The supportive context of taking MDMA as part of a medicine session is integral to its therapeutic value. Just as somatic therapy on its own, without a chemical catalyst, is beneficial but in a limited way, ingesting MDMA on one’s own, without the preparation and support of a somatic therapy session, simply doesn’t lead to the same results in terms of processing and clearing trauma.

During a medicine session, we wear an eye bag to ensure that the experience is internal. Within the structure of the somatic therapy technique, our unconscious mind guides and teaches our conscious mind. Our mind is like an iceberg. What is above the water line is the conscious mind, the ego. It is everything to us, and we worship it in our culture. All conventional psychotherapy techniques address this part of our mind. It is by its very nature linear, analytical, and most importantly, driven by fear.

Below that water line is the unconscious mind. This part of our mind, which we access during meditation, has many names. We call it intuition, and when we talk about “trusting our gut,” we mean the unconscious mind. In Sanskrit the name for this part of the mind is Drishti, which means inner wisdom, inner divine, or inner physician. It holds a full record of everything that has happened to us and all the stories we have made up about what happened. We use these stories, which we usually believe without question, to create our sense of who we are and to determine our value.

The body is the portal between the conscious and the unconscious mind, and in its tissues we store emotions that we cannot process. Most of the chronic pain in our bodies is a manifestation of such unprocessed emotions.

The somatic emotional release technique, also known as containment, provides relief from anxiety, depression, emotional disconnection, and the impenetrable fogbank of malaise that is disassociation. Characterized by a profound state of lethargy, exhausted apathy, and detached resignation, this state is the most intractable, and one that conventional psychotherapy techniques have been unsuccessful in treating. Especially when amplified by the medicine, somatic therapy provides long-term healing through the discharge of suppressed emotions stored in the body.

During the medicine session, our unconscious mind revisits experiences that were difficult for us to cope with. The medicine guides us through the experience and supports us, opening and allowing our empathy for ourselves and any perpetrators involved in the event. We are also supported by the therapist, who keeps referring us back to our bodies. This is essential; the drama of the revisited events is very seductive, but healing and discharge takes place in our bodies, not in our stories. This is why conventional psychotherapy techniques have limited value, for they simply provide the conscious mind with better coping techniques. But we are still coping. 

What’s happening in the body and the nervous system during this therapy? What does it feel like?

As the medicine reveals our past traumatic experiences to us during a session, the following four stages of the autonomic nervous system are activated. These stages re-enact the nervous system’s progressive response during the event where the trauma we’re clearing was originally stored in the body: 

·      Stage 0: Relaxed and alert. You are safe and you feel equanimity and well-being. 

·      Stage 1: Mild stress. You are very alert. Mild “hot” symptoms of restlessness, tension, irritation, or discomfort.

·      Stage 2: Strong stress. You are hyper-alert. Intense “hot” symptoms of strong emotions like anger, sorrow, anguish, terror, or regret.

·      Stage 3: Trauma. “Cold” symptoms of lethargy, heaviness, panic, helplessness, or confusion.

·      Stage 4: Severe Trauma. “Cold” symptoms of blankness, lack of awareness, void, or disassociation. 

These re-enacted stages all involve the sympathetic nervous system, which is where our “fight or flight” instincts reside. The medicine’s role is to release the suppressed emotion in the body and engage the parasympathetic nervous system, which is about connectivity, empathy, repose, and self-repair.

Reliving stored trauma is experienced as a wave passing through the body, causing it to tighten, clench, shake, and even freeze—much as it would in a fight-or-flight response to a real threat. As the physical body revisits these states the emotional body recapitulates repressed emotions and begins to discharge them. Physically revisiting these states, guided and supported by the medicine, is key to allowing the body to release trauma that it was unable to release at the time of the traumatic event.

In preparation for my first session, my therapist helped me understand resourcing, which is the body’s natural process for calming itself after a traumatic event, and which can be consciously supported through focused guided meditation. Resourcing occurs during a medicine session, after the nervous system has progressed through the four states outlined above, and it is an important part of how the body integrates the discharge of stored trauma.

