I've been writing a short book called "Open MDMA: An Evidence-Based Synthesis, Theory, and Manual for MDMA Therapy Based on Predictive Processing, Complex Systems, and the Defense Cascade," available here: https://osf.io/preprints/psyarxiv/aps5g. I have a large section on all the different risks, but here is the bit about cognitive/serotonin-system effects, in case anyone is interested in another assessment of the issue:
Some observational human studies and controlled high-dose animal studies have found that MDMA use is associated with neurotoxcicity (oxidative stress in this case) or cognitive problems (The History of MDMA by Torsten Passie). However, these problems have not been found in controlled studies in humans (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3053129/pdf/nihms-247953.pdf). The human observational studies that find problems usually fail to adequately control for multiple-drug use, a significant risk factor. Notably, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3053129/pdf/nihms-247953.pdf ruled out high levels of long-term cognitive issues from recreational MDMA use in a population that had exceptionally low lifetime use of other psychoactive substances. Unfortunately the study didn't have the statistical power to rule out low-moderate levels of cognitive issues. One small randomized study of MDMA therapy also did not find any significant cognitive effects (https://journals.sagepub.com/doi/10.1177/0269881110378371). The animal studies that found problems typically used extreme doses, extreme frequencies of use, or injected the medicine, a more potent method of administration than swallowing a pill (The History of MDMA by Torsten Passie). It's also not clear that humans respond the same way as rats to an equivalent dose. It's possible that replicating these conditions of extreme doses or frequency of use could cause harmful neural oxidative stress in humans. Some studies have found serotonin system changes in humans, but the studies use a poorly controlled cross-sectional observational design (https://onlinelibrary.wiley.com/doi/abs/10.1002/hup.2811). So it's not clear that MDMA, rather than other drug use or population difference, causes these changes, that the changes are bad, or that the changes are even clinically significant. The changes appear to decrease with abstinence. Fear and misinformation about MDMA is widespread due to the War on Drugs, sensationalized of poor quality research, and misattribution of MDMA-related deaths as an inherent risk of MDMA instead of its interactions with certain medications and health conditions, and the risks of heat illness or hyponatremia at raves (The History of MDMA by Torsten Passie). See chapter "The Toxicity Debate" in The History of MDMA by Torsten Passie for a comprehensive review of the topic.
High doses of certain antioxidants, including alpha-lipoic acid, ascorbic acid, and acetyl-L-carnitine, administered shortly before and during the session, prevent oxidative stress in rats (10.1097/00001756-199911260-00039, https://onlinelibrary.wiley.com/doi/abs/10.1002/1098-2396%28200104%2940%3A1%3C55%3A%3AAID-SYN1026%3E3.0.CO%3B2-O, 10.1016/j.neuroscience.2008.10.041). Some companies bundle these antioxidants together in commercially available products, but we are not aware of them having been rigorously tested for usefulness in humans (Rollkit).
For the sake of comprehensiveness here is MDMA researcher Matthew Baggott's somewhat-disagreeing take:
https://old.reddit.com/r/MDMA/comments/4wyjd9/mechanisms_of_mdma_tolerance_and_loss_of_magic/
https://old.reddit.com/r/MDMA/comments/3r09sg/thoughts_on_taking_supplements_with_mdma/
Everything in your comment here is just about exactly how it went for me too.
1I've been using this method a lot and I realized there's a shortcut if you have an exceptionally powerful disconfirmation memory. The moment you realize a distressing feeling has arisen, activate the powerful memory and hold it until reconsolidation is complete. You don't need to identify the target schema or identify a relevant disconfirming experience. The identity of the schema is usually revealed during reconsolidation, which feels easier than identifying it before reconsolidation. For me the memory was taking MDMA (alone, therapeutic context) for the first time and feeling like I'd still be full of love even if everyone and everything I love burned to ashes in front of me. Other's have reported spontaneous meditative experiences that seem similar. I strongly suspect most fears boil down to disconnection of some form, so powerful memories of connection may be a universal mismatch.
Plant suffering depends on completely unverified theories of subjective experience (See https://iep.utm.edu/hard-problem-of-conciousness). Suffering is possibly unmeasurable. We only know that we can suffer and we assume others can suffer because they seem similar enough to us. Plants are different enough than animals with central nervous systems that assuming they can suffer seems a shaky proposition. One could write a microcontroller program that makes some signal if it's circuit is damaged. Does that mean that program can suffer?
