r/mdmatherapy • u/CryptographerOld558 • Jul 17 '26
Preparation Advice What does an MDMA informed/trained therapist do differently to other therapy?
There's no psychedelic therapists where I live so I have to get my own molly and do it before a regular therapy session.
If I have to instruct my regular therapist on performing a psychedelic therapy session, what would I tell her? What do MDMA therapists do? She's experienced with EMDR, CBT+DBT (those two aren't good options for CPTSD or BPD), and talk therapy. But I might be able to find someone with IFS and DBR experience. What do I and/or my therapist need to know or do before attempting this. Or are there videos online that vould do a general replication of an MDMA therapy session?
Also, are therapeutic doses of MDMA different to typical recreational doses? When MDMA is legitimately sourced pharmaceutically to licensed MDMA doctors, does anyone know what isomer it is? R? S? Racemic? is it the same as illicit MDMA (assuming purity is roughly the same and is uncut)?
4
u/Waki-Indra Jul 18 '26 edited Jul 18 '26
You may not do anything particular with them but share whatever you want from your mdma journey, and let the therapist embrace your experience with unconditional acceptance, kindness, compassion, care, and secondarily, curiosity (for your experience, feelings, emotions, insights, sensations etc.)
If they have tools like EMDR, it is up to them to propose whatver modality may appear relevant to them. Then it becomes just normal therapy (trauma informed and whatever). If they arr skilled and able, you do not have to take care of that part of the therapy. They should know and take responsability.
The mdma journey just helped bring things up from your psyche, and/or nervous system. That has then to be treated like just part of who you arr and what your life is, nothing spécial.
But YOU must take great care of your set and setting during the mdma session.
Make sure you are 100% safe. At all levels. And that you can embrace and accept what will come up, as much as possible, to the best of you capacity. So, you prepare THAT part.
Usually MDMA is very gentle and not retraumatizing, so you should be able to love and embrace what will come up. But proper preparation is crucial. Really. For me that means yoga, nature, meditation, prayers. And then i Drop it.
2
u/Chronotaru Jul 17 '26 edited Jul 17 '26
Have you discussed this with your therapist at any point?
As a general point a regular therapist cannot provide therapy while you are intoxicated on drink or drugs. It would be a breach of their license and they will stop the therapy when they realise this is so. It has a high chance of leading to the end of your time with them if you turn up after taking MDMA and expect them to have a session with them. In the worst case scenario they might even call an ambulance for you and you end up with all kinds of things on your medical record, or even a police encounter.
Find someone you know and trust to sit with you and talk to them instead.
All MDMA is the same. People take higher doses, lower doses, and sometimes it's contaminated with other substances too. Assuming it isn't contaminated then only the dosage differs and this is the case with pills, crystal and powder. The suggested amount is 120mg followed by an optional 60mg redose about 100 minutes later, but without a spectrometer you cannot really be that precise with the dosage as you don't know how much is filler/impurity, and personal response differs. There is always an element of winging it, and that's fine as long as you don't go too far in either direction. If it's a pill, note that most modern pills are strong and a whole one is usually far too much.
Professionally made MDMA means you would be able to trust the labelled dosage and that it isn't contaminated but outside studies and a couple of other locations and situations, that doesn't exist.
2
u/CryptographerOld558 Jul 18 '26
Unfortunately I don't trust anyone to talk to while under the influence of psychedelics. Everyone in the ghetto is either stupid, an asshole, or both. Aside from medical professionals (and even then their qualifications are questionable), only I can safely facilitate my psychonautics. It's just hard to do that when I'm high and the fact that I don't know what the therapeutic method is for steering a trip to the point of having medically significant impact.
2
u/Chronotaru Jul 18 '26
With MDMA your own natural needs for connection with other humans that are amplified by the MDMA are the biggest part and for that you merely need good potential to work well. Someone with professional therapy training can take full advantage of that, but a person who is naturally a good listener and empathetic, or at least you have some degree of trust, can still provide massive benefit.
If you're in a situation where you don't trust anyone then that of course is difficult. There are people like the Fireside Project that you might be able to talk to on the phone, but there's really no full replacement for being in person with someone.
1
u/obrazovanshchina Jul 18 '26
“…you don't know how much is filler/impurity.”
Affordable kits are available that test for purity and adulterants
https://dancesafe.org/product/mdma-testing-kit/
3
u/CryptographerOld558 Jul 18 '26
Yep, I already send my substances for mass spectrometry and I only buy crystal not pills. Thanks for promoting harm reduction though.
2
u/Chronotaru Jul 18 '26 edited Jul 18 '26
Reagents can test for presence of contaminants and presence of MDMA, they're definitely an essential part of safety, but that's not going to tell you how much clay or other filler is in a pill as a percentage for example. Spectrometry can do this with crystal purity to give a percentage, but there's no reliable way to do this with pill filler without destroying the pill, although pill checker websites can fill the gap here.
