“I’d never really felt happy, no matter what was going on in my life,” he says. “I always felt restless, always felt this underlying heaviness. Things just didn’t connect in my head. It was like someone had taken a cable and unplugged it, and I was trying to fit it back in.”
Eventually, Nathan heard about a study that was testing the use of MDMA to treat severe PTSD and managed to get into a phase 3 clinical trial, the final hurdle before US regulators consider whether to approve the therapy.
MDMA is a synthetic psychoactive with a reputation as a party drug popular among clubbers—you may know it as ecstasy, E, or molly. It causes the brain to release large amounts of the chemical serotonin, which causes a euphoric effect, but it’s also been found to reduce activity in the brain’s limbic system, which controls our emotional responses. This seems to help people with PTSD to revisit their traumatic experiences in therapy without being overwhelmed by strong emotions like fear, embarrassment, or sadness.
To test this theory, the Multidisciplinary Association for Psychedelic Studies, a California-based nonprofit, set up a randomized, double-blind trial—the one Nathan took part in. Participants attended three eight-hour sessions, during which they were given either placebos or two doses of MDMA before discussing their problems and receiving counseling from two qualified therapists.
In May 2021, the trial’s results were published in Nature Medicine. They were breathtaking. Of the 90 patients who participated, those who received MDMA reported significantly better outcomes than the rest. Two months after treatment, 67% of participants in the MDMA group no longer had PTSD, compared with 32% in the placebo group.
I’m seeing life as a thing to be explored and appreciated rather than something to be endured.
Ben Sessa, a UK-based researcher involved in launching the country’s first psychedelic therapy clinic, in Bristol, says the US Food and Drug Administration could approve MDMA-assisted psychotherapy for PTSD by the end of 2023.
There are other trials under way in the US, the UK, and beyond to test whether compounds like psilocybin and ketamine could be similarly used to help treat mental illness. The early signs are positive, and if they’re borne out, they could shake up the world of mental-health treatment.
I spoke to Nathan about what the experience of MDMA-assisted therapy was like. Our conversation has been condensed and edited for clarity.
Q: How did your mental-health struggles manifest?
A: Before I participated in the trial, things weren’t going well for me. Everything I was trying went horribly. Nothing worked. I tried so many different therapists and different techniques. I lost my job in January 2018. That was depressing, and I’d lost jobs before, but this time it was different. I decided if this is being caused by my mental health, I’m going to fix this. I’m going to do whatever it takes. If my therapist had told me I had to strip naked and walk through a crowded mall and that would help me, I’d have done it.
Q: How did you come across this study?
A: I was just in a late-night internet rabbit hole. I’d been researching PTSD for a few hours, and I came across this study. I thought I might as well just apply. I didn’t think anything of it. In fact, I forgot about it after. I didn’t even tell my wife. Then, two months later, I got this phone call from them, asking if they could interview me.
Q: Walk me through the experience of what the sessions were like.
A: When you get there, it really just looks like an office building. From the outside, you’d never know there’s a bunch of people taking MDMA inside. But you go through, and you’re taken to the treatment room, which has a couch, bedding, blankets, and a pillow. There’s music playing, and that’s pretty integral to the whole experience. It’s very calming. It almost feels like a spa. There’s a lot of sunlight coming in, and through the window you can see trees and a canal. It’s very peaceful. Then the two therapists come in. They check your vitals—your temperature, your blood pressure, your heart rate, and so on. They chat to you a bit about what you hope to get from the experience today. And then they do this little ceremony or ritual, where they light a candle to signify that things are starting. It almost feels a bit like a religious or a spiritual experience. So they light the candle, and then one of the therapists goes and comes back with a little dish with a pill on it. They present it to you with a cup of water, you drink the water and swallow the pill, and then you just sit and wait. You chat as you’re waiting.
At one point I said, “I don’t think this is the MDMA.” I’d never taken anything like that before, and I was a bit nervous, to be honest. They don’t tell you if you have the MDMA or not, but the head therapist told me pretty much everyone knows. Almost as soon as I said I didn’t think I’d taken it, it kicked in. I mean, I knew.