Dr. Rick Doblin, founder and executive director of the Multidisciplinary Association for Psychedelic Studies (MAPS) told NPR’s Ted Radio Hour that the MAPS Institute’s work is not unlike exploring “the final frontier.”
“What we need to do is to engage in a deep understanding and exploration of the unconscious,” he said.
Cutting edge. Groundbreaking. Revolutionary. They’re often-repeated descriptions of MAPS work at the forefront of psychedelic-assisted therapy research and advocacy. And as MAPS approaches the final stretch of full FDA approval of methylenedioxymethamphetamine (MDMA)-assisted therapy for PTSD, depression, substance abuse and suicide ideation, Doblin will be the keynote speaker at the 2022 Sun Valley Wellness Festival and Conference.
Doblin visited with Morning Edition host George Prentice to talk about his institute’s research, the FDA approval timeline, and his definition of “wellness.”
"Wellness means acceptance, openness, honesty, not suppression. It doesn't mean the absence of pain, trauma, sadness."
Read the full transcript below:
GEORGE PRENTICE: It's Morning Edition on Boise State Public Radio News. Good morning, I'm George Prentice. The theme of the 25th annual Sun Valley Wellness Festival is “Coming Home.” And indeed, the festival returns in-person this year to explore our social health and well-being… and how they define our collective wellness. The keynote speaker is Dr. Rick Doblin, founder and executive director of the Multidisciplinary Association for Psychedelic Studies, also known as MAPS. And Dr. Doblin joins us this morning from Boston. Dr. Doblin, good morning.
DR. RICK DOBLIN: Yes, it's great to be with you, George.
PRENTICE: How can you best describe to laypeople about your research, and how that treatment works, say, for victims of abuse or post-traumatic stress?
DOBLIN: Well, the most important thing about our research is to recognize that it's really about psychotherapy, the drug MDMA, which we're trying to make into an FDA approved medicine and to have it approved around the world as well makes the therapy more effective for ways that we can talk about soon. But it's really about the therapy. The drug is different than the fundamental approach for drugs from Big Pharma in that those are drugs that are meant to reduce symptoms and you take them every day, often for months, years or lifetime. What we're trying to do is to do intense psychotherapy that the drug makes more effective and that there's only several experiences with the drug trying to get at the root problems, to help people work through the overwhelming nature of their memories so that they can place these memories in context, put them in the past, learn from them, and move forward.
PRENTICE: Let's talk a little bit about that. So, for abuse victims, who with this type of treatment, return to those memories in their therapy, does the treatment that you're talking about lower or reduce our fear so that we can confront those memories?
DOBLIN: Yes, that's one of the things that it does. And in fact, the amygdala - the portion of our brain that processes fear - may cause reduced activity in the amygdala so that we don't react in such fearful way to difficult, threatening memories. To give you a good contrast, the Veterans Administration just completed around a five-year study with 900 subjects looking at two different treatments for post-traumatic stress disorder. One is called prolonged exposure, where you talk about the trauma over and over till you get desensitized to it. The other is called cognitive processing therapy, where you sort of look at the flaws in your thinking that makes it feel like it's always about to happen. But in those studies, they had about half the people with PTSD dropped out of the studies because it was so difficult for them to be confronting these memories. But also, the memories never really go away. It comes in their dreams. It makes them hypervigilant. But with MDMA, we had an extremely low dropout rate of around six and a half percent. And so, the reason I think for the difference in the dropout rates is that the MDMA makes it possible for people through the reduction of fear, also through the release of oxytocin, which is the hormone of love, connection, nursing mothers and MDMA releases this, which helps people to build a deeper connection with themselves. It builds self-acceptance, certain therapeutic alliance that it builds with the therapists so that there's a trusting, safe place. And within that context, then people can look at the traumatic memories and see them in a different way than they've seen them before.
PRENTICE: Wow… MDMA, right?
DOBLIN: Yes.
PRENTICE: How does a patient prepare for a psychedelic experience?
