Note: Guests of The Psychedelic Blog do not endorse, support, or otherwise advocate on behalf of any particular treatment approach for mental illnesses unless stated otherwise. The views expressed during this interview do not necessarily reflect the opinions or endorsement of The Psychedelic Blog. Readers should always consult with qualified healthcare professionals and conduct their own research before considering any treatment options. The blog and its authors are not responsible for any decisions made based on the information provided.
Are you comfortable, Alex?
The Psychedelic Blog: Alex struggles to open his eyes. Facing a new day has not been easy since the accident especially during the past few months. He looks at the ceiling and tells himself that today might be different. The appointment with Ava begins in just ten minutes.
After slicking back his hair and brushing his teeth, he removes his neural-interfacing, augmented reality contact lenses from their case and watches in the mirror as he places them carefully in each eye. He blinks a few times and sits down in a chair. Ready. “Good morning, Ava, I’m here.”
It's December 31, 2040. Ava is a therapist who wants to help Alex overcome the trauma with which he has been living for exactly one year. It's a world where traditional therapy blends with cutting-edge technology, and Ava represents the new frontier of mental health care. Alex was instructed to take something commonly called a “smart pill" earlier in the morning. Ava asks Alex if he's ready to start then remotely prompts the release of MDMA from Alex’s small intestine into his bloodstream. The meeting begins in Ava’s virtual office. She has a confident and easy way about her.
“Are you comfortable, Alex?”
“I am.”
“The questionnaire you filled out says that your happy place is a beach on the island of Barbados.” Ava is sitting in a chair across from Alex in their shared vision of Ava's comfortably appointed virtual office. Their chairs slowly begin to turn. “It sounds lovely,” Ava remarks.
“Yes, it's fantastic. I went there once with my parents.” The chairs ease to a halt, and gradually, the surroundings begin to transform. Alex is now sitting next to Ava on a breathtaking beach where he can feel a gentle breeze on his face, warm sand beneath his feet, and he can hear the sounds of sea birds and the soft crash of waves on the shore. After allowing Alex time to acclimate to his happy place and begin to feel the effects of the MDMA, Ava asks him to close his eyes. She assures Alex that he’s as safe here as he is in own bedroom.
“Now, I want to take you back for just a moment to the accident you had one year ago," Ava gently suggests. "Imagine the accident in your mind as if it were a movie.” Alex’s face grows tense and is overcome by a pained look. Alex nods, “I have it.”
“I want you to speed up the movie. Very fast. When it finishes, play it backwards in your mind. I want you to do that again three more times.” Alex concentrates. Ava's voice is soothing, guiding Alex through this bizarre screening of his traumatic memory. “Now, picture everyone in the movie with orange faces as if they ate too many carrots.” Alex smiles. “Imagine that the people with orange faces also have gigantic floppy ears and they’re moving quickly between scenes, forward and backward. When you playback the movie of the accident, notice the strange characters that keep showing up. There’s even a silly children’s song accompanying the movie.” Ava could tell that Alex’s tension was leaving him.
Ava continues, "Imagine the camera that filmed this scene was located on a satellite in space. Very slowly begin to zoom out of the accident: you see the street where it happened then several blocks surrounding the location. As your perception continues to ascend, the scene gets smaller and smaller. Through the camera’s point-of-view, you can now see the curvature of the earth and you’re zooming out even further. As the accident disappears completely, you see the entirety of the earth from the serenity of space.” She pauses as Alex floats. “Whenever you’re ready, you can gradually open your eyes.”
Once again, Alex can hear the sounds of the beach as the sand and ocean come into focus. At first, he sees no one else. But, as he turns to where Ava was seated, he sees his best friend, Omar, facing skyward sunbathing. Alex is surprised and realizes that the therapy is over. Omar turns toward Alex, looks over his sunglasses and says with a grin, “I can’t believe how good this feels!” and begins to laugh. Alex and Omar roll in the sand with laughter.
I’m not sure if this is what the future of MDMA-assisted therapy looks like, but there’s no doubt that the field is changing quickly. The above is just a creative interpretation of a therapeutic method described by Jonathan Robinson, a pioneer in MDMA-assisted therapy, in his new book called, Ecstasy as Medicine: How MDMA Therapy Can Help You Overcome Trauma, Anxiety, and Depression ...and Feel More Love. I'm Robert Benz. Let’s meet our guest, Jonathan Robinson.
