A report on the state of the MDMA Therapy orchard

In the beginning, all was well. Yes, there were hiccups, minor problems, and even one major ethics violation during the early MAPS-sponsored FDA trials, but overall the MDMA-Assisted Therapy orchard was sprouting healthily from the seeds planted half a century ago, re-emerging from under the ground, blossoming.

What a promising sight. What a relief to those who felt condemned to suffering. It was the second coming of a healing art thought to be lost to the dark ages of prohibition and misinformation.

Research results were truly unprecedented, the safety profile was very good, two thirds of participants reported being cured of chronic PTSD, the FDA granted MDMA-Assisted Therapy a rare “breakthrough therapy” designation, and the media and public opinion was galvanized by the promise of this blooming revolution in mental health treatment.

And then there was the March 2022 Symposia’s Power Trip podcast. It started out with one of the two hosts of the podcast venturing out into the middle of the jungle in search of psychedelic-assisted salvation, but instead getting sexually taken advantage of. Subsequently, I understand, she sets on a mission to expose the wrongdoings of psychedelic gurus and guides, a mission that soon engulfed the entire field of psychedelic therapy. In her words, “It is not just one bad apple. The whole orchard is rotten.”

Of course exposing unethical and abusive behaviors is a virtuous and welcome endeavour. One has to prune the orchard to keep it healthy. And some pruning was very clearly needed. The video that MAPS released to Power Trip, where a therapist is seen laying flat on top of a distressed study participant is hard to stomach indeed. And later, after the study was over, this same therapist having sex with the client is also far outside of the ethical norms of conduct for any psychotherapist. There indeed was one bad apple, and that’s why we now have rigorous therapy safety protocols.

But the indiscriminate mixing of the legal field of psychedelic studies with the sometimes wild field of psychedelic underground, the gross selectiveness of what was reported, and the one-sided attack on the entire field of psychedelic therapy made the podcast feel more like a political campaign than a piece of investigative reporting.

What about the podcast calling MAPS a “cult”? What about picking only three quotes from Rick Doblin, all of which portrayed him in a very negative light? These tricks are an affront to anyone who’s ever come in touch with the incredible work of the Multidisciplinary Association for Psychedelic Studies, or glimpsed the size of Rick Doblin’s heart.

The biggest problem with Power Trip podcast was that it was so well produced that only people who had some prior knowledge of the area of psychedelic studies, only the gardeners, could see the manipulative and dishonest nature of it. For all the uninitiated, as we shall soon see, the podcast must have sounded very convincing.

The Symposia’s Power Trip podcast came and went. Within the broad psychedelic therapy community, the podcast, while bringing attention to some important issues, was generally and justifiably considered an unbalanced and hyped-up smear campaign, and thus was mostly dismissed. Few imagined that the podcast would have far reaching consequences.

Until two years later, when in May 2024 the Institute for Clinical and Economic Review (ICER), which assesses the benefits and fair pricing of various medical treatments, produced a report which surprisingly concluded that the current evidence was insufficient to assess the benefits of MDMA-Assisted Therapy. Interestingly, the ICER’s report seemed to rely more heavily on the information from Power Trip podcast, including their anonymous sources and hyperbolic arguments, than on the existing FDA research data.

This downward momentum then spilled over into the Pharmacologic Drugs Advisory Committee meeting in June 2024. The task of this group of independent experts (most of whom were not experts in psychedelic therapy) was to provide independent advice to the FDA on their perception of the safety and effectiveness of MDMA-Assisted Therapy (two months before the FDA was due to make its final decision on whether to approve this treatment for clinical use). Again, the discussion in this meeting was strongly colored by the themes raised by Power Trip podcast and the ICER’s report. The research data showing unprecedented effect sizes and the good safety profile of MDMA Therapy took a back seat. Lycos (MAPS’ for-profit reincarnation) had little opportunity to defend the integrity of the studies during the meeting. And all this gave the experts little choice but to reject MDMA-Assisted Therapy, again stating that there was no sufficient evidence to prove its safety or effectiveness.

This is how Power Trip became its own power trip. This is when I realized that the title of the podcast more appropriately referred to what the producer set forth to do.

In the meantime, nothing has changed regarding the orchard of MDMA-Assisted Therapy. If you look closely at the data, there was for sure one bad apple, maybe even a few, and some pruning was indeed in order. But the orchard is still there, still in bloom, still waiting to bear, for us, the forbidden fruit of healing.

As the existing research clearly shows, MDMA-Assisted Therapy, while not without risks, is still one of the most powerful psychotherapies ever developed. Its power comes from not only the love drug MDMA, but also from the kind of therapeutic paradigm shift it has produced, as MDMA-Assisted Therapy is about healing not numbing, about connection not dissociation from self and others, about love not egotism, about hope not cynicism, about acceptance not judgment, about empowerment not fear.

This story is not yet over. Whether Power Trip becomes a truly consequential power trip is now all up to the FDA. In August, meaning NOW, the FDA is scheduled to make its decision about whether to approve MDMA-Assisted Therapy for the treatment of PTSD. Like many, I only hope that whatever the FDA decides will be guided by evidence not hype, science not politics, good will not bad faith.

Dr. Darek Dawda is a psychotherapist, Clinical Psychologist, co-founder of Enhanced Therapy Institute, and host of MDMA Therapy Podcast. For a more elaborate discussion of the issues raised in this article, listen to the MDMA Therapy Podcast episode with Dr. Matthew Baggott @ enhancedtherapy.ca – https://enhancedtherapy.ca/what-happened-at-the-fda-expert-panel-meeting-regarding-mdma-therapy/

* Note that MDMA is illegal and MDMA-Assisted Therapy is not approved for any use at this time. We do not encourage or condone the use of MDMA in any context.