Rick Doblin: How Can We Use Psychedelic-Assisted Therapy To Treat Trauma?

Mar 19, 2021

Part 3 of the TED Radio Hour episode Through The Looking Glass

Many psychedelic drugs are illegal in the U.S. But Rick Doblin says psychedelic-assisted therapy helps many patients get to the core of their trauma.

About Rick Doblin

Rick Doblin is a psychedelic-assisted psychotherapist as well as the founder and executive director of a nonprofit pharmaceutical company — the Multidisciplinary Association for Psychedelic Studies (MAPS).

His research focuses on developing legal contexts for the safe uses of psychedelics and marijuana as prescription medicine and for personal growth. Today, his non-profit is both designing and sponsoring drug development research in over a dozen countries.

Doblin received his Bachelor's from the New College of Florida, and Master's and Ph.D. in Public Policy from Harvard University's Kennedy School of Government.

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TED Radio Hour / NPR

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MANOUSH ZOMORODI, HOST:

On the show today, Through the Looking Glass. and so far, we've taken the looking glass quite literally - scientists peering into space or magnifying the tiny universes that exist in a drop of water. But how about we turn that looking glass inward and into our own minds?

RICK DOBLIN: I think we can talk about the human mind, the unconscious, as the final frontier.

ZOMORODI: This is therapist Rick Doblin.

DOBLIN: And what we need to do is to engage in a deep understanding and exploration of the unconscious.

ZOMORODI: And Rick researches the final frontier of the unconscious with psychedelics.

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DOBLIN: Preparing for this talk has been scarier for me than preparing for LSD therapy.

ZOMORODI: Here he is on the TED stage.

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DOBLIN: Psychedelics are to the study of the mind what the microscope is to biology and the telescope is to astronomy. Dr. Stanislav Grof spoke those words.

ZOMORODI: Right now, there are clinical trials using psychedelic drugs in conjunction with therapy to treat...

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DOBLIN: ...PTSD, Depression...

ZOMORODI: ...Social anxiety...

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DOBLIN: ...Substance abuse...

ZOMORODI: ...Alcoholism...

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DOBLIN: ...And suicide.

ZOMORODI: And so far, the results are promising.

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DOBLIN: Psychedelic psychotherapy is an attempt to go after the root causes of the problems with just a relatively few administrations, as contrasted to most of the psychiatric drugs used today that are mostly just reducing symptoms and are meant to be taken on a daily basis.

ZOMORODI: But changing people's minds over the safety and efficacy of psychedelic drugs has taken decades.

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DOBLIN: In the 1950s and '60s, psychedelic research flourished and showed great promise for the fields of psychiatry, psychology and psychotherapy. But psychedelics leaked out of the research settings and began to be used by the counterculture and by the anti-Vietnam War movement. And so there was a backlash.

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RICHARD NIXON: America's public enemy No. 1 in the United States is drug abuse.

ZOMORODI: So there's this huge backlash. There's lots of fear. There's cautionary tales around psychedelics. But despite that, you decided to try it anyway. What was your experience like?

DOBLIN: Well, I felt like this experience opened me up to emotions. It started making me more balanced and was really starting to make me think of existential questions, and who am I, and where am I, and where did I come from? When you shift from your ego orientation, where you don't see things from your individual perspective so much, you hear more a sense of the group and of how we're all interconnected.

And this is only a few years after we had the first images of the Earth from space. And so my kind of awakening to psychedelics was, you could say, humanity's awakening to our place in the universe. And so this was like a drowning sailor in a crazy world finding this life preserver, which for me was LSD.

ZOMORODI: So - OK, so there probably were a lot of college students who dropped acid and then went on to live a life, but you actually decided to dedicate your life to researching the effects of various different psychedelics on people's mental health. Tell me, like, how did that happen?

DOBLIN: Well, when I had this experience with psychedelics and thought, just in the early stages, this could be a contribution to helping people overcome their sense of separateness and to build a healthier world, I thought, this is what I want to do. And so that's where, at age 18, I decided to go through my own psychedelic therapy, become a psychedelic therapist and try to bring back psychedelic research.

ZOMORODI: Rick started down a long path to become a psychedelic-assisted psychotherapist, but he realized his dream couldn't come true if these drugs were illegal. And so he founded a group to help legalize psychedelics for medicinal use. Just a warning - parts of this next story may be hard to hear. It all started with one particular drug, MDMA, and Rick's friend named Marcela (ph).

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DOBLIN: Marcela, who suffered from post-traumatic stress disorder from a violent sexual assault - Marcela and I were introduced in 1984 when MDMA was still legal, but it was beginning, also, to leak out of therapeutic circles. Marcela had tried MDMA in a recreational setting, and during that, her past trauma flooded her awareness, and it intensified her suicidal feelings.

During our first conversation, I shared that when MDMA was - is taken therapeutically, it can reduce the fear of difficult emotions, and she could help move forward past her trauma. I asked her to promise not to commit suicide if we are to work together, and she agreed and made that promise. During her therapeutic sessions, Marcela was able to process her trauma more fluidly, more easily.

And so being able to share the story and experience the feelings and the thoughts in her mind freed her, and she was able to decide that she wanted to move forward with her life. Now, 35 years later, after Marcela's treatment, she's actually a therapist, training other therapists to help people overcome PTSD with MDMA.

