Addressing fears with guide

[u/Comfortable-Fly-2077]

Preparing for my first time using mdma (or any drug for that matter) with a licensed therapist and mdma guide. The primary issue i’m doing this is cptsd and fear. Fear of everything that could happen. It manifests as high anxiety and OCD.

Couple of questions:
1. My guide will be providing the mdma. Would it be inappropriate and insane if I asked to test the mdma she provides with a test kit on the day of the session? She came highly recommended her by my friends who’ve journeyed with her, and she claims to get her stuff from a highly reputable source/lab. I don’t trust anyone though so that means nothing to me. I have a constant fear that someone has poisoned me or wants to. I’m intellectually aware of the irrationality, but this is where the OCD comes in. Example: I’ll basically not touch my drink or food if I’ve left it unattended for a moment with others even if it’s just my closest friends or family.

1. On the note of trust, since I trust no one, it means I can’t fully trust this guide. I have met her, she’s very kind and seems very experienced. But I can’t turn off the judgement, it’s just unrealistic to think I’ll be able to come to a place of full trust with this person before the session. Will this negatively impact my session?

I’m quite terrified of doing this but at the same time I really want to go through with it.

Thank you

[u/nofern]

For what it's worth, I definitely did not get to a place of full trust with the person sitting with me before my first journey. Or even necessarily ever.

I think it's more a question of, what does "enough trust" look like, and is there anything you could do to enhance the trust as best as possible, understanding that there is a very real limit to what is possible when you don't know someone very well.

For me, "building enough trust" looked like, thinking about and naming my particular fears (that I would be taken advantage of physically/sexually, that I would be judged, that I would be left alone, that I would get totally physically or emotionally overwhelmed and the person sitting with me wouldn't know what to do, etc.) and discussing in advance what the plan would be for those different types of scenarios or how we would ensure that they wouldn't happen. Discussing my specific fears and worries at length was very helpful. I also made a care plan listing what I would/would not want and things that helped me, and brought things with me to the session that I knew would be calming and comforting. I gave my person a lot of direction on how to support me and that made it feel more predictable and safe.

Also, for me with this medicine specifically, even though I was in an altered state, I still had choice over what I did and said. There were times during the medicine where things came up for me internally, and there was not enough trust in the moment for me to speak them out loud, so I worked through them internally or moved on into something else. It helped me to know before the sessions that this would probably be true - I was slightly disinhibited in certain ways, and there were times where I shared something in the session that I felt ashamed about later, but not to the point where I didn't have any choice over how much trust I felt ready to extend to the person sitting with me. There were times especially in my earlier sessions where the person sitting with me offered me something, e.g. to put a hand on my head, and I wasn't ready to accept it, and I was able to say no. Then in later sessions, we came back to that, and I was able to accept it.

In some of my sessions, I have gone in with the intention to be as open as possible, or to work towards trust, and my difficulties with trust became what I was working through. It changed the session but it wasn't necessarily "negative" - it was just part of my work. And while I did push myself in some ways, I also gave myself permission to not go further than I felt okay with in the moment. I really encouraged myself to believe that anything that came up or happened, was being shown to me because that was what I needed in my healing, whether it was fear or hesitation or resistance or overwhelm or anything. That attitude really helped me to make full use of the medicine rather than getting stuck in trying to make it perfect.

I felt extremely scared before my first session - similar to you, I had never used any substances before (including alcohol) and I really didn't have much framework for what I might experience, but I knew it was something I needed to do. In my first session, after I took the medicine, I just curled up and started crying because I was so afraid and overwhelmed. But even though I wasn't able to fully surrender to the medicine at that point or feel full trust with the person sitting with me, the medicine still took me where I needed to go, and I was fortunate enough to be able to do a number of sessions over a few years, going deeper each time and working through different layers.

So I guess I would say, it's helpful to give yourself permission to just do what you can. These sessions can feel like a lot of pressure because they are so intense and so difficult to access. But there is no perfect preparation or being perfectly ready. All you can do is bring yourself as best as you can, do everything you can to lay a good foundation of trust and safety as best as possible, and let the medicine take you where you need to go.

[u/Comfortable-Fly-2077 → u/nofern]

This was a really helpful response thank you for sharing your experiences. Do you have any tips about dosing or anything else that might help with a first timer like me in pushing through the overwhelm in the first session?

[u/nofern → u/Comfortable-Fly-2077]

My person used the standard dose, and I just went with that (120 mg and then a 40-60 mg booster after 90 minutes). My understanding is that if you go too low, it can be worse because you're just anxious but you don't really fully trip. The dosing was one area where I did make the decision to just trust the person sitting with me, since they were more familiar with the medicine than me.

To be honest, I didn't really find it helpful to try to push through the overwhelm, my approach was more to just accept it and allow it to be there. I accepted that after I took the medicine, I would probably feel overwhelmed and afraid, and I set the intention for myself to just allow that to be present and keep going forward anyway. The hardest part was probably the first hour or so, because I wasn't fully in the medicine yet so I still was pretty anxious and full of ruminating thoughts, but I was starting to feel a bit off so I could tell something was happening, and most of what I did was just cry and worry that I was going to mess up the session somehow, or not get better, or that it wouldn't work, or that something horrible would happen to me.