For a more in-depth discussion of resourcing, watch Saj Razvi’s video about how it works. More information about disassociation can be found on Innate Path’s blog. The most pertinent articles are “Disassociation and Psychedelic Therapy” and “Psilocybin Mushroom Therapy Part 2,” also by Saj Razvi. 

MDMA therapy is contraindicated for people who are taking monoamine oxidase inhibitors (MAOI’s), selective serotonin reuptake inhibitors (SSRI’s), Wellbutrin, tricyclic antidepressants, Adderall, and Ritalin. These medications must be discontinued two months before a session. You can check out EROWID, and MAPS (Multidisciplinary Association of Psychedelic Studies), and tripsafe.org for more information about drug interactions.

If you are currently taking any of the above medications, please read the following.

Ketamine Therapy and Withdrawal from Antidepressants

Antidepressants suppress the activity and effectiveness of entheogens. For people who struggle with suicidal thoughts or are taking antidepressants to treat anxiety and depression, a series of three or four ketamine therapy sessions may be necessary to prepare them for the full benefits of therapy with MDMA.

Current research indicates that several sessions of ketamine, which is a sedative and is currently legal, can help people better resource depressive or anxious symptoms with a therapist and clear themselves of medications typically prescribed to treat those symptoms. Patients can then work with their therapist to slowly and over time decrease their dosage to the point that they can discontinue the use of antidepressants altogether and begin to address, with the support of MDMA and cannabis therapy, the suppressed emotions that led to their need for antidepressants in the first place. 

Antidepressants were never designed for long-term use, but to temporarily support an individual to steady themselves emotionally enough to then address, with a therapist, the causes of their depressive symptoms. (Talk therapy alone, however, has limited effect in uncovering the unconscious stories and beliefs driving those symptoms.) The long-term use of antidepressants is linked to the outdated notion that depression is a chemical imbalance that one inherits. New research has discredited this theory, but the practice of indiscriminate, long-term over-prescription of antidepressants continues in part because pharmaceutical companies maintain profits by intertwining their interests with medical and research practices.

In particular, current research lays bare the harmful effects of long-term use of the class of antidepressants called selective serotonin reuptake inhibitors (SSRIs), which artificially increase levels of the neurotransmitter serotonin. Under normal circumstances, one nerve communicates with another by shooting a serotonin molecule across a synapse. The receiving nerve reacts when it is hit by that molecule. The original nerve then uses suction to reel the serotonin back in. SSRIs essentially deactivate the suction of the first nerve so that it can’t reuptake the serotonin, which sits in the synapse and bombards the cell membrane of the receiving nerve. The nerve cell is overwhelmed and damaged. Over time its structure changes and it becomes numb. This suppresses the patient’s symptoms, leaving the individual emotionally numb. But the underlying causes of the patient’s depression and anxiety are never truly addressed. These drugs are dangerous because they can randomly affect many other nerve cells, causing a host of side effects from skin problems to surges of rage. (For an in-depth discussion of current research on the dangers of long-term use of antidepressants, watch Joe Rogan’s interview with psychiatrist Kelly Brogan.)

Withdrawal is often extremely difficult, particularly in patients who have been taking SSRIs since adolescence, leaving them with no sense of their own unmedicated baseline personality. Ketamine therapy supported by psychotherapy can help people wean themselves off these medications with minimal withdrawal symptoms.

Unfortunately, most ketamine clinics in this country follow the outdated practice of giving the drug intravenously and putting the patient in a dark room with headphones. New research shows that combining ketamine with a somatic therapeutic practice is much more effective, partly because trauma usually happens in isolation, with no one to see or hear our suffering. Healing occurs in a related process with being witnessed the essential component of the healing progression. In states where cannabis has been legalized, new clinics offering ketamine and cannabis-assisted psychotherapy are seeing much more positive outcomes than clinics holding to the isolation therapy model.

 If you or someone close to you wants to safely decrease dosage or stop taking antidepressants, look for ketamine clinics in your area. They are often affiliated with a university. Further resources and community support can be found at the Withdrawal Project, which is part of the Inner Compass Initiative. While that particular journey is not within the purview of this website, it is an issue that touches many of us intimately and as such, it is part of our greater collective struggle to fly free.