MDMA – a hallucinogenic substance used in raves – could dissolve insecurity and resentment in lovers in crisis. A researcher from Toronto is preparing to test the effectiveness of this extraordinary couples therapy on 60 people. While in Quebec, psychologists learn to supervise their clients in a hurry to try the formula for themselves.
“All your barriers are falling! »
ILLUSTRATION CATHERINE BERNARD, THE PRESS
Coiled under their blankets on a beautiful autumn afternoon, Brigitte and Dominique each swallow half a capsule of white powder. The heart beating at the idea of having finally found a tool to love each other without scratching.
Like many couples, the two Montrealers had found themselves exhausted after more than a year of a pandemic, misunderstanding and unmet needs.
“It erupted while we were renovating. It had become toxic. We separated, ”summarizes Brigitte. The 40-year-old businesswoman asked us to change their names because they defied the law by swallowing this famous powder. A hallucinogenic substance, MDMA, which is also found in ecstasy.
Brigitte, mother of one child, has always shunned drugs. But the work of a psychologist friend – trained to use MDMA in a clinical trial – gave him confidence. This friend therefore taught her how to proceed on her own, without putting herself in danger.
The experience left Brigitte amazed. “It produces a huge emotional, sensory and sexual explosion! All your barriers are falling! You feel so safe that you automatically want to reveal your vulnerability and listen to the other without anger or judgment. »
“I had never experienced such deep intimacy and trust in my entire life. »
A unique study in the world
After nearly 40 years of prohibition, the approach that Brigitte and Dominique tested in secret is reborn in broad daylight.
A psychologist and professor from Toronto, Anne Wagner, has just obtained approval from Health Canada to study, on 30 couples, the effects of a treatment combining psychotherapy and MDMA.
She will recruit her subjects in the fall, if the ethics committee of the Institute (for research in mental health) Remedy, where the study will take place, allows it.
PHOTO PROVIDED BY ANNE WAGNER
Anne Wagner
It’s exciting! With MDMA, people have more empathy and less fear. They manage to approach difficult themes without letting themselves be overwhelmed, closed or accusing themselves.
Anne Wagner, psychologist and professor
Before this unique substance was criminalized in 1985, researchers reported similar success in dozens of couples1.
In 2017, with another Toronto psychologist, Ms.me Wagner followed in their footsteps by going to treat six couples in South Carolina, as part of a pilot trial duly approved by the American authorities. A world first with promising results.
Its Canadian study will be five times larger. But as in the United States, one spouse of each couple will have to be in a state of post-traumatic shock. Because the effectiveness of MDMA to treat this evil has already been the subject of an encouraging study2and since then, Health Canada has provided access on a case-by-case basis.
During a two-month psychotherapy, two sessions of MDMA will occur under supervision, to better bring out the buried feelings and memories of the participants. For eight hours, they will lie down – blindfolded and with headphones on – and will be able to dive into themselves and exchange ideas.
What we avoid – like discussing an affair – perpetuates the problems. Finally getting out of this impasse can therefore be very restorative.
At the end of the sessions, Anne Wagner will compare the state of the participants to that of a control group, who will receive the same drug-free psychotherapy.
“Emotional surgery”
In Quebec, a few dozen psychologists have learned from organizations how to supervise individuals who obtain hallucinogens themselves in the hope of getting better.
About 75 North American psychotherapists visited Montreal in November 2019 to take training from Fluence, an American organization founded by researchers to teach how to proceed ethically and without breaking the law. “No therapist can provide MDMA or be present when people take it,” says trainer Andrew Rose, who lives in the metropolis.
It is a question of properly preparing its clients for the intensity of the emotional discharge that awaits them. Then to promote the integration of what they have experienced.
“The experience can destabilize them and leave them raw and vulnerable, so it is better to support them than to reject them”, pleads Andrew Rose.
MDMA shines the light on your problems, not magically erases them, he warns.
PHOTO CHARLES WILLIAM PELLETIER, THE PRESS
Andrew Rose
It’s like an emotional operation. She helps some couples reconnect and others see that ending their relationship is the best solution.
Andrew Rose
Brigitte and Dominique are lucky. Their experience has brought them so close together that they repeat it a few times a year. Always in small doses, alone and without alcohol. “The next day, we look each other in the eye again,” says Brigitte. Our emotional and sexual complicity is constantly progressing. We feel more in love than when we started! »
ILLUSTRATION CATHERINE BERNARD, THE PRESS
The process does not always turn out to be so successful. A few participants in the Multidisciplinary Association for Psychedelic Studies (MAPS) trials have publicly stated that their treatment (individual, in their case) only made their dark thoughts worse.
MAPS – which is funding the approved study in Toronto – therefore indicates on its website that “MDMA-assisted psychotherapy is not suitable for everyone and carries risks, even in a therapeutic setting”.
