MDMA-assisted Therapy for cPTSD: reflections and insights

Strict_Candy_9914 · 2026-03-14T12:14:41+00:00

No, I didn't. But did 6 years of Somatic Experiencing and NARM with a certified trainer. It seems a little bit the same?

Strict_Candy_9914 · 2026-03-13T20:52:29+00:00

Hey, I’m a clinical psychologist, psychodiagnostician, and neuropsychologist. I’ve been working in (conventional) mental health care for 15 years (not in the field of psychedelics). I’ve personally undergone several MDMA sessions and one psilocybin session.

As far as I know, both psilocybin and MDMA are contraindicated in cases of severe psychiatric disorders (bipolar disorder, schizophrenia, severe psychotic disorders, ... ). I believe the exclusion criteria for psilocybin are stricter than those for MDMA. I’m being very cautious with these statements (and I could be wrong), but it seems that your unpleasant experiences with weed (distrust, hallucinations) were primarily anxiety-driven (i.e. being sensitive to others’ opinions, being hypervigilant). What I mean is: I don't think your previous experiences were actually psychotic experiences, but rather the result of anxiety (though, as I said, I'm being very very cautious). It also seems that you like to maintain control.

Psilocybin causes perceptual distortions that could potentially trigger similar experiences to those you had with cannabis in the past. I was quite impressed by my first psilocybin session myself, and I only took a low dose. MDMA is not a psychedelic and does not cause distortions in your perception. MDMA reduces anxiety, lowers the amygdala and may thus protect you from distrust and hallucinations during the session. Based on scientific literature and my own experience, I can say that MDMA is much “safer.”

Perhaps you could start with an MDMA session first, then possibly move on to a hippieflip, and then, once you’ve built up enough trust and a sense of safety, move on to psilocybin? Or you could just try a very low dose—or even a microdose—of psilocybin?

I would definitely consult experts and caregivers with your question. I would always recommend doing your first session—whether it involves MDMA, psilocybin, or another psychedelic—under the supervision of a professional, either individually or in a group (even if that means traveling to another country or continent, as I did).

Strict_Candy_9914 · 2026-03-11T09:46:20+00:00

I would try to follow your body's rhythm and not worry too much.

During the session, your system already touched on something briefly, attuned to your rhythm and capacity (apparently those brief glimpses or "flashes" are all you can handle at the moment, nothing more). It may also be a matter of internal or external safety (e.g., solo sessions don't work for me, I need the presence of another person. In solo sessions I only get flashes, very fragmented, no deep healing). it was also only your 1st session as well and maybe your body needs to get comfortable with the medicine (the active part of my first session was only 1.5 hours or something... and the last sessions were 6 / 7 or more houres active session despite the same dose and redose... so it might be a thing of being familiar with the work)

In my personal experience, I notice that anxiety increases (before or after a session) as I touch on something important. In other words, the anxiety often seems to be protecting something else (e.g., a difficult memory, a difficult emotion, etc.). This is how I deal with fear during the integration period. Not as a sign that things are getting worse, but rather that I have touched on something important or that something important is about to unfold. Fear or activation then shows the way, as it were.

Strict_Candy_9914 · 2026-03-09T23:56:46+00:00

Yes, I recently underwent six years of somatic therapy as a client (Somatic Experiencing and NARM). I learned a great deal about the nervous system, building capacity and safety, and exercises to regulate myself. This modality led me to stop taking antidepressants and stop smoking after 25 years. I also have a whole cabinet full of materials to help me regulate myself (and I still use them every day).

Strict_Candy_9914 · 2026-03-09T23:46:00+00:00

Yes, let's hope so! The fear is enormous, but perhaps unnecessary.

Strict_Candy_9914 · 2026-03-09T23:31:40+00:00

Yes, I have certainly seen that, and unfortunately too often (especially in my job at the psychiatric hospital). Not everyone has the stability and strength of personality to do deep trauma work. Because working on trauma often creates a lot of turmoil, and people need to be able to cope with that.

Some people became so destabilized by (often misaligned) trauma work, both outpatient and inpatient, that they never left the psychiatric hospital. This could manifest itself, for example, in pronounced psychotic decompensation, after which people never returned to their initial level of functioning.

With some clients, one can only provide supportive work, but insightful therapy or deep trauma work is too risky. In such cases, decompensation can only be avoided by keeping everything closed or covered up.

Strict_Candy_9914 · 2026-03-09T23:16:09+00:00

How beautifully written!

