The holidays can be tough. I used to avoid going home every year because I couldn’t handle the pressure. Pretending to be someone I wasn’t around extended family, sleeping in my childhood bedroom that brought up so many angsty memories, thrown back into family dynamics that frustrated me and made me act childish, it was all too much. But could the answer to my holiday season blues be a little pill, sometimes known as ecstasy?
Will Siu, MD, DPhil and MAPS-trained psychiatrist tells Playboy that MDMA-therapy is different than our current psychiatric model of prescribing medications because it’s “evocative therapy” rather than “suppressive therapy.” Meaning, during an MDMA-therapy session, painful and difficult old memories are recalled and explored. “[You] bring them to the surface to the point that we can deal with them,” says Siu, “that we can bear them with a therapist and then we can finally heal them, or to have catharsis in an old school, kind of Freudian way. We release the mental, emotional, spiritual energy from a trauma so it can heal in the context of when it happened and it doesn’t continue to ail us.”
What we see with MDMA-assisted therapy is that people will read this [trauma] as a memory and be like, ‘Uh, yeah, this is painful, let me release the anguish, the sadness, the fear from it and let me understand that this wasn’t my fault.’
As for whether or not you should roll with your whole family after Christmas dinner? While that’s up to you and your loved ones, in the future, MDMA-assisted therapy could be a game changing tool for family counseling. After all, MDMA was first used therapeutically for couple’s therapy before it was outlawed by the DEA in 1985.
Siu explains that family or couple’s therapy could be enriched by MDMA because of its ability to help people communicate things they otherwise push down because they’re ashamed. He says there’s six basic emotions that we experience: sadness, fear, anger, joy, shame, and sexual arousal. But two of the six, sadness and fear, are deemed intolerable and shameful in our culture. In fact, Siu says we’ll often hide our sadness or fear, like of rejection, by expressing angry—an emotion that we have learned to tolerate even though it is more likely to destroy relationships.
While recent reports make the legalization of individual MDMA-therapy for PTSD seem inevitable, Siu explains that using the word “trauma" more broadly (to describe circumstances that don't necessarily involve an IED blowing up) is still at the root of a lot of civilian folks’ struggles. More specifically, insecurities, social anxiety, depression, disordered eating, Obsessive-Compulsive Disorder, and substance abuse are all issues that can be heightened during the holidays. Sue elaborates that, as children, we only code things as black and white, so we can misread situations (like divorce) and blame ourselves and end up believing we’re bad or unlovable. When those negative emotions are suppressed for years to come, they will continue to ail us and surface as other problems, like substance abuse.
MDMA, if used properly, can break the whole cycle of guilt. “What we see with MDMA-assisted therapy is that people will read this [“trauma”] as a memory and be like, ‘Uh, yeah, this is painful, let me release the anguish, the sadness, the fear from it and let me understand that this wasn’t my fault,’” says Siu. “They can let go of the self-blame or they can make some peace with the caretaker that did this, but it’s not just held in a completely black and white fashion.” Letting go and releasing destructive memories and feelings is saving people’s lives.
Siu does believe a therapist will help people—especially those with more severe traumas—heal at much higher rates of success, but he also discusses the possibility of people doing the integration work on their own. According to Siu, self-reflection and “embodying the experience” can be part of integration, as can journaling, creativity and expression, and even yoga.
Cocaine can understandably cause problems, but Giordano maintains that even antibiotics, over-the-counter meds, cannabis, and grapefruit juice could affect the metabolism of MDMA in your system. The most dangerous mixture, however, is MDMA with antidepressant SSRIs (or Selective Serotonin Reuptake Inhibitors) like Prozac because they interact with the same systems as MDMA in the brain: serotonin transmission. And some of these medications stay in your system for a long time (possibly over 100 hours) so people on antidepressants should proceed with caution when considering experimenting with MDMA.
The worst case scenario? Mixing MDMA with SSRIs could cause serotonin syndrome—basically a serotonin overdose. A serotonin overdose would come with extreme anxiety and agitation, increase in body temperature, dehydration, and has the potential to become lethal if a spiked fever or cardiac arrhythmia develops. “Mixing MDMA with other compounds is just a disaster waiting to happen,” says Giordano. While these worst case scenarios would never happen in controlled therapeutic settings, it’s important to educate yourself how to take MDMA safely even when you're taking for a night of dancing.
Maybe MDMA, if taken with the proper precautions, can help shed light on why the holidays are so difficult and bring you closer to your loved ones. Or maybe, we’ll all be doing MDMA for the holidays in a few years...with our therapists.