“You have to be careful, concludes Andrew Rose. But the alcohol and painkillers that people take every day to forget about their difficulties cause much more damage than hallucinogens. »
PHOTO CHARLES WILLIAM PELLETIER, THE PRESS
Joe Flanders
Outside of clinical trials, MDMA remains difficult to obtain and can be cut with harmful substances, warns psychologist Joe Flanders, one of the pioneers of the therapeutic use of hallucinogens in Montreal and assistant professor at the University McGill.
Anyone who ventures there must therefore obtain a chemical analysis kit. And avoid consulting anyone, he advises.
In 2022, when he developed a training program for Numinus, a network of clinics specializing in these treatments, Joe Flanders found that 35 other organizations offered courses – sometimes very brief or superficial. “We see just about anything,” he said. The lack of standards is a serious problem when a tool gives so much power. »
1. “Subjective Reports of the Effects of MDMA in a Clinical Setting”, 1986, Journal of Psychoactive Drugs.
2. “MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study”, 2021, NatureMedicine.
An elixir of love?
ILLUSTRATION CATHERINE BERNARD, THE PRESS
According to a scientific article, MDMA creates the ideal biological conditions to repair a relationship, by increasing key substances3 such as oxytocin, a hormone that promotes attachment and trust, serotonin, a mood-stabilizing neurotransmitter, and cortisol and norepinephrine, which can increase arousal and motivation (and anxiety). MDMA often increases the urge to touch and be touched. In addition to reducing the activity of the amygdala, the cerebral structure of fear, points out psychiatrist Nicolas Garel, who has legally treated patients with hallucinogens.
He therefore considers it theoretically possible that MDMA proves beneficial in couples therapy: “But the evidence is almost nil. We don’t have a rigorous study. The researcher finds it hard to imagine, anyway, how a doctor could prescribe MDMA to a couple: “We don’t prescribe pharmacological interventions for so-called relational problems. In the United States, where the race for profits is intense, an anesthetic supposed to break down resistance, ketamine, is administered to couples during retreats in spa-like clinics – which are springing up like mushrooms. Canadian doctors in general are more careful with off-label prescribing of substances at risk of abuse, assures the Dr Garell. “At this level, it’s the Wild West over there! »
3. “Couple Therapy With MDMA – Proposed Pathways of Action”, 2021, Frontiers in Psychology.
MDMA in five questions
ILLUSTRATION CATHERINE BERNARD, THE PRESS
Although illegal, MDMA can already be prescribed to patients in exceptional cases. Here’s what you need to know about it.
1. Do doctors already prescribe MDMA?
When an individual suffering from a serious illness cannot be treated otherwise, Health Canada can authorize a doctor to prescribe MDMA, although it remains illegal. For 18 months, the Ministry has accepted 17 of the 30 requests submitted to the special access program, he wrote to us.
1er Last July, Australia became the first country in the world to allow its doctors to fill an MDMA prescription without going to the authorities first.
Their American colleagues could imitate them by the end of the year, if the next results of the Multidisciplinary Association for Psychedelic Studies (MAPS) – which funds the trials – turn out to be as positive as in 2021.
2. Where is it offered today?
In addition to university hospitals, a few private clinics – such as Numinus in Montreal – treat patients who have been granted special authorization to receive MDMA.
PHOTO CHARLES WILLIAM PELLETIER, THE PRESS
A person in post-traumatic shock was treated with MDMA in this Montreal office, as part of a clinical trial of MAPS. The sessions lasted eight hours.
Because the latter increases emotional intensity and sensitivity to the environment, the setting must be calm and reassuring, explains psychiatrist Nicolas Garel, who uses hallucinogens in research and in the clinic. ” That makes all the difference. That’s why the treatment rooms are beautiful and welcoming, with plants and light. »
3. How long does MDMA work?
“After a few hours, the acute effects of MDMA fade, but for several days it continues to exert a subtle influence,” observes Joe Flanders, the only Quebec psychologist to have used it to treat post-treatment shock. trauma in a clinical trial.
“The emotional openness it creates lasts for up to two weeks,” he says. Over time, she can continue to increase the harmony in a couple. »
4. How can MDMA bring about a profound transformation?
The psychologist François Saint-Père treats (without MDMA) many lovers on the verge of breaking up. He knows how demanding changing their dynamic is. “Often, when I meet them, things have been going badly for years. They attach their spouse to something aversive. The repetition of his little behaviors heightened their emotional reactions. So they are no longer interested in him, no longer reveal themselves and accuse each other or counter-attack. »
“If a substance like MDMA breaks down those barriers and breaks that deadlock, it can produce a positive juxtaposition experience, which will consolidate another emotional memory. It’s like reprogramming. »
5. Is MDMA physically dangerous?
Ecstasy bought on the black market is typically mixed with mystery drugs and swallowed without supervision, which increases the risk of heat shock or, sometimes, psychiatric problems, among other things. During repeated intakes, amateurs can also develop cognitive deficits, reports psychiatrist Nicolas Garel.
Nothing similar has been observed in clinical trials, however, he says. The blood pressure and the temperature of the participants climb slightly: “But a whole monitoring medical is done. »
For fragile people, who are particularly at risk of psychosis or a heart attack, MDMA remains contraindicated.