, there was nothing that she could do in traditional psychiatry that she hadn’t already tried. And it hadn’t worked.

I agreed to talk to her on the phone and and during this conversation I said, will you promise not to kill yourself while we’re working together? And she made that promise. And then she came down and, with other women friends of mine, we got a safe space for her. We did two sessions – once was MDMA and once was an LSD-MDMA combination, and it worked. It broke the spell of this trauma and she was able to rebuild her life.

How did your training prepare you for this experience?

In traditional psychiatry, you are trained to think of trauma as a process that must be stopped or tranquilized. You want to pull people away from it, and help control and minimize the symptoms.

Whereas the approach of the Spiritual Emergence Network is that these are symptoms of a healthy process, you need to let them fully manifest and integrate them, rather than just try to squash it all down. You trust that there’s a healthy process wrapped into this disintegration.

How has the therapy component evolved over the decades?

Rick Doblin: Basically not at all. There’s two parts to it. One is: trust the process.

Even though we don’t recognize it, there is an inner healing intelligence of the psyche. Through all these billions of years of evolution, we know our body heals itself below our level of conscious awareness.

The other part is: who’s doing the healing. It’s not the therapist doing it. We’re not surgeons going in there and taking out stuff. We are helping the patient heal themselves by creating a safe context for them to do this internal work. That’s the essence of it, and it has stayed the same.

Ultimately, you did not go the route of becoming a therapist.

Rick Doblin: I switched my career from trying to be a psychedelic therapist to studying policy. But what I’m really doing is psychotherapy for sick public policies.

I see a parallel between the work of psychotherapy for an individual and cultural change related to psychedelics.

Your work spans drug development and drug policy reform. How would you describe your overarching mission?

With the enormity of trauma and PTSD in the world, what is our real mission?

Humanity as a whole is like lemmings going off a cliff. And we tend to do our very best to procrastinate. We’re procrastinating about deadly things like climate change, the spread of war, the spread of authoritarianism, the spread of prejudice. All these things are not being dealt with as they should. And we may end up having even worse tragedies. So the goal for me from the very beginning was global consciousness change.

I understand that one can have a beautiful, mystical, even life-altering psychedelic experience, but are these substances really going to heal the traumas of this world?

Rick Doblin: The answer is totally yes.

First off, what does our data show? One of the most important things that we identified in phase two of our clinical trials was that MDMA-assisted therapy can work regardless of the cause of PTSD. It can be sexual assault, it can be complex trauma from childhood, it can be war-related, it can be natural disasters. We are able to deal with PTSD of any causation. So that is the traumas of the world.

But, we talked earlier about procrastination. We’re going to get to the edge of disaster before people will really do things.

We don’t know what Trump is going to say or do if he gets elected. In many ways, it will be like the decline of western civilization if Trump gets elected. What I’ve realized in my psychedelic trips is that there’s always going to be psychopaths who are just into power. But they get their power from the people. And so the psychopaths … we’re not going to change their minds. But the people, we can help them process trauma and anxiety.

I think that we’re on a track towards addressing these bigger changes, but we’re losing. I’ve described it as lighting a candle of healing in a hurricane of trauma. Over time, maybe it’ll make a difference.

In a recent Maps Bulletin, you wrote about the importance of amplifying Indigenous perspectives in your work. Where does this fit into the therapeutic process you’re developing?

Rick Doblin: There’s a lot of misunderstanding. I think when we talk about Indigenousness, most people don’t go back far enough – to the Greeks. They had the longest-running mystery ceremony that we know of in the history of the world: the Eleusinian mysteries, which were practiced for about 2,000 years and which involved a psychedelic drug.

And then it was wiped out by the Catholic church in the 4th century, because it was in competition with the church. If you could have your own direct experience of spirituality, what do you need all these priests for?

There’s a history of psychedelic work across cultures that has been suppressed for an enormous amount of time.

When the conquistadors came, the first people they wanted to kill were the shamans, the ones that work with ayahuasca. Sacred mushroom use went way underground in Mexico, but it was never completely killed, it was brought back. We owe a debt to this history – both to Indigenous groups under pressure from colonizing societies and to ancient traditions in western societies.

Between MDMA in the clinic and, say, ayahuasca in the jungle, it seems like there are very different healing modalities at work.

Rick Doblin: One fundamental difference is that we’re doing individual therapy not group experiences.

I think a lot of the theoretical frameworks are the same. On the other hand, how to put it, there’s something good about rationality and science. In many Indigenous contexts, there is a sense of personified spirits. In a more western context, it’s not spirits outside of you. What is emerging is a reflection of what’s inside you. Everything is spiritualized and we see that there is a spirit of MDMA. But I think there’s a little bit more that’s empowering the patient to heal themselves.

One of the other concerns I have about some healing practices is the power dynamics at play. It’s the same way doctors used to be in the 1950s. My dad was a doctor and doctors were God. You had to listen to them. In some Indigenous contexts, the shaman is the healer. Whereas, our approach is to help patients heal themselves.

Lykos is a public benefit corporation that now has $100m in series A funding. Do you see any potential conflict of interest between a for-profit pharma company and Maps’ guiding vision of global consciousness change?

Rick Doblin: I don’t see any conflict of interest there at all.

In the industry, there’s a lot of fear that legalization is bad for the business model. If you can buy MDMA for $10 or grow your own psilocybin mushrooms, why are you going to pay thousands of dollars to get these drugs?

Well, first off, you’re not: the insurance companies are going to pay for your treatment.

But I think legalization is actually good for the business model. And even if it’s bad for the business model, we have a moral obligation to end prohibition. MDMA can soften people, can make them less prejudiced, and can make them want to see other people.

So I think that we need legalization, we need honest drug education, and training for peer support. We need harm reduction methods at festivals and raves and all of that. And then we also need pure drugs.

Humanity is at a crossroads. The last sentence of my Ted talk was, we’re in a race between consciousness and catastrophe. And I think that’s even more clear now. So the medicalization of psychedelics is really good.

But what is at stake as psychedelics become pharmaceuticals?

Rick Doblin: I just had a conversation with a former special operator veteran earlier this morning. He retired after 20 years, spent a lot of time in Afghanistan. He went to ketamine therapy and they told him that the content of what happens doesn’t matter at all. It’s all about the pharmacological effect on your brain – don’t even talk to us about the meaning, the purpose, your moral injuries. None of that matters.

I think what we’re seeing is the standard traditional pharmaceutical approach stripping out the psychotherapy component because it’s the most expensive part. And the pharma companies don’t make money on that anyway. They only make money selling the drug.

So we have to get out of this traditional pharma thinking and really prioritize the therapy and the proper training of therapists.

The treatment is the human interaction. It’s the therapy. It’s not really the drug.

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