Running head: CLINICAL POTENTIAL FOR USE OF LSD AND MDMA IN TREATMENT OF TRAUMA HEALING HIGHS: THE CLINICAL POTENTIAL FOR THE USE OF LYSERGIC ACID DIETHYLMIDE (LSD-25) AND 3,4-METHYLENEDIOXY-METHAMPHETAMINE (MDMA) IN THE TREATMENT OF PSYCHOLOCIGAL TRAUMA

Trauma, including Post Traumatic Stress Disorder, is a prevalent and challenging issue in the psychology field, with a number of treatment approaches with varying degrees of success. Historically, the psychedelic substances lysergic acid diethylamide (LSD-25) and 3,4methylenedioxy-methamphetamine (MDMA) were used in therapeutic settings, under the supervision of trained practitioners. However, prohibition and the subsequent scheduling of these substances as illicit effectively halted their use in therapy and ceased exploration of their therapeutic potential. As a result, a generation of therapists has been uninformed of the potential of these psychedelic substances as an adjunct to psychological therapy, including in the treatment of trauma. This qualitative thesis will aim to uncover the history behind these substances, their relationship to psychotherapy, and the more recent utilization of them in our culture of psychotherapy through a best practices document analysis and synthesis. Exploring the use of psychedelics in treating trauma will provide further insight into the ways in which we approach and deal with psychological healing. CLINICAL POTENTIAL FOR USE OF LSD AND MDMA IN TREATMENT OF TRAUMA 3 Acknowledgments This undertaking could not have been done without the committed, unwavering support and insight of my partner, Stephen Lawson, who challenged me to see new perspectives and encouraged me when I lost momentum or confidence. My friends and family who supported me through the years of this degree played a significant role in my success. Also, the learning, challenges, and fun that was experienced as part of BC Cohort 15 at City University of SeattleI would not be the professional I am today without each professor, each peer, and each assignment over the past three years. And of course, Glen Grigg, my thesis advisor, and Karen Grant, my faculty reader, for their support, guidance, and feedback throughout this thesis project. Though I am grateful it is over, I also have gratitude for the journey that brought me here. CLINICAL POTENTIAL FOR USE OF LSD AND MDMA IN TREATMENT OF TRAUMA 4 TABLE OF CONTENTS ABSTRACT . 2 ACKNOWLEDGEMENTS . 3 CHAPTER 1: INTRODUCTION Introduction . 6 Nature and purpose of the study . 7 Scholarly context . 8 Definitions . 11 Assumptions, limits, and scope . 13 Significance . 15 CHAPTER 2: LITERATURE REVIEW Search Strategy and Inclusion Criteria . 16 The context: Trauma . 17 The history: LSD . 22 Implications for therapy . 25 The history: MDMA. 30 Implications for therapy . 30 Prohibition and the end of research: Implications and impacts . 31 The Resurgence . 35 Conclusion . 40 CHAPTER 3: METHODS Design and approach . 41 Sample selection and procedure . 42 CHAPTER 4: RESULTS Data collections . 45 Historical influence on best practices . 46 Setting. 47 Set . 48 Dosage and number of sessions . 50 Outcomes . 50 Current best practices: MDMA . 52 Initial trials . 52 Recent trials . 54 Set and setting . 56 Outcomes and experience. 57 Role of therapist: Addressing risks and creating safety . 57 Conclusion . 59 CHAPTER 5: DISCUSSION Reflection of context . 61 Implication and recommendations . 63 CLINICAL POTENTIAL FOR USE OF LSD AND MDMA IN TREATMENT OF TRAUMA 5 Limitations . 66 Personal insights . 67 Conclusion . 69 REFERENCES . 70 CLINICAL POTENTIAL FOR USE OF LSD AND MDMA IN TREATMENT OF TRAUMA 6 Chapter 1: Introduction This thesis will present an analysis and synthesis of information on two psychedelic substance, LSD and MDMA, and their place in psychotherapy practice as it relates to the treatment of trauma. It will offer valuable and accessible reference for counsellors and non-medical psychotherapists in understanding alternative methods of treatment for posttraumatic stress disorder. As a result of both of these substances being removed as an available prescribed method of pharmacology, there is limited experience and information in the psychotherapy community, which this thesis will review in addition to the recent renewal of clinical research utilizing them in conjunction with traditional psychotherapy methods. A focus on how these substances have been used historically in addressing the necessary conditions for effective treatment, including development of the therapeutic alliance and improving the experiences of the debilitating symptoms of PTSD, will be discussed. The aim of this thesis is to provide a manner of orienting current therapeutic practitioners to the therapeutic potential, concerns, and best practices of using these psychedelic substances as an aide in the treatment of psychological trauma. The use of pharmaceutical drugs to combat mental health issues has been going on for decades, ushered in by the use of Thorazine for psychosis in the 1950s, or lithium for mania (Fink, 2000). Prescription drugs are used in an attempt to alleviate symptoms of mood, anxiety, or psychosis. We permit, and at times demand, pharmaceuticals be administered to those who are suffering with psychological pain, including experiences and effects of trauma. A variety of psychological therapies have proven to be helpful for trauma related issues, including Cognitive Behavioural Therapy, Prolonged Exposure Therapy and Eye Movement Desenzitization and Reprocessing (EMDR), but efficacy is not always long term (Oehen, Traber, Widmer, & Schnyder, 2012). At times, medications may be beneficial in supporting the client’s improvement CLINICAL POTENTIAL FOR USE OF LSD AND MDMA IN TREATMENT OF TRAUMA 7 of symptoms, in combination with psychotherapy. Oehen, et. al (2012) explain that the only FDA approved medications at this time are Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-norepinephrine Reuptake Inhibitors (SNRIs), which seem to have only moderate impact on managing the symptoms. Furthermore, there are individuals who, despite a range of available treatment approaches and medications, find no solace from their traumatic suffering, and may benefit from alternative methods. Decades ago, substances that we now view as dangerous or illegal, were used to help guide