Jonathan Robinson is a psychotherapist, multiple-time best-selling author, and professional speaker from Northern California. His practical methods have reached over 250 million people worldwide, and his work has been translated into over 46 languages. Articles about Jonathan have been in USA TODAY, Newsweek, and the Los Angeles Times, as well as dozens of other publications. In addition, Mr. Robinson has made numerous appearances on The Oprah Winfrey Show, CNN, and other national TV talk shows. He's spent over 35 years studying the most practical and powerful methods for personal and professional development.
"I always found that when I took MDMA, it felt like I had done two years of therapy in a day."
- Jonathan Robinson
Robert: Hello, Jonathan.
Jonathan: Hey there, Robert.
RB: It's nice to meet you, and thank you for joining us. Can you share what inspired you to pursue a career in this field and how your journey began?
JR: Well, I was a very depressed teenager, from a dysfunctional family. I used to get beaten up a lot by my stepfather. At some point, I realize I wanted to heal myself. I tried a lot of things, you know, various drugs, self-help. But I always found that, when I took MDMA, it felt like I had done two years of therapy in a day. I ended up doing my master's thesis on the therapeutic effects of MDMA on PTSD, back in 1984. Then the US government made it Illegal about two weeks later. That didn't stop me from doing MDMA-assisted therapy with people as a therapist. I found I could just cure people in a day.
So, I had my regular psychotherapy practice and then I would have people take the medicine: MDMA or Ecstasy or Molly, whatever you want to call it, and they would get better. Well, when something really works, for better or worse, you can’t hide it.
RB: And, you don't want to.
JR: Right. So, I've written a lot of books on spiritual stuff and happiness. I was trying to avoid legal trouble for a long time. I don't know if you know this, Robert, but the FDA plans to make MDMA a legally prescribed medicine in 2024. They've never done that in its history, but the clinical trials were so ridiculously good that they couldn't come up with a reason not do it. It's taken a long time. Now, I make a living teaching other therapists and coaches how to do this type of therapy in a way that really is effective. As I said, two years of therapy in a day and it's just fun to watch, fun to do. I do most of it over Zoom so I'm not at any legal risk. That's how I got into this.
RB: Before MDMA came into the public consciousness was the primary purpose for MDMA to help people open up during therapy?
JR: Yes, in the late 70s, that's how it was used. Then, of course, it became a recreational drug, in the 80s and 90s. At the time, I was saying, This is amazing! It makes you feel love and totally open and allows you to see all the obstacles and go beyond them. I said, How are people going to abuse this thing? The idea of a dance drug never occurred to us. But you can use a fork to eat some meat or poke yourself in the eye. They both work. It was originally made well known, because a lot of therapists were using it and saying that it was just amazing.
RB: In your early days, there were some studies that came out that said MDMA causes holes in the brain. Did this kind of misinformation scare you at all? Or did you know better?
JR: Well, I knew better because I knew people who had been taking MDMA twice a month for 10 years, and they seemed to be doing well. It’s interesting, psychedelics go through periods when they're amazing and great for everything, then they're terrible and they'll kill you if you try them once. That's how the pendulum swings. What MDMA does is it actually reduces blood flow to the amygdala part of the brain. That's like the reptile, fear-inducing part of the brain. That is what they said was a hole in the brain. Of course, once you're off MDMA, the blood flow returns there. That's actually a good thing: reducing blood flow to the reptile part of your brain. But the way the media handled things in the past was to portray all drugs as bad. It wasn't until all these very well-funded, very well-studied clinical trials, showing that it can often cure trauma, PTSD, in one day that the media now says, Hey, this thing works for everything. That's also an exaggeration.
You know, my book is called "Ecstasy as Medicine". Not every medicine works for every person or every condition. 1% of people are allergic to aspirin. Aspirin is not a terrible medicine, but if you give it to the wrong person, it's not a good idea. The studies show that it's very safe and very effective under the right conditions. That's why I am trying to inform people the best ways to do this.
