Ecstasy Could Improve Therapy by Making People More Open

Research has shown that combining psychotherapy with MDMA, also known as ecstasy or Molly, can help improve treatment for people with post-traumatic stress disorder (PTSD). Patients who'd previously failed to respond to either drugs or psychotherapy saw improvements when their treatment was complemented with guided MDMA sessions. Now a new study suggests a possible reason why these people made progress: their personalities had changed.

Specifically, they showed greater Openness to Experience and a reduction in Neuroticism. (These are two domains in the five-factor model of personality; each domain is measured with self-reports from participants.)

Past research suggests that some symptoms of PTSD, such as withdrawal, isolation, and distrust, can become lasting, harmful personality changes. MDMA, meanwhile, is known for increasing feelings of empathy, love, and trust, and reducing feelings of fear. The new work from the Multidisciplinary Association for Psychedelic Studies, or MAPS group, suggests that MDMA-assisted psychotherapy may help reverse some of the harmful personality changes that can result from PTSD.

To reach that finding, researchers looked at data from an earlier study involving 20 subjects (17 women) diagnosed with PTSD which has previously been untreatable. The subjects had as many as 12 sessions of psychotherapy with a pair of therapists working in tandem. In the middle of their course of therapy, they took part in two experimental sessions, lasting eight hours each. Half of the subjects received a dose of MDMA, while the others received a placebo.

During those sessions, they were guided by the psychotherapists into introspection and reflection on their traumatic memories and experiences. More than 80 percent of the subjects who took MDMA showed lasting improvement and recovery compared to those who took the placebo (they were later offered the MDMA treatment, too). Researchers then looked at the people's personality trait scores before and after the study period to see if changes in scores were associated with the differences in recovery outcomes.

According to their personality reports, the people who got MDMA had higher levels of Openness and lower levels of Neuroticism two months later compared to baseline. In both treatment groups, the researchers found that greater increases in Openness correlated with better recovery results; the effect was stronger in the MDMA group. Reduced Neuroticism helped people, too, but to a lesser extent.

Here's the key part: when they adjusted the data to make the changes in Openness equal in both the MDMA and placebo groups, the difference in recovery outcomes disappeared. To the authors, that finding suggests that the Openness from the MDMA experience improved the psychotherapeutic treatment by helping patients reflect on themselves and their experiences. (There's been similar discussion about therapeutic use of other psychedelics like psilocybin and LSD, which can fundamentally alter the way people see themselves.)

"Individuals scoring higher on Openness tend to seek out new experiences and be open to self-examination, factors that can serve to enhance therapeutic change in both behaviors and cognitions," the researchers wrote, adding, "Qualitatively, and consistently with previous work, therapeutic change seemed to be associated with an epiphany-type experience that subjects consistently reported following the MDMA-assisted psychotherapy sessions and reiterated in the long-term follow-up."

Of course, these are early-stage results from a very small study and one in which people were able to tell if they got the placebo or not by the fact that they didn't have a psychedelic experience. More research in bigger groups will be needed to suss out how MDMA might work alongside psychotherapy; the authors caution that any beneficial effects may not happen outside a clinical setting. They also reminded people that street MDMA has unknown strength and purity levels. Still, it's promising news for anyone whose PTSD may today seem inescapable.

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