To quote Eliza Doolittle from My Fair Lady, I’m a good girl, I am.
I am scrupulous with my tax return, obey speed limits and send thank you cards after I’ve been invited to someone’s place for dinner.
If you’d told me three years ago that I’d be breaking numerous laws by seeking underground MDMA therapy for complex post-traumatic stress disorder, I’d have scoffed. Let alone admit it in public and in print.
But here I am nonetheless. Why?
After prohibiting use of MDMA, commonly known as ecstasy, for decades, Australia now finds itself at the forefront of MDMA therapy. Numerous clinical trials exploring the potential for these drugs to treat PTSD, alcoholism and long-term grief are under way or imminent.
And, in a controversial world first, since 1 July 2023 some Australian psychiatrists have been authorised to prescribe MDMA for post-traumatic stress disorder, or psilocybin for treatment-resistant depression.
But my journey began before any of that. Before any of this was legal.
At 50 years of age, I found myself at a plateau with my conventional approach to therapy (seeing a psychiatrist regularly) and with my own regime of mental health self-care (walking, meditation, yoga, time in nature). I was working overtime to try to process the violence and abuse I’d experienced in my childhood as well as a stillbirth and two miscarriages I had in my 30s. I was worried “mental health treatment as usual” wasn’t helping me progress away from anger and towards acceptance.
On the advice of a psychologist friend, I started reading up on trauma and its impacts on the brain and the body – books including Gabor Mate’s The Myth of Normal and Bessel van der Kolk’s The Body Keeps the Score. These authors write about the potential of psychedelic drugs including MDMA to help people with PTSD and complex childhood trauma.
Interesting but not salient information for me. I had never taken ecstasy, even in my misspent youth.
And then another friend told me she had had a session with an alternative therapist offering underground MDMA therapy; through the treatment, she said, she had been able to “relive” a particularly traumatic experience she had as a child, and been able to comfort her child-self as a loving parent would. I was intrigued because this friend was like me – measured, evidence-based. A good girl. I was concerned enough about my mental health plateau to give it a try.
I connected with this person, who we will call Julia, via email. But before she would meet me I had to fill out a lengthy questionnaire; pages of personal and medical information. She was working out if I was the right fit. Was I ready?
I researched the drug and how it works: by flooding the brain with serotonin, which calms the amygdala – the part of the brain that processes fear and anxiety. This subdues your fight or flight response, allowing some people to explore past experiences without the usual reactivity.
(Crucially, mileage may vary; this type of treatment will not necessarily be a safe way for everyone to explore past traumas – and there can be an added distress for those whose experience doesn’t match their expectations.)
Over a number of Zoom calls, Julia emphasised not the drug but the process – three sessions spaced out over six months, with emotional and physical preparation and aftercare. She didn’t over promise. The drug was a facilitator of a process that would not “cure” me, she told me. What I brought into it, the work I was prepared to do before and after, that’s what mattered.
The first session would run from 10am to 4pm. I would take one capsule of the drug at the start, and then she would offer me a second after a few hours. Julia arrived with a backpack containing MDMA, a curated soundtrack for our eight hours together and a notepad to write down anything I might say.
I had no point of reference for what the drug might do to me, and a healthy dose of scepticism about alternative approaches to health. And yet, for me, the experience was transformative.
It was like being pulled into a deep, warm ocean of emotion, moved by a riptide from memory to memory, those forgotten, repressed, reworked to be more palatable.
Tears streamed down my face for hours as I visualised and keenly felt what lay beneath all my anger. A deep sadness for both my parents, for all the pain they had endured as children and throughout their lives. The only path away from anger is of course, empathy, compassion. I knew that intellectually but in the aftermath of taking MDMA I could feel it at an almost cellular level.
This session was followed by another two MDMA sessions over a six-month period with Julia, with numerous integration sessions and support from my friends and my longtime psychiatrist (who was non-judgmental and curious about my experience). I started to move away from the plateau, enthusiastic again about my familiar regime of psychiatric care, hiking, time in nature and so on.
With Australia a global leader in the adoption of MDMA therapy, I find myself in a unique position. I’ve experienced the potential of MDMA to play a role in healing but I am also deeply worried about the risks, particularly if prescribed or experienced without trained professionals.
I am worried, like some in the psychiatric community, about making this therapy available before we have a more robust evidence base for its use and a long-term safety profile of the drugs; and about lobby groups, not experts, leading the way forward.
There is also the question of who gets to access the treatment, and how to identify those for whom it could be detrimental (beyond the risk of a bad trip, not everyone has the safety nets I did: a secure family, socioeconomic and cultural privilege, and a lot of therapy behind me).
Will the people who could benefit from this the most be able to afford the treatment, which in some cases is costing $24,000 a person? (There is not enough evidence yet for the therapy for the government to subsidise it.) Will those who do get the therapy be able to access the essential wraparound care after the treatment is over, and what does the best support and care look like?
While underground MDMA therapy was entirely positive for me, I worry that all the enthusiasm for this approach opens a trap that we often fall into when it comes to addressing our complex mental health problems: the misguided belief that there’s a wonder-drug out there; that just taking a pill will cure what ails us.
Sassafras: A memoir of love, loss and MDMA therapy by Rebecca Huntley is published by Hachette ($34.99)
In Australia, support is available at Beyond Blue on 1300 22 4636, Lifeline on 13 11 14, and at MensLine on 1300 789 978. In the UK, the charity Mind is available on 0300 123 3393 and Childline on 0800 1111. In the US, call or text Mental Health America at 988 or chat 988lifeline.org