"One of the reasons why Ecstasy got a bad name for itself in the 80s is that, what was sold as MDMA really wasn't MDMA"
- Jonathan Robinson
RB: You say that much of what is sold in the US as MDMA, is actually mixed with bath salts, methamphetamine and other mind altering compounds. Do you think that FDA approval for MDMA-assisted therapy may help change that dynamic?
JR: Yes. It may not happen in the first month, but what will happen is that doctors will be able to prescribe MDMA—just like they might be able to prescribe Lipitor for cholesterol—and it will be a pharmaceutical, at that point, that is of known purity. You can get test kits now to test for MDMA purity, or you might know somebody that always has a good batch, and you trust them. One of the reasons why Ecstasy got a bad name for itself in the 80s is that, what was sold as MDMA really wasn't MDMA, or at least not pure MDMA.
RB: By the way, I did know about the FDA approval date targeted for 2024. I was on a Zoom call with Rick Doblin a few weeks ago, and he mentioned that. I say this because I wanted to ask you to talk a little about the benefits of one session versus three sessions?
JR: Yea, well, Rick Doblin, his organization, called MAPS (Multidisciplinary Association for Psychedelic Studies), funded the original studies, and [early on] he was just guessing what would help. He thought, well, we'll do three sessions. That was just a guess. But you have to [make a best estimate] when you're trying to get FDA approval, spending millions of dollars and 10 years doing these studies.
What I found is that, if you tell people they are getting three sessions, they change on the third session. If you tell people they get one session, they change in one session. When I talked to Rick, which was a couple months back, he said, he's now funding studies that try to show, Does it work with two sessions? Does it work with one session? So far the results show, Yes, it does. But, because there was a certain protocol, he had to stay with that just because they invested so much in the three session idea which he created. He just said, Well, let's try see three sessions.
RB: Jonathan, I'd like to ask a somewhat parallel question. Earlier this year, I wanted to bring an MDMA for PTSD clinical trial to Colombia. Colombia is a kind of ground zero for trauma after six decades of armed conflict. The trial was being done at Mount Sinai Hospital in New York City using the MAPS protocols. I have a friend there who is one of the directors at the hospital. I asked if she might help advance a proposal for Colombia if I could put one together. I spoke to the mayor's office in Medellín earlier this year but didn't get much traction, in large part, because that administration was ending and the staff would change out completely. Now they have a new mayor coming in January 1st of next year.
When I read your book, it made me think about how I might want to proceed. Colombia is a place with almost one-fifth of its population officially identifying as victims of armed conflict. That means, aside from being squeezed for resources, as it already is, there’s a fairly high degree of urgency to reach people who need help. I thought that, the more ambitious the protocols were—in terms of the number of sessions—the harder it would be to accomplish something like this. Are there other clinical trials happening that prescribe a lower number of sessions?
JR: From what I hear there are. Way back in 1984, I did my master's thesis. I took 36 clients, 30 that suffered from PTSD. I did one session with them and 34 of them said that they had little or no symptoms anymore after three months. That's the type of result I get; 90% are getting better in one session. Now, everybody's different so you’ve got to take that into account.
The other thing about MAPS, they don't actually do therapy on the drug, which is a huge mistake as far as I'm concerned. [Their goal is] to get FDA approval. FDA stands for Food and Drug Administration. It's not called the Food and Therapy Administration. They wanted to see if you just give people a friggin pill, does that cure them of trauma? The answer is yes. But, if you give people a pill and you do therapy on them, the results, in my opinion—and I don't have millions of dollars in 10 years of study to back this up—but in the 600 or 700 people I've helped, it seems to work much better.
RB: So, the MAPS protocol* is mostly about observation during the drug period?
JR: They give you a blindfold and headphones. If you say something, there's a therapist there to write it down. If you need emotional support, there's a therapist there to offer that. But they don't do therapy on the drug.
The Multidisciplinary Association for Psychedelic Studies (MAPS) protocol for MDMA-assisted therapy for PTSD involves a carefully structured treatment process. This protocol, as part of ongoing clinical trials, is designed to explore the potential risks and benefits of MDMA-assisted therapy in participants with chronic posttraumatic stress disorder (PTSD). It's important to note that this manual and method are intended solely for use in approved clinical trials with subjects who have provided informed consent (per the MAPS website).
