Psychedelic renaissance: A status update on psychedelics and MDMA in therapy
In this article, we show how trends in academia, clinical practice, popular culture and underground make knowledge about the therapeutic use of psychedelics and MDMA increasingly imperative, especially for health professionals.
Tools that should have the potential to open the heart and expand the mind should obviously be of interest to psychology. As long as they are safe in the clinical setting – what can there be to learn?
It is important to be equipped with knowledge in the face of the psychedelic renaissance. We present the status of the field worldwide, as well as some of the most important issues.
We are happy to share our experiences with psychedelic therapy as well the talks we offer about the psychedelic renaissance.
«What a communication ability! I have seldom or never experienced so much knowledge and wisdom conveyed so well. We have received many emails from employees afterwards, who were all very happy! ”
Psychologist specialist Anne Berthelsen, Sørlandet Hospital
Toe contact for lecture offers or read on to learn more.
Psychedelic renaissance in academia - and clinical practice
There is one going on psychedelic renaissance in academia and in mental health care. Prestigious institutions around the world are now getting involved in this field, which has become one billion industry with a number of listed companies.
Currently, only ketamine is an approved drug and available for use in Norway. A recent one phase 3 study on MDMA-assisted therapy however, seems to confirm that MDMA-assisted therapy may become an approved treatment in the United States during 2024.
Psychedelics are on the agenda at countless conferences. For the first time, the international IEDTA conference, which includes methods such as EFT, ISTDP and AEDP, had a separate program item on psychedelics.
Psykologvirke presented two speakers.
In May 2022 arranged saws Norwegian Psychedelic Science the first Nordic conference in the field, Nordic Psychedelic Science Conference in Oslo.
Psychedelic renaissance in clinical practice
Israel has already started pilot projects with MDMA-assisted therapy outside of clinical trials. Likewise, a larger program stands for so-called Expanded access on the stairs in the United States.
Canada has for some time approved psilocybin therapy in existential anxiety in life-threatening illness. They have recently softened the regulations further so that people with other problem indications can also get psychedelic therapy after individual assessment.
In Switzerland, it has been the practice for a number of years that psychiatrists can apply for a license to operate psychedelic therapy upon individual application. Unfortunately, this environment has not carried out good clinical studies, but research indicates that the treatment is safe and effective.
Furthermore, the state of Oregon in the United States has enacted one public system for therapy with psilocybin fungi, to be implemented during 2023.
Research status
A lot of interesting research was done on psychedelics in the 50s and 60s. But little of that research meets today's methodological standards. This means that it cannot be conclusive, but that does not mean that it is worthless.
The relatively few studies that have been available so far in the psychedelic renaissance, the modern research era, all point in the same positive direction. But most are small, with methodological challenges.
How to interpret the research status in the field?
While some studies show very large power sizes and transformative experiences, have other problems to outperform traditional antidepressants. How can this be?
The results are promising enough that both mdma and psilocybin-assisted therapy have been given priority regulatory status as "breakthrough therapies" by the US FDA. But what does that really mean?
MDMA-assisted therapy is in the latest Phase 3 study needed for final drug approval. The first phase-3 study was published in Nature in May 2021 with strong results. How good the results can be said to be is an ongoing discussion, including in the columns of the psychology journal.
It also remains to be seen how positive the results from the last, mentioned phase 2 study actually are, beyond statistical significance and no new concerns related to risk.
In any case, drug approval is expected in the USA in 2024 and in Europe a couple of years later.
This is one of the best interviews on trauma-related topics I have heard! For a knowledge, experience and clarity. I really appreciated this.
Thomas Malme, IOPT trauma therapist
Clinical experience meets basic research?
When it comes to MDMA-assisted therapy, there are also more and more prominent professionals who give strong testimonies.
In a podcast interview with Psykologvirke, where we discuss personal experiences with the method, Nestoren says Bessel van der Kolk that the treatment yields deeper transformations than anything else he has seen.