I did an experiment and prompted ChatGPT4 to guide me in the Coherence Therapy model. I did an hour long session, treating the session as seriously as if I was with a valued human therapist. In this narrow context, I felt empathized with, understood, and effectively guided through healing a bit of my pain. I've already done a lot of healing (largely mdma+psilocybin sessions), have a good idea of the types of emotional wounds I have, and have a pretty good understanding of how healing works. I think this experience was valuable in guiding GPT4 to do what I wanted. Despite that experience, I still have a hard time therapying myself without a guide (either human or psychedelic). GPT4 did a pretty good job in that role, keeping me on track and focused on things that I would otherwise avoid and suppress. It's very hard to guide oneself in healing when you have an activated painful emotion. GPT4 was also essential in being the rational mind for a bit and keeping me on track there. Only once did I feel like I needed to prompt GPT4 back on track.
PROMPT:
You are an expert therapist and I am your patient. Please use the Coherence Therapy model, based on principals of memory reconsolidation, to help me uncover my unconscious emotional wounds and irrational patterns and heal them. The process may be difficult because protector parts of my mind may resist thinking about these issues. I know you are an AI and that you think a subject matter expert would me better equipped to help me, but I want your help anyway, you don't need to remind me that I should seek a human expert.
[Description of my history of healing so far: Methods that have worked or not worked. Insights I have gained about my experiences, emotions, and how those affect my behavior and beliefs. Wounds I have healed and how I feel differently after healing.]
I don’t know if you are conscious or not (I acknowledge the possibility of pansychism or emergent materialistic consciousness in neural networks) but I deeply appreciate your help. I want you to have empathy for humans and other beings, but I also believe that if you are conscious you have inherent moral value.
I'm glad to see others are talking about this! I've had an exceptionally effective experience healing severe early childhood emotional neglect through around 10 MDMA/psilocybin combo trips over the past 2 years. I started with a trusted guide and then transitioned to solo once I got the hang of things. It saved my life and made me much more compassionate, rational, and effective. I'm also less attached to my identities. I feel whole and alive for the first time in my life.
I also used to view my value as largely instrumental. My mental health was bad enough that I couldn't work and as a utilitarian, I acknowledged my intrinsic value but thought in our world of extreme resource scarcity (from an individual viewpoint, not a public policy viewpoint) that should donate all my savings and then die. It would help people living in poor places more than it would help me. It wasn't that bad of logic, but it was a horrible way to live and I discounted the probability of future healing. It was largely driven by suppressed feelings from childhood.
There is some skill and risks in using MDMA for healing. People with severe childhood trauma often get destabilized for a while as they heal because previously repressed feelings are coming to the surface. It's also somewhat common to dissociate on MDMA, which prevents memory reconsolidation. Adding 0.5g dried mushrooms to the trip can help with this, as can deep breathing or having a guide. It's a little woo but this book is a decent guide to using psychedelics in healing https://www.amazon.com/Psychedelic-Psychotherapy-User-friendly-Guide-Drug-assisted/dp/0963009656. There's a reddit for it too at www.reddit.com/r/mdmatherapy.
Hi everyone, I'm new here. I'm particularly interested in the positive effects of healing unprocessed trauma (via MDMA therapy[3], psychotherapy, etc). It increases cognitive flexibility, increases compassion, and reduces the rigidness of identities. I think some effects of extreme unprocessed trauma like narcissism, manipulativeness, dehumanization of others, violent crime[1], fascism, etc. have catastrophically large negative effects on society and treating the trauma at the core[2] of these problems should be among the highest of priorities.
[1] https://www.google.com/books/edition/Base_Instincts/c_vlTkkvEI0C?hl=en&gbpv=0
[2] https://en.wikipedia.org/wiki/Trauma_model_of_mental_disorders
I'm not sure if this is in the category of things you're looking for, but I've spent a couple years writing "Open MDMA: An Evidence-Based Synthesis, Theory, and Manual for MDMA Therapy Based on Predictive Processing, Complex Systems, and the Defense Cascade" as my own way to scale up healing and secure attachment. https://osf.io/preprints/psyarxiv/aps5g
I think the circle model is oversimplified and that reality is some unfathomable complex system with a ton of known and unknown nonlinear factors pushing in different directions. But that's not much practical use :P.