The therapy is delivered in three 8-hour sessions, which are scheduled three to five weeks apart. Alongside these MDMA sessions, there are 12 non-drug therapy sessions aimed at aiding with preparation and integration. This combination of drug-assisted and non-drug sessions is a critical aspect of the therapy, ensuring that patients are both psychologically prepared for and can effectively integrate their experiences from the MDMA sessions into their ongoing mental health journey.
"Ecstasy is a little bit like a Swiss army knife: it does a lot of things quite well."
- Jonathan Robinson
RB: You say in the book that it's easier to hit a target when you know what you're aiming for. Can people establish their own healing trajectory?
JR: Yea, I'm going to go with what people want. As a therapist, they’re paying me to lead this session, whether it's for spiritual deepening, resolving a relationship issue, overcoming trauma or increasing love in their life. As a therapist, I feel like my job is to serve them, not to say, I think you should be a Buddhist or whatever I might think. When they get it really clear what they're looking for the Ecstasy is a little bit like a Swiss army knife: it does a lot of things quite well. I direct the guidance towards their desired result.
RB: Going back for a moment to the question of therapy while on the drug, I read a book talking about Gül Dölen's work on critical periods*. In a sense, if you're not taking advantage of that critical period, are you losing a precious moment to help people overcome whatever they're trying to overcome?
JR: I think you are. I mean, for your readers, the critical periods idea is basically saying that after you take almost any psychedelic, it kind of makes you more open to learning and changing behavior. So, one of the things I think that's missing in the whole psychedelic field is a systematic approach to integration. Right now, the model is just to take the drug and hope for transformation. Well, combining the drug with therapy, and then adding a systematic integration process, is far more effective. So, I do emphasize that. I meet with people about a week after their session to facilitate an integration system, where they take their insights and figure out, we figure out, how to implement those insights in their daily life.
MDMA -> Result
MDMA + Therapy -> Better Result
MDMA + Therapy + Integration -> Best Result
*As described in the article, Psychedelic Drug MDMA May Reawaken "Critical Period" in Brain to Help Treat PTSD (2019)
Critical periods were first described in the 1930s in snow geese. About 24 hours after a gosling hatches, if mother goose is nowhere to be found, the hatchling will bond with an object, including non-living ones. Yet, if mother goose disappears 48 hours after her gosling hatches, the critical period is over, and the hatchling won’t bond to an object.
There is evidence for critical periods that smooth the way for development of language, touch and vision.
[Gül] Dölen and her postdoctoral student and first author of the current study, Romain Nardou, also observed that MDMA works to reopen the critical period only if the drug is given to mice when they are with other mice, not if it is given to mice while they are alone. This suggests that reopening the critical period using MDMA may depend on whether the animals are in a social setting, say the scientists.
The mice maintained their ability to learn the rewards of social behavior for up to two weeks from the time they were given MDMA. During this time, Dölen and her colleagues also found that the brains of the mice had corresponding responses to oxytocin, known as the “love hormone,” which is made in the hypothalamus and acts in the brain as a signal between neurons that encode information about social rewards. They found these responses by looking more closely at synapses, the spaces between brain cells called neurons. Their experiments showed that, in mature mice given MDMA, oxytocin triggers signaling in the synapses that encodes learning and memory, which does not typically happen in mature mice.
Dölen says that opening the critical window for social reward behavior may also have implications for treating psychiatric conditions. A strong bond between a psychotherapist and patient is well-known to be important for successful treatment. If MDMA reopens the critical period for social reward learning in humans in the same way it does for mice, then it could explain why the drug has been successful in treating people with PTSD, perhaps by strengthening the psychotherapist-patient bond.
RB: Integration was actually my next question. In therapy sessions, and this is related to my question about Colombia, there are obvious restrictions, relative to time, resources, and the real world. But, if you could devise the perfect integration protocol, what would it look like?
