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Beyond Fear
1. Beyond Fear: The
Effects of MDMA in
Humans
Matthew Baggott, Ph.D.
University of Chicago
Photo by Simon Webster
2. About Me
Worked on the first
federally funded
MDMA dosing study in
1998
Helped MAPS get FDA
permission to give
MDMA to patients
Have studied, in
humans: MDMA,
MDA, LSD,
stimulants...
3. About this research
University of Chicago: Harriet de Wit, Matthew
Kirkpatrick, Megan Wardle
California Pacific Medical Center: John
Mendelson, Gantt Galloway, Jeremy Coyle,
Kathleen Garrison
UCSF: Reese Jones
4. About this research
University of Chicago: Harriet de Wit, Matthew
Kirkpatrick, Megan Wardle
California Pacific Medical Center: John
Mendelson, Gantt Galloway, Jeremy Coyle,
Kathleen Garrison
UCSF: Reese Jones
University of Basel: Cédric Hysek, Matthias
Liechti
8. • 1856, Perkin discovers mauveine, the first
synthetic dye.
• 1863, Bayer company founded as a dye
maker in Wuppertal
• 1865, BASF (Baden Aniline and Soda
Factory) founded in Mannheim, with factory
on the Rhine river
• 1886, Sandoz founded in Basel
Before drugs there were dyes
9. • 1886, aniline dye derivative
acetanilide sold as analgesic /
antipyretic “Antifebrin”
• 1891, methylene blue used to
treat malaria
• 1935, “Prontosil”, a red dye,
sold as the first antibiotic
Many dyes have biological effects
(Wikipedia)
15. Overview
MDMA does something novel
•not a typical stimulant (drunken/sedated effects)
•not a typical hallucinogen (consistently positive)
How does it work?
•Neurochemistry: Serotonin, oxytocin,
norepinephrine
•Psychology: Prosocial effects, authenticity
•Reduced anxiety may not be the core effect
(Focus here is on acute (short term) effects)
49. Hypothesized MDMA Effect Hypothesized Benefit
Improved mood Positive mood encourages changes
in cognitive models about the
world
Increased interpersonal
connection
Improved couples therapy;
facilitation of therapeutic alliance;
more rapid therapy with fewer
sessions required
Reduced fear response Allows difficult/negative emergent
material to be re-evaluated
Entactogenic (“touching within”) Deeper contact with true self;
recognition of positive aspects of
self
(adapted from Parrott 2007)
How does it work? Psychology
50. Hypothesized MDMA Effect Hypothesized Benefit
Improved mood Positive mood encourages changes
in cognitive models about the
world
Increased interpersonal
connection
Improved couples therapy;
facilitation of therapeutic alliance;
more rapid therapy with fewer
sessions required
Reduced fear response Allows difficult/negative emergent
material to be re-evaluated
Entactogenic (“touching within”) Deeper contact with true self;
recognition of positive aspects of
self
(adapted from Parrott 2007)
How does it work? Psychology
52. Hypothesized MDMA Effect Hypothesized Benefit
Improved mood Positive mood encourages changes
in cognitive models about the
world
Increased interpersonal
connection
Improved couples therapy;
facilitation of therapeutic alliance;
more rapid therapy with fewer
sessions required
Reduced fear response Allows difficult/negative emergent
material to be re-evaluated
Entactogenic (“touching within”) Deeper contact with true self;
recognition of positive aspects of
self
(adapted from Parrott 2007)
How does it work? Psychology
63. Hypothesized MDMA Effect Hypothesized Benefit
Improved mood Positive mood encourages changes
in cognitive models about the
world
Increased interpersonal
connection
Improved couples therapy;
facilitation of therapeutic alliance;
more rapid therapy with fewer
sessions required
Reduced fear response Allows difficult/negative emergent
material to be re-evaluated
Entactogenic (“touching within”) Deeper contact with true self;
recognition of positive aspects of
self
(adapted from Parrott 2007)
How does it work? Psychology
65. Does MDMA really reduce
fear/anxiety?
It significantly decreased anxiety in one
study but not in two others, using the
STAI-S(Liechti & Vollenweider 2000; Liechti et al. 1998; Hasler et
al. 2008)
It increased anxiety scores in females but
not males, using the EWL Apprehension-
anxiety(Liechti et al. 2001)
It increased anxiety, more in females than
males, using a VAS (Bedi and de Wit 2011)
66. MDMA increases anxiety in our
studies
N = 29 (15 M)
Time (hr)
VASScore(-pre)
-15
-10
-5
0
5
10
15
Anxious
0 1 2 3 4 5 6
Relaxed
0 1 2 3 4 5 6
Condition
Placebo
MDMA
N = 29 (15 M)
69. Anxious and More Loving ?
• One possibility: a „Tend-and-befriend‟
response to threat
• Science has traditionally focused on a
„fight-or-flight‟ response to stress, but
mammals often seek safety and comfort
with others.
(Taylor 2006)
76. Hypothesized MDMA Effect Hypothesized Benefit
Improved mood Positive mood encourages changes
in cognitive models about the
world
Increased interpersonal
connection
Improved couples therapy;
facilitation of therapeutic alliance;
more rapid therapy with fewer
sessions required
Reduced fear response Allows difficult/negative emergent
material to be re-evaluated
Entactogenic (“touching within”) Deeper contact with true self;
recognition of positive aspects of
self
(adapted from Parrott 2007)
How does it work? Psychology
77. How do you measure feelings
of deeper contact with one‟s
true self?
78. How do you measure feelings
of deeper contact with one‟s
true self? Authenticity:
The operation of one‟s true self without impediment
1. Awareness: knowing and trusting own motives, feelings, desires,
and self-relevant cognitions.
2. Unbiased Processing of self-relevant information: lack of
interpretive distortions in processing of self-relevant information
(e.g., not being defensive)
3. Behavior: acting in accordance with own values, preferences, and
needs; not acting „„falsely‟‟ for others or rewards.
4. Relational Orientation: acting with openness, sincerity, and truth
in relationships with close others.
(Goldman & Kernis, 2002; Sheldon, Ryan et al. 1997)
80. Overview
MDMA does something novel
•not a typical stimulant (drunken/sedated effects)
•not a typical hallucinogen (consistently positive)
How does it work?
•Neurochemistry: Serotonin, oxytocin,
norepinephrine
•Psychology: Prosocial effects, authenticity
•Reduced anxiety may not be the core effect
(Focus here is on acute (short term) effects)
81. Drugs, like dyes, can serve
as tools to see things that are
difficult to see