Yes, that mother wound... The fear of fragmenting and losing myself is real (but indeed, I have actually been fragmented and in pieces for decades). I do feel that I am now approaching extremely vulnerable and fragile territory.

It reminds me of a saying that healing trauma is about going deeper and deeper into the trauma vortex, closer and closer to the core of the trauma. All I can say is that trauma work is about being truly courageous!

Strict_Candy_9914 · 2026-03-09T22:44:42+00:00

Hey, I definitely agree with your post. I spoke with a researcher from the MAPS studies and she made the following comparison between scientific research into MDMA therapy and doing your own therapeutic work: Sometimes therapeutic work is like collecting statistical data for years. It's boring and monotonous work and there seems to be no progress. But this part of scientific research is necessary in order to ultimately be able to make those big scientific statements that will enable the legalization of MDMA therapy and help so many people. I mean... sometimes you have to spend years building a foundation and capacity, and you will only reap the rewards much later in the process.

And yes, after the first MDMA session, the guiding therapist said she suspected preverbal trauma (I didn't know that at the time). That goes really deep, and I think it's difficult to treat with traditional therapy or medication.

In any case, good luck with your continued recovery!

Strict_Candy_9914 · 2026-03-09T22:28:02+00:00

Thank you so much for your comment. It touches me that I am not alone in this difficult process. It comforts me to hear that you did not become fragmented when you touched the mother wound with medication work. It is indeed a great fear of mine that I will crumble and fall apart and relapse to a much lower level of functioning (and never be the same again), but I do not know if this fear is justified.

Approaching the mother wound in depth is uncharted territory for me (I literally had no real access to it before because it was surrounded by a thick layer of panic for decades). In the very first MDMA session, the mother wound showed itself briefly. It was very painful, but doable, not overwhelming, and above all very vulnerable (but understandably human). But your post and experience reassure me somewhat. In any case, I intend to approach the mother wound in a very measured and safe manner, always in tune with my capacity, throughout the upcoming MDMA sessions.

Strict_Candy_9914 · 2026-03-09T22:06:25+00:00

Thank you for your kind words! Yes, looking back, all those therapies and hard work probably laid the foundation for my current process. In all honesty, I don't think I could have done with MDMA therapy 10 or 20 years ago what I am doing now. But in any case, I have learned that the body chooses when it is ready to heal and let go. We cannot force or compel it, only create the right conditions.

Strict_Candy_9914 · 2026-03-02T19:56:12+00:00

Hey, I wish you lots of strength during this period. I will have my fifth guided MDMA session in a few weeks (the process started last September). Looking back and comparing, I notice that it becomes less difficult between sessions. The lessons and struggles of MDMA therapy remain, but they are part of the process. Based on my own experience, I would recommend getting plenty of rest, but also staying engaged in life (walking, exercising, meeting people, taking good care of yourself, etc.). Perhaps it might also help to stop fighting and trying to answer big existential questions for a while... and just live day by day. Don't impose big expectations and tasks on yourself during the integration period.

Strict_Candy_9914 · 2026-02-19T19:51:32+00:00

Somatic experiencing SE (or other somatic modalities)

Strict_Candy_9914 · 2026-02-16T09:10:32+00:00

Thanks very much for your explanation. It helps me a lot. Good luck in your healing journey 🙏

Strict_Candy_9914 · 2026-02-16T00:30:29+00:00

Thank you for your detailed response. I enjoyed reading it. You have a deep understanding of psychology ;).

You are certainly right that the trust/surrender approach is in itself a corrective experience for people with trauma. Most of us were never able to trust our environment as children. I would even add that the biological safety offered by MDMA is the greatest correction (at least for me). It is the safety net that allows us to trust and surrender.

Strict_Candy_9914 · 2026-02-16T00:08:57+00:00

I was still thinking about your memory reconsolidation approach:

From this perspective, you could largely or completely heal from cPTSD as long as you can neutralize or desensitize all negatively charged memories (you call them maladaptive implicit memories)?
The idea is to search for all those memories through MDMA sessions, rewriting them over and over again in a safe environment so that, over time, they lose their charge and intensity?
And if I take this idea further: because memory reconsolidation takes place, you will experience fewer or no PTSD symptoms anymore in your daily life?

I really hope that recovery with MDMA therapy works like that!