JR: Well, in the book, Ecstasy as Medicine, I describe it. Basically, you want to reduce cost. Is there some way that somebody can take their big Insights from the session and consistently use them in their daily life forever, preferably, without a therapist helping them week after week? In my integration system, I give them a motivation method that takes about three to four minutes per week. Using this method, people can consistently apply their session insights in their daily life. If you know that 10 minutes of meditation a day would be a good thing for you, well, that's a nice thought, but information is not transformation. With the motivation method I give, they'll be able to do that for the rest of their life. Or, if they know that having three drinks a night is not good for them, when they do my motivation method, they'll be able to curtail that for the rest of their life. I only have to spend that one hour telling them about the system. I don't have to check on them week after week so that reduces the cost. When there are clinics opening up, doing these therapies, it will [cost] like $10,000 to $15,000. Well, I'm training hundreds of therapists to do this for $500 and up. That's a big difference.
RB: Via Zoom for the most part.
JR: Yes. And that's the other thing: it's a lot more convenient for everybody and seems to get better results over Zoom than in-person sessions, which surprised me and everybody else.
RB: Yea, it surprised me to learn this when I started reading the book.
JR: Yea, I've had to backward engineer why that might be the case. I think it's because, in your own home, you feel totally safe. There's a kind of an intimacy you and I have here—if you're on MDMA, it'd be more—but, if you were right here [next to me in my office], it would be almost too much intimacy. If I'm in your office and you're in my face, I'm vulnerable and I'm on this drug. It seems like the perfect amount of intimacy and connection for therapeutic work that happens over Zoom.
RB: Again, as you talked about in the book, Ecstasy as Medicine, with the right frame of mind, you can accomplish amazing things. How careful do we have to be about negative messages when people are in a vulnerable, altered state of mind?
JR: Yea, you have to be careful. But, you know, people are giving themselves negative messages all the time. One of the things Ecstasy does is, it kind of lifts up your mind. So, it's less likely that negative messages can even get through. If you're feeling wonderful and I say, Robert, you're a mess, [the MDMA acts] almost like a protective shield around you.
RB: Right. Along the same lines, psychedelic-assisted therapy seems poised to blow up in popularity. You've done this for 40 years and you have a training program for teaching therapists and coaches how to do this kind of therapy. What are your biggest concerns about a potential flood of therapists entering this field?
JR: Yea, good question. Well, one of the reasons I started the training is that I wanted people to know, when you see a great basketball player like LeBron James, he makes it look so easy. He's just flicking his wrist and everything goes in. What is it? Why does he get paid $50 million a year? Well, there's a lot to it. And, there's a lot to doing this therapy with others effectively. There are a lot of subtleties. There a lot of things to do to avoid trouble.
In the course I teach, there are over 30 hours of training and 150 pages of information. I want to make sure people are trained to do this properly and they can avoid the pitfalls. If people want to learn about the training, it’s at www.MDMAtraining.net. They can learn all about it. Although the book might make it look like anybody can do this, yes, anybody can stop bleeding. But, if you're doing surgery, you want to make sure that the surgeon knows what he's talking about. MDMA is almost like brain surgery. You're rearranging things or you're healing things that have been there for a long time. So, the training can be very helpful, if you want to do it in the sense of a career or to help your friends or other people as well.
RB: How can the field best guard against the danger of sexual misconduct in this space, obviously not over Zoom but in person?
JR: Well, one of the advantages of doing it over Zoom is that it takes care of that one really well. I think anybody certified or trained in this has to be aware of the potential problems and take an oath that they won’t take advantage. I tell [therapists], if you’re thinking of dating someone, you cannot have a date with anyone you guide for at least 6 months. If you conduct a session in person, you cannot touch any part of their body other than their hand, and only with permission. Zoom seems to take care of that. I haven’t had any trouble nor have the therapists I’ve trained or coaches. To be in my training you don’t have to be a therapist. You just have to be somebody who wants to learn how to really help people.
"We need to reduce the cost of these mental health services greatly and increase access."
- Jonathan Robinson
RB: You have a very creative approach to individual and couple therapy with or without MDMA. Do you ever think about how you could provide therapy to groups of 50 or even more at once?
JR: Well, I did four days ago. So, yes. To tell you the truth, I don’t have that much experience [in doing group therapy] and that’s one of the reasons why I did this. That’s a cutting edge thing both on MDMA or not on MDMA. I think in the future, AI will be involved in [group therapy] somehow. We need to reduce the cost of these mental health services greatly and increase access. It ends up that some of these are just educational things; educating people how to change thoughts, change feelings, change how they look at trauma. I think that it will be a growing field.