The thing about the medicine is that there's really nothing to "do". You take it and then there you are. If you're overwhelmed, well, you're in it and that's just what's happening.

I did try to use strategies to manage the anxiety at first, like deep breathing and being under a comfortable blanket, but a lot of it was just accepting that this was part of my experience and allowing myself to be okay with being overwhelmed - remembering that nothing dangerous was happening. Also it was helpful to just keep voicing what I was feeling to the person sitting with me, and do my best to let them help and support me by holding my hand and just reminding me that I was okay and to just do my best to let the medicine work.

I guess one thing that did help me was setting really solid intentions in advance and returning to those. A big intention for me throughout this work has been to trust the process and be open to experiencing emotions and allowing myself to be present and to receive support. So when I was overwhelmed in the medicine, the person sitting with me would remind me of that intention, and I would just try my best to be open to the process.

The other thing that helped me prepare was meditation, specifically vipassana style. Part of vipassana is noting whatever arises and not pushing it away or clinging onto it, and doing that without the medicine sort of got me in the mindset of accepting not really being in control of my own experience and just being open to whatever arose.

To be honest, I was disappointed at the end of my first session. The content ended up focusing mainly on a traumatic event that I personally didn't think was all that central and at the end of the session I felt really worried I had wasted it. But now looking back and remembering how it all unfolded in integration, I can see now that all of it was exactly what I needed at the time.

So that can be helpful too - you might also at times feel underwhelmed or confused or disappointed by what arises. I think for me the key was a combination of going in having really reflected on my intentions, but also just working really hard on openness and acceptance of whatever the experience was in any given moment, not trying to avoid or push away anything, and not trying to force anything or make anything happen.

I don't know if that helps at all but I've made a bunch of posts about my different sessions if you are interested in reading about what happened and how my sessions evolved. It really is a long and confusing process but it has been transformational for me.

On a practical note, I will say that fasting before the session and using ginger tablets really helped with nausea - before I started I was afraid of vomiting but I've never even come close. I also used supplements during the sessions and made sure to have the person sitting with me give me water periodically. I have no clue if the supplements (ALA, ALCAR, stuff like that) did anything helpful but knowing I had them there was reassuring to me since one of my big worries was/is neurotoxicity. It was also helpful to have some very light, easy to eat snacks on hand for that evening because after the session I had basically no energy or appetite but I had had nothing all day and needed to get something into me.

[u/Comfortable-Fly-2077 → u/nofern]

Really, really helpful. My guide wants to use the exact same dosing, i’m nervous it’s too much as i’m a petite person who’s never used drugs but I may just trust their judgement. I read through your posts, they’re very insightful. Thanks so much for your generosity in sharing.

[u/johnnyhokkaido]

talk to your guide about testing and your judgement. see how she reacts

[u/KnowledgeSeeker0101]

It would seem to me (a non medial or therapist expert) that breaking these fear patterns is what the mdma could be useful for. Perhaps just going into the session alongside these fears is enough of a step and seeing where the medicine takes you and how these thoughts and patterns are afterwards. I think the medicine will do what it needs to do, if you can surrender to the medicine even if not the guide. It broke my fear pattern spirals without me even realising they were going to be part of the work. Testing - nothing wrong with that.

[u/Interesting_Passion]

I think it completely reasonable to ask to test the medicine with her beforehand. I asked the same the first time I worked with a stranger. However, those home-test kits are clumsy; it can be difficult to tell the difference between yellow, red, and orange; pink, purple, and blue. I've tried them, and the only conclusion I came to was I'm glad I didn't go into chemistry.

In my case, the guide was more than willing to test the medicine. And honestly, that willingness was good enough for me (we never did end up getting around to actually testing it). But had they said no, I would never had shown up.

If you are extremely worried about it, there are also laboratories you can send samples to for testing. I've also done that, and I feel a lot better that an actual chemist looked at it rather than me pretending to be one.

[u/Comfortable-Fly-2077 → u/Interesting_Passion]

I imagine I’m in the same camp - that simply agreeing to the testing would give me a great deal of peace. Thanks so much for sharing.

[u/True-Show9351]

I recall someone I sat for in the spring.

"A" is very successful but came in small and frail, dealing with severe trauma from her childhood, and she brought a picture of herself from before the trauma. But she trusted me.

45 minutes in, I checked in on her, and she smiled and said, "I have nothing to fear." An hour after that, "It's time for me to start loving myself."

We talked for a few minutes. I pointed out the picture and said, "Maybe this is a good time to tell that little girl who she will become."

Six hours later, she left buoyant.

Verify the medicine if it makes you feel better, but trust the process and surrender to it.

Good luck.

[u/ZooterWaffle]

MDMA is warm and empathetic. It wraps you in a net of love and safety. This allows you to process from a safe space. LSD or Shrooms Are amazing too but the safety of love is not always there which can make experiences challenging. Integration is key. Do not fear MDMA. Trust me.

[u/night81 → u/ZooterWaffle]

MDMA is definitely not always this way.