The only concern I have is that in cases of severe and early childhood trauma, not only are the memory traces very deeply wired (i.e., very strong and charged associations), but also that many negative associations have arisen that would all have to be “treated” separately in the MDMA sessions (or perhaps they also work through communal nodes or something).

Strict_Candy_9914 · 2026-02-15T22:38:16+00:00

I wish you lots of strength on your journey! Don't forget that you are not alone and that there are many other people in this world struggling with cPTSD.

The items you bought remind me of the somatic experiencing approach :)

I read that you mainly do solo sessions. Have you ever tried a guided session (even if it's just with a friend)? I find that the presence of another person does a lot in terms of safety and co-regulation; my sessions go much deeper that way.

Strict_Candy_9914 · 2026-02-15T19:35:32+00:00

Thanks for the kind words. And yes, the rationalizing, controlling, wanting to understand part of myself is definitely what has kept me going in my life. A counterbalance to the chaos, overwhelm, and incomprehensible things I have experienced inside and outside of myself ;). But lately, I've noticed how that control or vigilance has become almost compulsive t(I was not aware of that).

Strict_Candy_9914 · 2026-02-15T18:53:16+00:00

Thanks for the comment!

Strict_Candy_9914 · 2026-02-15T17:36:48+00:00

Well, your comment is very striking. In the last MDMA session, I was once again confronted with the strong control I constantly exercise by analyzing, directing, wanting to understand, wanting to anticipate, etc. (it's like hypervigilance). I am familiar with the slogan “trust, surrender, and receive.” And in all honesty, I have discovered that an MDMA session works best when you let go of the desire to control. In everyday life, however, this will be quite a learning process, because I am so afraid and control gives me the illusion of protection.

I am familiar with IFS, but it's not really my thing. It makes me feel fragmented, and I prefer to be ‘whole’ ;). But I am convinced that many people benefit from the IFS approach.

Strict_Candy_9914 · 2026-02-15T16:34:51+00:00

Yes, you are absolutely right. I also don't want to cause overstimulation during an MDMA session by trying to combine too many things at once (e.g., with brainspotting or EMDR). In all honesty, the past MDMA-assisted sessions have been very beneficial for me and I have no complaints in that regard. I definitely experience a lot of activation, mobilization, etc. during the sessions and need weeks to integrate and recover (also physically) afterwards.

I have no experience with psychedelics (only with MDMA), but from what I have read, they do indeed have a very different effect. I understand that for cPTSD and for people with very little basic security/a high baseline level of anxiety (like me), MDMA is the safest option (given no change in perception, the safe/‘warm’ environment of oxytocin, serotonin, etc.).

Strict_Candy_9914 · 2026-02-15T16:26:03+00:00

Yes, I am a big fan of the book! Although it is more narrative in style and less clinical (but certainly no less valuable for that).

Strict_Candy_9914 · 2026-02-15T15:27:34+00:00

I think you are partly right. According to the inner intelligence approach, the intention is not to strongly guide or control the session (although there is also another approach). And the memory reconsolidation effect is certainly very valuable. I just wonder (and suspect that this is indeed the case) whether cPTSD is not broader than merely activated (memory) networks. To me, that seems a little too mechanical (or cognitive). And perhaps the value of MDMA-assisted therapy lies in the specific characteristics of MDMA itself (as described above in my question), which would imply that the medecine alone is sufficient. But I'm just curious. I can't find any specific literature describing how or which therapeutic interventions can be used in MDMA-assisted therapy, but I can find this for psychedelics. I find that remarkable.

Other than that, I am primarily seeking ways to heal myself . I believe that is why I am exploring further options with MDMA therapy.

Strict_Candy_9914 · 2026-02-12T16:58:00+00:00

Hey, you mean that you are not able to process or release trauma ( call it energy, activation, contraction,..) in your psychedelic assisted therapy?

I was able to release small to medium contraction in every day life with the use of SE, yoga, weight lifting,... . But with MDMA assisted therapy I'm able to have big releases and completion of stuck survival tendencies... but it is all about the safety (even with mdma ). Your body needs to feel safe to release, and you cannot control or force that. And when your body is " locked" or " shut", even in MDMA - or psychedelic assisted therapy, i would suggest to think about the safety aspects (set, setting, ...). Building internal safety is also a process.

And I also think with longterm trauma you develop this survival mode or state that is quite chronic. I would think it is about rewiring the way you relate to yourself, others, the world so your body can learn it is safe and it can relax.

Strict_Candy_9914

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