ZOMORODI: So this experience really changed both of your lives. And in particular, though, it really launched you on a path to try and legitimize MDMA as a therapeutic drug. And I wonder - can you just tell me more about how it actually works in the brain?

DOBLIN: Yeah. So what we do know is that MDMA releases serotonin, dopamine, norepinephrine - sort of neurotransmitters It also releases a lot of hormones and, in particular, oxytocin. As well, MDMA impacts how the energy is distributed in the brain. And so it reduces activity in the amygdala, which is the fear-processing part of the brain. It increases activity in the prefrontal cortex, where we think logically, and it increases connectivity between the amygdala and the hippocampus, where memories are put into long-term storage.

So the problem of PTSD is that the trauma from the past never really seems like it's in the past. It colors the present, and people see the present through the lens of the past and the lens of the past trauma. And so in this complex neurotransmitter release, hormonal release, energy that's shifted in how the brain is processing, it's actually the - in some ways, an ideal drug for PTSD.

ZOMORODI: More from Rick Doblin and the clinical trials happening today to treat PTSD with psychedelics when we come back. On the show today, through the looking glass. I'm Manoush Zomorodi, and this is the TED Radio Hour from NPR.

It's the TED Radio Hour from NPR. I'm Manoush Zomorodi, and on the show today, Through the Looking Glass. We're taking a look at the world, the universe and our own minds through specially built tools. And some people believe a tool to look through one's own mind is the psychedelic drug MDMA.

DOBLIN: It's the most gentle of all the psychedelics, and MDMA was sort of the best for the mission of trying to bring back from the underground psychedelic-assisted psychotherapy.

ZOMORODI: This, again, is Rick Doblin. He's a therapist and researcher at the forefront of psychedelic-assisted therapy. Rick and his team have spent decades running clinical trials and crafting therapies using MDMA to treat PTSD. One of his patients was Tony.

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DOBLIN: Tony was a veteran in one of our pilot studies. The treatment that Tony was to receive was three and a half months long. But during that period of time, he would only get MDMA on three occasions. We call our treatment approach inner-directed therapy in that we support the patient to experience whatever is emerging within their minds or their bodies. During Tony's first MDMA session, he lay on the couch. He had eyeshades on. He listened to music, and he would speak to the therapist whenever he felt that he needed to.

In a moment of calmness and clarity, Tony shared that he had realized that his PTSD was a way of connecting him to his friends. It was a way of honoring the memory of his friends who had died. He was able to shift and see himself through the eyes of his dead friends, and he realized that they would not want him to suffer, to squander his life. They would want him to live more fully, which they were unable to do. And so he realized that there was a new way to honor their memory, which was to live as fully as possible. That was seven years ago. Tony is still free of PTSD and is helping others less fortunate than himself in Cambodia.

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ZOMORODI: I mean, it's an incredible story. But, you know, was Tony a special case? How has the program done overall? What is the success rate?

DOBLIN: So in phase two, we looked at the control groups. And what it turned out is that 23% at the two-month follow-up no longer qualified for a diagnosis of PTSD with therapy, basically. But when we add MDMA to the mix, now 56% no longer have PTSD. But even more important than that is the 12-month follow-up. And at the 12-month follow-up, two-thirds no longer had PTSD.

ZOMORODI: OK, so you've seen it work in a therapeutic setting. But that doesn't mean that it would work for everyone or that there aren't any risks involved, right?

DOBLIN: Yeah. So I think that psychedelics have a role to play in the survival and thriving of humanity, but it doesn't mean everybody should take them. And it also doesn't mean that psychedelics are the only way to get through these experiences. So I think one of the big mistakes of the '60s was that the advocates said, I've taken psychedelics; I know more than anybody; unless you've taken psychedelics, you don't really know what's going on, and exaggerated the benefits and minimized the risks. In the face of the government that was getting more and more scared about psychedelics and counterculture, they were denying the benefits, suppressing the research and exaggerating the risks.

ZOMORODI: OK, so then what would you say is the biggest hurdle for you right now, Rick? Like, is it to be able to get MDMA into the hands of therapists and then to patients? Is it still regulations and the government?

DOBLIN: Well, in the process of this, we have basically changed the attitudes of regulators. They actually would like us to succeed. I think the biggest concern that we have now is public education. It was the public fear in the '60s and '70s that led to the wiping out of psychedelic research around the world. The regulators were following sort of the attitudes of the public, who got frightened about problem use of psychedelics.

But there's a general sense now that we are in the midst of a massive crisis of opiate overdoses, fentanyl overdoses, alcoholism, drug - deaths of despair. The need is greater than ever before. The war on drugs is seen more and more around the world as not a solution to drug abuse but as a contributor to drug abuse and to the black market. So all of this, I think, is that public education is the most important thing for us to do now.

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DOBLIN: I'm proud to say that we have now initiated our phase three studies. And if approved, the only therapists that will be able to directly administer it to patients are going to be therapists that have been through our training program. And they will only be able to administer MDMA under direct supervision in clinic settings. We anticipate that over the next several decades, there will be thousands of psychedelic clinics established, at which therapists will be able to administer MDMA, psilocybin, ketamine and other psychedelics to potentially millions of patients. And now if you all just look under your seats - just joking.

(LAUGHTER)

DOBLIN: Thank you.

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ZOMORODI: That's Rick Doblin. He's founder of the Multidisciplinary Association for Psychedelic Studies. You can see his full talk at ted.com. Transcript provided by NPR, Copyright NPR.