The Promise & Peril Of Psychedelic-Assisted Therapy

Marcela Ot’alora, M.F.A, M.A., L.P.C, a psychotherapist and the principle investigator for the MAPS MDMA-assisted trials, tells mbg that in the ongoing phase 3 trials, participants and therapists spend three 90-minute sessions preparing and getting to know each other before the 8-hour session with MDMA. Following that session, they then meet in person three more times to unpack the experience further as well as connect on the phone. It’s not a quick treatment plan.

“It’s about 42 hours of therapy,” Ot’alora tells mbg, explaining that her team believes that in MDMA-assisted psychotherapy, the therapist’s involvement is just as essential as the drug. Therapists are the ones responsible for setting up a safe and secure container for the experience, and helping patients translate it to day-to-day life.

The therapy component of the psilocybin for depression study was also substantial: Before the session, therapists spent 8 hours developing trust with participants and equipping them with skills for navigating the experience. They also met for 3 hours after the initial session. “The therapy after the session is spent talking about how [participants] are going to move forward—what they are going to do differently or what they want to change,” Alan K Davis, Ph.D., a researcher on the Hopkins study, tells mbg.

“Our philosophy is that you can have a psychedelic experience that’s pretty powerful but if there’s no way for you to integrate it, then it just kind of gets lost” Ot’alora at MAPs says.

This shows that even when administered by trained professionals in a safe setting, these drugs do not act as a panacea. They need to be followed up with consistent self-inquiry and reflection. They are also not for everyone: People need to undergo extensive medical and psychological screening before taking them.

“The safety element is huge, because there are risks with some of the more intense treatments,” Gita Vaid, M.D., another psychiatrist trained in psychedelic-assisted therapy, said on the mbg podcast. “If maybe you’re not as familiar as you should be with your genes, or you don’t have the best medical practitioner at your side, you can do some damage.”

If those criteria are met and the right person links up with the right therapist and is administered the right drug in the right setting, holistic psychiatrist Ellen Vora, M.D., said on the revitalize stage that “it’s pretty reliable you’re going to have a peak spiritual life experience.”

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