Scott Douglas Jacobsen: What was the outcome of the panel for Psychedelic Career Day?
Dr. Anne Wagner: It was an interesting and well-received conversation. Lots of different questions in terms of the folks taking part and attending on diverse ways in which careers can be had in the field.
There was a lot of interest on clinical applications within the field, e.g. becoming a clinical psychotherapist in the field. We were there for 3.5 hours. We had a presentation by Dr. Ben Sessa and then answered folks’ questions.
Jacobsen: With respect to your own presentation, what were some of the questions asked of you in particular?
Wagner: Unfortunately [Laughing], I did not take notes, so this will be a bit harder to answer. Folks were asking me about the training to be a psychedelic researcher, the opportunities available regarding the research, the trajectory to becoming involved in this area, and so on.
I talked about how I am a PTSD development researcher. As a clinical psychologist, primarily, we were invited – my mentor and I – to develop this protocol that combined Cognitive Behavioural Conjoint Therapy with MDMA to see if that would yield helpful results.
The idea being that I did not seek this out but landed in this area. I was very clear that if this area is of interest, develop a skill-set that will support the work that you want to do in this area, therapist training or training in some other area that might be helpful, e.g., lots of lawyers work in this area or other folks with different skill-sets like project management.
I gave an overview of my trajectory.
Jacobsen: When it comes to some of the MDMA research in a clinical setting, what are some of the more cutting-edge aspects of the research that may be of interest to undergraduates looking into that area and even high school students?
Wagner: One area that is interesting is the combination of MDMA with psychotherapies that are already stand-alone psychotherapies. A lot of the work with MDMA and psychotherapy up until now has been with non-directive supportive psychotherapies, which would draw upon the skill sets and the best clinical skills of the providers – but they are not based on a treatment in and of itself that would be, for example, used to treat PTSD.
The theorizing I am doing is about combining things we know that work for a good segment of the population and adding MDMA into that as an adjunct to see if we can improve outcomes. It is to deepen and create breadth in our understanding how MDMA and other compounds work in terms of the psychotherapeutic process.
With MDMA, the offer of the opportunity to have this optimal zone of arousal, where you are activated enough to be able to experience emotion and sit with it and so that you are not fearful of those emotions, which is helpful with PTSD.
PTSD is clearly linked with avoidance, so to be able to feel your feelings and to have that experience in an MDMA session potentially adds something important to a trauma-focused treatment. I think that is a particularly interesting way forward for the treatment.
We did this pilot trial of this couple’s treatment, Cognitive Behavioural Conjoint Therapy for PTSD. I will be doing another pilot study with Cognitive Processing Therapy, which is an individual treatment for PTSD, with MDMA.
Then there is team in the US lead by Barbara Rothbaum who is going to be combining prolonged exposure with MDMA. All three of those protocols with Cognitive Behavioural approaches will be interesting to triangulate the data to show how these different interventions that we already use in practice that do have effects: what will happen when we combine with MDMA?
Jacobsen: What are the common variables or factors – I guess we can precisely say – positively correlate with preceding PTSD – or more colloquially – cause PTSD? What are those pathways for someone ending up with PTSD? With MDMA in particular, what are the pathways in the brain to reduce those symptoms of that disorder?
Wagner: We conceptualize PTSD as a disorder of impeded recovery. The idea is that when someone experiences a traumatic event, many people will develop symptoms that look like PTSD right away if the event is severe enough. Many will continue on this course of natural recovery, and will go back to baseline. Some will not follow that natural recovery as a trajectory. The idea is that conceptually, especially with Cognitive Behavioural treatment, is that there have been difficulties with memory reconsolidation but also making meaning of the event.
There is something that has gotten stuck in terms of that recovery trajectory. The idea with our current best treatments is that they are both exposure-based like CBCT (that offers approach assignments to things that people avoid when they have PTSD) and prolonged exposure (which offers an exposure literally to the memory of the event), and use cognitive approaches that make meaning of the trauma and associated thoughts that might be associated with it: blame, acceptance, trust, control, power, intimacy, and the like. The idea with combining the treatments with MDMA is that MDMA has strong effects on the brain with the release of certain neurotransmitters that allow a more easeful experience.
As well, there is activation of the prefrontal cortex and a quieting, if you will, of the amygdala. The amygdala is very heightened in PTSD. It is the fight, flight, freeze response that goes alongside a traumatic event or stimuli.
It is like this alarm system that does not go off afterward with PTSD. When that is quieted with the help of MDMA, it is experiencing and feeling what it is to not have that alarm system go off at quite the same rate and to experience the feelings that go alongside the trauma.
We facilitate this with treatments without MDMA. But the question is, “Can you help more people or others who have not been helped with these treatments using MDMA as well?”
Jacobsen: Thank you for the opportunity and your time, Dr. Wagner.
(Last Update: September 28, 2016)
Scott Douglas Jacobsen researches and presents independent panels, papers, and posters, and with varied research labs and groups, and part-time in landscaping (lifting, mowing, and raking) and gardening (digging, planting, and weeding). He is the Founder of In-Sight: Independent Interview-Based Journal and In-Sight Publishing. UCI Ethics Center awarded him with the distinction of Francisco Ayala Scholar (2014) for mentoring, presenting, researching, and writing. If you want to contact Scott, you may inquire or comment through e-mail: Scott.D.Jacobsen@Gmail.com.
He published in American Enterprise Institute, Annaborgia, Conatus News, Earth Skin & Eden, Fresh Start Recovery Centre, Gordon Neighbourhood House, Huffington Post, In-Sight: Independent Interview-Based Journal, Jolly Dragons, Kwantlen Polytechnic University Psychology Department, La Petite Mort, Learning Analytics Research Group, Lifespan Cognition Psychology Lab, Lost in Samara, Marijuana Party of Canada, MomMandy, Noesis: The Journal of the Mega Society, Piece of Mind, Production Mode, Synapse, TeenFinancial, The Peak, The Ubyssey, The Voice Magazine, Transformative Dialogues, Treasure Box Kids, Trusted Clothes.