DOBLIN: Well, the first part is that we our treatment that we're now going through the FDA with, and we have one successful phase three study and the second one is looking successful. We'll have the final data point in October. But there are only three days that they get MDMA around one month apart. And then there's twelve 90-minute nondrug psychotherapy sessions. So, there's three for preparation before the first MDMA session and then three for integration after each MDMA session. So, during the preparation sessions, what they're doing is they're building what's called a therapeutic alliance with the therapists. And we have two therapists for one person in this model, often male, female, but not always. So, the first thing that people have to do, and this is difficult for some, is we ask them to stop taking all their psychiatric medications, which many people are on to help reduce the symptoms. And we tell people that your feelings are going to come to the surface more. It may feel like it's getting worse before it gets better, but that we need you to be open to your feelings. Because once you enter the therapy, these difficult feelings are what we're going to work with. And if you have them muted from your psychiatric medications, the therapy might not work as well. The research in psychotherapy outcome has shown that the most important factor for whether the therapy works well is this idea of the therapeutic alliance. It's not whether it's this school of therapy or that school of therapy. It's whether you have a trusting relationship, a safe relationship with the therapists. And that gives patients the strength to sort of look at and experience things that have been overwhelming in the past. We ask people to pay attention to their dreams as well, to start really getting deeper into what's coming up and for them to feel that there's going to be this process that's directed from them. Basically, what we tell people, our therapy is called inner directed therapy, that we're helping people learn how to heal themselves, and that the key aspect of that is for when memories or emotions or bodily sensations come up, rather than try to suppress them for fear of being overwhelming, they're to let them emerge and that they could end up crying or shaking or letting out a lot of the fear that happened when the original trauma took place. But they weren't able to fully let themselves go because they had to pay attention to survival, or it was just too dangerous. So, the preparation is. Very important part of the therapy, and most of it is just to help them understand that there's this inner wisdom, we call it this inner healing intelligence, and that for an eight-hour MDNA session, whatever emerges in whatever order we will, the therapist will help the patient to experience that. There's no one right way to do this. There's no standard pattern. Some people go directly to the trauma. Some people have memories of happy experiences that sort of build strength. So we basically try to help people understand that there's going to be support for whatever they're going through and that that's the key element of the preparation.
PRENTICE: Inner healing intelligence?
DOBLIN: So, let's just say we all know that that's the case for the body. We get a scratch, we get a hurt. The body heals itself. The role of the doctor is to clear out the impediments, to stitch things together, put a band aid on, put an antiseptic on. But then the body has this wisdom that heals itself. And we feel that there's something similar for the psyche and that you could say trauma is like these infections or like the impediments to healing. And we need to reduce the fear and the overwhelming nature so that the trauma can be metabolized. You can say, so that's what we mean by the inner healing intelligence, that there's a wisdom to the psyche that goes beyond what the therapist it's not the therapist giving an interpretation or the therapist really helping people to figure out what's going on. It's the patients themselves opening up in some order that we believe is makes sense. And that's why we support whatever's emerging.
PRENTICE: Well, as we approach the Sun Valley Wellness Festival, I'll ask you what I've asked many of the keynotes over the years. How might you describe wellness?
DOBLIN: Well, wellness is a sense of belonging, a sense of optimism, a sense of the challenge, a worthy challenge. Life is a worthy challenge. Wellness is this sense that you are capable of meeting these challenges. And it's a feeling that there's kind of a process of life and death that one has made peace with. So, wellness means acceptance, openness, honesty, not suppression. It doesn't mean the absence of pain, trauma, sadness. I think maybe some people think that wellness means you're just happy all the time. So, I think that's not at all the case. Wellness means being open to whatever is happening but having this sense that there's a meaning and purpose to life.
PRENTICE: Dr. Rick Doblin will be the keynote at the Sun Valley Wellness Festival, which begins June 11th. Dr. Doblin, safe travels to you. Great. Good luck and all that you do. And we will see you in Sun Valley.
DOBLIN: Thank you. I'm looking forward to coming.
Find reporter George Prentice on Twitter @georgepren
Copyright 2022 Boise State Public Radio