The trauma researcher Rachel Yehuda, and many with her, refer to the experience of MDMA-assisted therapy as several years of therapy in one day.
A recent study even showed that MDMA reopens critical developmental periods in mice. If this is transmissible to humans, as clinical experience also suggests, this could be a potentially important medicine.
In fact, early pioneers concluded that MDMA's most unique contribution was precisely to help change the imprints of early relationship experiences (Harlow in 1994, in Passion 2018).
Can future research and clinical practice confirm these early indications?
MDMA and psychedelics in popular culture and the underground
In parallel with such changes in academia and in clinical practice internationally, there is also an ongoing one decriminalization and legalization wave of psychedelic drugs in the United States.
On the American west coast in particular, there are psychedelic therapists "everywhere" and psychedelics are about to be seriously integrated into the therapeutic culture.
Recently, one could see that Swedish psychologists offer psychedelic retreats in the Netherlands.
NRK recently made a case about the increasing incidence of MDMA underground therapy in Norway. Danish tv2 had recently similar postings about underground therapy.
In the media here at home, people stand up and say that they do not get help from available public offerings, and will try therapy with MDMA underground.
How should we relate to such a development?
Ayahuasca
South American ayahuasca rituals have long been an international megatrend, also in Norway. Now there is also the first randomized, controlled study that shows something promising results for depression.
However, it is far from these first "promising" indications of a reliable drug.
Psychedelics are also playing an increasingly large role in popular culture with high-budget series such as "Nine perfect strangers" starring Nicole Kidman.
The streaming giant Netflix is the latest with a documentary series about the psychedelic renaissance, based on Michael Pollan's best-selling book of the same name.
Incidentally, we wrote one book essay in the psychology journal about this book a few years ago.
More and more celebrities, everything from Mike Tyson, via Sting, to Will and Jada Smith who comes out of the "psychedelic closet" and talks about alleged life-changing therapeutic experiences.
The blows on the Oscar stage clearly show that psychedelics are not a quick-fix. Many people swear by psychedelics but from the outside it can be difficult to see what they are really adding.
The experiences can seem amazing. But they work amazing?
Psychedelics and MDMA in Norwegian therapists' everyday lives
The media-driven hype surrounding psychedelics and MDMA as new "miracle cures" creates hope but also unrealistic expectations.
When more and more people experiment on their own, and Oslo has even been designated as Europe's MDMA capital, it in itself means that knowledge about MDMA and psychedelics is increasingly relevant for Norwegian health professionals.
We need to be able to answer knowledge-based when the patient asks. Some of our patients are already using psychedelics and MDMA, or are considering doing so, in more or less wholehearted attempts to heal themselves.
Some are disappointed with experiences that do not meet expectations, others are destabilized after difficult experiences. Some may be over-optimistic after a rare upswing. Some will be in the midst of essential therapeutic processes.
If they are met correctly, they may be able to make a positive contribution to the overall therapeutic project. If such a project does not really exist, then perhaps it can be created.
Lecture on psychedelics: open-minded and knowledgeable meetings
We know that many people never share their experiences with MDMA and psychedelics for fear of being misunderstood, stigmatized, reported to the child welfare service or deprived of the note.
It is therefore difficult to know how many on the client list have experience with MDMA and psychedelics - and what these experiences consist of.
As health professionals, we must know how we can relate as constructively as possible to both good and less good psychedelic experiences. The goal should be to minimize harm and maximize benefit.
Everyone will need to be met without prejudice and knowledgeable. It forms the basis for a healing relationship where one can also be in a position to actually influence any problematic use.
Pragmatic considerations aside. Medicines that "reveal the mind" should be interesting for anyone who deals with the psyche. It makes sense that medications that are supposed to help expand the mind and open the heart may have something to do with it.
As long as they are in fact sufficiently confident in the clinical setting - what can there be to learn?