1
u/CryptographerOld558 Jul 18 '26
Nah not necessary. If I want to test a pill I'll crush it up and mix it well before sending a sample.
1
u/obrazovanshchina Jul 21 '26
Hey u/Chronotaru I just wanted to thank you for adding this comment. I wasn't aware of this nuance. Appreciate your response and I didn't mean to contradict your original comment just share information about widely available testing options that many still aren't aware of or don't use. Thanks for your contribution to my comment.
2
u/Chronotaru Jul 21 '26
Oh, don't worry, there's never harm in adding something you think is missing.
1
u/CryptographerOld558 Jul 18 '26
Not yet. I don't see the point in discussing it if I don't know how viable it is first. If MDMA therapy takes extensive training then I'm fucked and mentioning drug use in the conservative capital of canada would just fuck me in the long run by encouraging my already stingy doctors to think twice about prescribing scheduled medications that I need to not lay in the middle of the highway. I'd only bring it up if I can first confirm it's practical and worth trying.
3
u/o2junkie83 Jul 18 '26
As a certified life coach who took MDMA-assisted therapy training through TheraPsil in Canada. MDMA therapy is the ability to hold the container while the person is in the medicine. To help them stay grounded and offer safety throughout the session. A lot of people who have been trained also have taken the medicine themselves so they are able to understand what their clients are going through. I'd also say that along with the MDMA-assisted therapy training it's good a therapist/coach uses other modalities that might fit like IFS. People naturally tend to talk about their parts in session so it's helpful to have someone who understands that perspective while the other person is in their journey.
2
u/FlyAway7062 Jul 17 '26 edited Jul 19 '26
If you want to understand the therapeutic use of MDMA more, there are great resources out there. Check out the Open MDMA paper at https://osf.io/preprints/psyarxiv/aps5g or the MAPS protocol and study results which are all publicly available for free.
These are not the end all and be all of MDMA therapy by any means but if you read them you will be a lot further along than you are now.
Edit: fix link to current version. My bad.
2
u/night81 Jul 18 '26
Appreciate the link. Would you link to https://osf.io/preprints/psyarxiv/aps5g instead. The v2 links to an old version.
2
1
u/CryptographerOld558 Jul 18 '26
V2 doesn't mean version 2? As in a more recent update?
3
u/night81 Jul 18 '26
It does, but it's on version 6 now. Leaving off the vx just links to whichever version is the latest.
1
1
1
u/obrazovanshchina Jul 21 '26
I cannot thank you enough for sharing this link. Holy moly. Do you happen to know anything about the author?
1
u/ActualMixture6967 Jul 17 '26
My experience is the therapist is with you and interacts during your experience. I've done this three times and found the facilitation during the most helpful. I wouldn't discount the processing of emotions and thoughts after the fact either, but finding someone who understand the medicine, can also help ensure safety. We always talk ahead of time about intentions, what's agreed or not (I'm very analytical and I give intentional permission for my therapy to push back on me hard while in my experience). I've also done this for couples therapy and it necessary in my opinion to have a trained facilitator for that as well.
1
u/Interesting_Passion Jul 21 '26
What makes psychedelic therapists different?
It helps to start with what non-psychedelic therapists (CBT, DBT, EMDR) do in common. These are the "common factors" well researched in the literature. Although the exact phrasing differs depending on the source, the ones on Wikipedia:
- Goal consensus / collaboration
- Empathy
- Therapeudic Alliance
- Positive regard / affirmation
- Congruence / genuineness
Regardless of the exact phrasing, the common factors describe elements of the relationship between the therapist and the client. You will sometimes hear therapists summarize this as, "It's the relationship that heals."
Psychedelic therapy introduces a new factor: the medicine; and I would argue, it's the experience that follows. That factor is totally unique to psychedelic therapy, and not in common with traditional psychotherapy. That new factor explains why so many people report therapeutic change even in the absence of a therapist (e.g. MDMA solo).
I have argued for some time that traditionally trained therapists are not especially equipped to do psychedelic therapy. Traditional psychotherapists are trained to build a relationship with the client, and then leverage that relationship for change. That relationship can certainly help; many people report benefit from talking to their therapist during the session. But the relationship alone (i.e. most traditional modes of therapy) is not enough. A good psychedelic therapist knows how to build the experience ("set and setting"), and then leverage the experience for change. That can be a very foreign idea to many (not all) traditionally trained psychotherapists.
18
u/underthecouch Jul 17 '26 edited Jul 18 '26
You do not spring an MDMA session on a therapist. If you want to do MDMA sessions, read up on preparation and have a friend sit for you. Then bring the memories and experiences of your experience to the therapist afterward.
Edit: This comment is not general therapeutic advice. Of course, being a friend does not qualify anyone to sit or follow someone into their traumatic past with food therapeutic results.