“I had never really felt happy no matter what was going on in my life,” he says. “I’ve always felt restless, I’ve always felt that underlying heaviness. Things just weren’t connecting in my head. It was as if someone had taken a cable and unplugged it, and I was trying to put it back.
Eventually Nathan heard of a study that tested the use of MDMA to treat severe PTSD and managed to enter a Phase 3 clinical trial, the last hurdle before US regulators consider whether it Therapy must be approved.
MDMA is a synthetic psychoactive with a reputation as a popular party drug among clubbers – you may know it as ecstasy, E, or molly. It causes the brain to release large amounts of the chemical serotonin, which causes a euphoric effect, but it has also been shown to reduce the activity of the brain’s limbic system, which controls our emotional responses. This appears to help people with PTSD review their traumatic experiences in therapy without being overwhelmed by strong emotions like fear, embarrassment, or sadness.
To test this theory, the Multidisciplinary Association for Psychedelic Studies, a California-based nonprofit, set up a double-blind randomized trial, one in which Nathan participated. Participants attended three eight-hour sessions, during which they were given either placebos or two doses of MDMA before discussing their problems and receiving advice from two graduate therapists.
In May 2021, the trial the results were published in Nature Medicine. They were breathtaking. Of the 90 patients who participated, those who received MDMA reported significantly better results than others. Two months after treatment, 67% of participants in the MDMA group were no longer PTSD, compared to 32% in the placebo group.
I see life as something to be explored and enjoyed rather than endured.
Ben Sessa, a UK-based researcher involved in launching the country’s first psychedelic therapy clinic in Bristol, said the US Food and Drug Administration may approve MDMA-assisted psychotherapy for PTSD by the end of 2023.
Further trials are underway in the US, UK and beyond to test whether compounds such as psilocybin and ketamine could be used in the same way to help treat mental illness. The first signs are positive, and if confirmed, they could turn the world of mental health treatment upside down.
I spoke to Nathan about the experience with MDMA-assisted therapy. Our conversation has been condensed and edited for clarity.
Q: How did your mental health issues manifest?
A: Before I went to trial, things were not going well for me. Everything I tried was going horribly. Nothing worked. I have tried so many different therapists and different techniques. I lost my job in January 2018. It was depressing, and I had already lost my job, but this time it was different. I decided that if this was caused by my mental health, I will fix this. I’ll do whatever it takes. If my therapist had told me that I had to undress and walk through a crowded mall and that would help me, I would have.
Q: How did you find out about this study?
A: I was just in a rabbit hole on the internet late at night. I had been researching PTSD for a few hours and came across this study. I thought I might as well apply. I didn’t think about it. In fact, I forgot about it afterwards. I didn’t even tell my wife. Then, two months later, I got this phone call from them, asking if they could interview me.
Q: Explain to me what the sessions looked like.
A: When you get there, it really looks like an office building. From the outside, you would never know that there are a bunch of people taking MDMA inside. But you walk through and are taken to the treatment room, which has a couch, bedding, blankets, and a pillow. There is music playing, and that is an integral part of the whole experience. It is very calming. It almost feels like a spa. There is a lot of sun coming in and through the window you can see trees and a canal. This is very quiet. Then the two therapists enter. They check your vital signs – your temperature, blood pressure, heart rate, etc. They tell you a bit about what you hope to gain from today’s experience. And then they do this little ceremony or ritual, where they light a candle to signify that things are starting. It almost sounds like a religious or spiritual experience. So they light the candle, and then one of the therapists comes and goes with a little dish with a pill on it. They present it to you with a cup of water, you drink the water and swallow the pill, then you sit down and wait. You are chatting while you wait.
At one point I said, “I don’t think it’s MDMA. I had never taken anything like this before, and I was a little nervous, to be honest. They don’t tell you if you have MDMA or not, but the head therapist told me pretty much everyone knows that. Almost as soon as I said I didn’t think I took it, it started. I mean, I knew.