What can we learn from the therapeutic use of MDMA and psychedelics?
While somatics is constantly reducing mortality and finding new cures, mental health care has to a greater extent stood still and developed in a palliative direction, although it also happens very well in many environments.
Psychotherapy can work wonders, but it is not uncommon to reach in, past deeply cemented notions. Traditional psychotropic drugs simply seem disconnecting, while psychedelics open the psyche and connect.
Herein lies a potential. But can it be triggered in safe and reliable ways?
Psychedelic pitfalls
These medications raise many questions and dilemmas. First and foremost, we need to feel confident that they will not be harmed. For whom, when, how and why can psychedelics accelerate, deepen and more reliably trigger deep therapeutic processes and when can it be harmful?
In any case, is it advisable to open the psyche faster than it initially allows?
It is over a hundred years since Freud abandoned his focus on therapy through altered states of consciousness, hypnosis.
Is there now any reason to believe in lasting results from an artificially induced condition?
Besides, a lot of research was done on psychedelics in the 50s and 60s. Has not psychedelics all been weighed, and found both too light and too dangerous?
The empirical evidence increasingly supports that psychedelics have a satisfactory risk-benefit profile. With few exceptions, high-quality data is sparse, but most arrows point in the same positive direction.
With MDMA and Psychedelics as an addition to the psychotherapeutic toolbox, maybe we can reach more, in a different way and maybe we can reach deeper?
This and so many other research questions remain unanswered. For example, how can one optimize the synergies between pharmacological and psychological intervention?
Negative outcomes after MDMA-assisted therapy do not seem to be more prevalent than in other forms of therapy. However, some have reported that the rapid opening of the heart made the pain worse in these time-limited research protocols.
Alongside challenges linked to faster openings than the psyche normally allows, MDMA makes the patient extra vulnerable to exploitation by unprofessional therapists. Canadian health authorities are now carrying out extra monitoring following accusations of, and partly admissions of, sexual abuse of a study participant following a study with MDMA-assisted therapy.
What is needed to prevent such exploitation and how can one buffer against other inherent challenges with this form of therapy?
In our lectures on the psychedelic renaissance, we will discuss these and many other issues. We always set aside plenty of time for dialogue so that we can discuss the questions you yourself may be concerned with.
I had the absolute pleasure to hear Ivar Goksøyr at the Nordic Psychedelic Science Conference. You will not be disappointed. He is a powerful speaker and moved us all!
Anna Maria Matziorinis, Psychology student
Psychedelic research in Norway
Norway has one of Europe's leading psychedelic research centers, Psykforsk - Innovative Treatment Research, at the Hospital in Østfold. We have just completed a study for MDMA-assisted therapy against PTSD.
In August 2022, we will start the world's first study on MDMA-assisted therapy against depression, with doctoral funds from Health South-East.
In addition, we are planning two phase-3 studies (last phase before drug approval) for resp. MDMA-assisted therapy for ptsd and pilocybin-assisted therapy for depression.
We have initiated a dialogue with the Armed Forces about a study on MDMA-assisted therapy against ptsd and moral injury and with the medical faculty at UiO about an MDMA-assisted psychotherapy against fibromyalgia study.
We have also initiated conversations with the Department of Psychology about a therapist study.
Ketamine treatment
Last but not least, Psykforsk has orchestrated the roll-out of ketamine treatment for depression at the Hospital in Østfold. We also train other public Norwegian health institutions.
Ketamine treatment is a burning innovation where we still lack knowledge about how this treatment can best be combined with psychotherapy.
Psychedelic renaissance: From stigma to cutting edge
The psychedelic renaissance is an international megatrend.
In recent years, the field has gone from stigmatized to cutting edge, and is open, almost untouched. There may be opportunities to both lay academic golden eggs, reach more of those who are stuck in suffering and experience renewed inspiration as a professional.