RB: Even though you said in your book that “using this sacred medicine to have a good time dancing is like using a laptop as a doorstop” could you ever envision having a good time dancing as part of a group therapy approach?
JR: Oh sure, sure. And, in this group that I did a few days ago, we spent half an hour dancing together. It was very bonding. So, everything has its place. But I think you have to include some deep inner work.
RB: How important is touch? I know you’re doing these sessions through Zoom for the most part but, when you’ve taken MDMA, you want to hold or touch someone. I think in your book, you said that it’s good to have someone else there in person during your Zoom calls to accomplish that. Touch is important, yes?
JR: Well, it can certainly be part of a session. Obviously on Zoom it’s not, but I will often have people hold a pillow, hug the pillow as a stand-in either for hugging themselves or someone else. And, to my surprise, that works pretty well.
You know, unfortunately, a lot of people are touch starved. I do think that we can get some of our touch needs met by ourselves. I’m not just talking about, say masturbation, I´m talking about massaging yourself or hugging yourself or just stroking yourself. That can be part of the MDMA experience and your ability to get touched.
RB: How would you describe your philosophy or approach to life?
JR: Well, my philosophy is simple: find what works for you and do it consistently. Unfortunately, more people are exposed to religion and they may go to a church that feels dead to them. They may do that consistently, but it’s not working for them. Or a certain philosophy, that they were taught as children, not leading to peace, love, or joy for them but they do it. I say, try a bunch of stuff, find what works for you and then do that consistently. And it's different for different people.
RB: Do you have a personal motto or favorite quote that guides your decisions?
JR: Hmm, let’s see. Boy, I’ve not been asked that question ever so I need to think about it. Well, Tony Robbins has a quote, “A lot of people know what to do, but few people do what they know.” So, anytime I get a good idea or hear somebody’s good idea, I make sure that I incorporate that into my life. That has really made a difference. We all know how to lose weight, but not many people are consistent with what it takes. We even know how to find inner peace, to meditate or connect with something spiritual, but doing that day after day and making your values like that is what I’m really focused on. That’s what creates a really extraordinary life.
RB: Last question, and, if you don’t mind, I’m going to put myself into the role of the therapist. You mentioned that you saw the Beatles when you were 5-years-old. Can you close your eyes and describe the feelings that surfaced when you heard the new Beatles song, Now and Then?
JR: (Jonathan closes his eyes.) Well, the Beatles have meant a lot to me over the years. There’s a kind of bitter sweet nostalgic sadness and gratitude. Like a full circle of something was working through these four men that the entire world got to enjoy and they transformed a culture. It kind of brought tears to my eyes to have that whole completed cycle happen through that song.
RB: It brought tears to my eyes too. I must have listened to that song 20 times in a row.
JR: You know, some people say that Paul McCartney has brought more joy to the world than any other human being in existence. And, certainly, Jesus and Buddha have done that but there are factions there: not everybody likes either of those people, but most people have a Beatles’ song that has touched them.
RB: Well, I’ve really enjoying talking with you Jonathan. I can see why you do well as a therapist. You have a kind essence.
JR: Well, I’ve been very lucky getting help from MDMA and from lots of people and asking for help. Life is wonderful currently so I’m very grateful. I get your spirit too wanting to put out really good information. It sounds like that’s happening.
RB: Although, Jonathan talks about his 40 years of experience as a therapist, in many ways his work may be more about the future of psychotherapy rather than the past. His book, "Ecstasy as Medicine" embodies his forward-thinking approach to this booming field. It stands out for the author's relatable style and the absence of overly technical jargon, making complex subjects understandable and accessible to the average reader like me.
Considering the staggering number of people grappling with mental disorders, around 1 billion worldwide, coupled with countless others facing serious challenges with their relationship, there is a critical shortage of effective solutions. Books like this one represent an important starting point, offering insights and guiding us toward the initial steps in finding answers. We can't know as yet whether or not this is moving us closer to the future of psychotherapy, but, if you buckle your seatbelts, we'll find out together.
How do you see the future of psychotherapy evolving?
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