Psykforsk works to create powerful academic environments here at home that can make an impression on the field here at home, in collaboration with international research environments.
For example, how will MDMA as a pharmacological catalyst change outcomes and interact with the process variables one is concerned with within different psychotherapy models?
See blog post from NTNU about a lecture Ivar Goksøyr gave psychedelic therapy for professional students in psychology.
Psychedelics and MDMA in therapy: Renewed hope for deep healing
Two-thirds of participants in psilocybin studies for people with life-threatening physical illness and existential crisis, the experience ranks top-five list of important life events.
Clinical impressions from MDMA-assisted therapy indicate that self-healing capacities in the mind are triggered. Healthcare professionals can step out of the expert role, lower their shoulders and learn from the spontaneous processes that unfold.
One question is what psychedelics, MDMA and ketamine can do for patients. But another question is what can it do to us as healthcare professionals? If we get new tools in the battle to help?
Could it be that deep healing for far more people is within reach? Can we as healthcare professionals go from emotionally burnt out to glowing? Can we be empathy bombed rather than empathetic?
For us who work in this field, it is experienced as such.
Will the hard data eventually be able to confirm these early clinical experiences and preliminary findings? Or will they reveal that the whole thing has largely become a hype?
When the possible smoke from the hype has subsided - what are we left with?
And not least: Will the way the field is able to meet these questions now have an impact on the final decision?
Lecture or workshop on the psychedelic renaissance
We owe it to ourselves and all those who are still stuck in suffering to clarify the healing potential of all promising modalities, as quickly as possible.
Before the short-lived flame in each of us, and the light we throw at everyone around us, goes out for good.
It starts with putting on shoes with knowledge.
We are happy to contribute our experience in the form of lectures or subject days. We want to give you a boost into new ways of thinking and emotional landscapes. Which provides renewed inspiration but also concrete learning points back to everyday work.
Not least, we contribute knowledge that means that prejudices, which still to some extent hinder research involvement, are about to fall. We need a rational dialogue.
The psychedelic renaissance is here. We should at least stay up to date. Can we even be proactive and lead?
Feel free to send us an email to ivar@psykologvirke.no to discuss the possibility of lectures or longer professional days on psychedelic therapy. Or use the contact form below.
We also offer lectures on psychedelics at a larger audience, also outside the health sector. Read more about Psykologvirke's lectures on psychology which opens the mind, heart and laughter door.
Also look for updates in Psykologvirke's portal for online course in mdma-assisted therapy.
Qualifications
Ivar Goksøyr is a psychologist specialist from the Norwegian Psychological Association and founder of Psykologvirke. He has a background as a sports officer and leadership developer in the Norwegian Navy.
He has been associated with the research unit Psykforsk – Innovative treatment research, at the Hospital in Østfold, since 2018. He is a certified MDMA-assisted psychotherapist under the auspices of the Multidisciplinary Association for Psychedelic Studies (MAPS) and has himself received MDMA-assisted psychotherapy as part of this education.
Ivar Goksøyr has been a therapist in a larger European multicenter study that looked at MDMA-assisted therapy for PTSD and is now a therapist in the world's first study that looks at MDMA-assisted therapy for depression. He collaborates with several national and international research environments on new studies. He has published both scientifically and popularly on the subject, in addition to presenting at international conferences on psychotherapy in general and psychedelic therapy in particular.
Psykforsk has also been responsible for establishing the first Norwegian and Nordic offer of ketamine treatment for depression. Ivar also has experience with psychedelic integration therapy for clients who have received such treatment at private clinics.
Ivar Goksøyr has received training in psilocybin-assisted therapy and has previously been a consultant and adherence rater for Compass Pathways in a clinical study that looked at the safety and effectiveness of psilocybin against depression. He has administered psilocybin to subjects in the world's largest study on the effects of psilocybin on healthy volunteers. He has been a guest on a number of podcasts and has lectured on psychedelic therapy across the country.
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