MDMA – a hallucinogenic substance used at raves – could dissolve insecurities and resentment in lovers in crisis. A Toronto researcher is preparing to test the effectiveness of this extraordinary couples therapy on 60 people. While in Quebec, psychologists learn to supervise their clients in a hurry to try the formula for themselves.

Coiled under their blanket on a beautiful autumn afternoon, Brigitte and Dominique each swallow half a capsule of white powder. The heart beating at the idea of ​​having finally found a tool to love each other without getting hurt.

Like many couples, the two Montrealers had found themselves exhausted after more than a year of pandemic, misunderstanding and unmet needs.

“It erupted while we were renovating. It was made toxic. We separated, ”summarizes Brigitte. The 40-year-old businesswoman asked us to change their names because they defied the law by swallowing this famous powder. A hallucinogenic substance, MDMA, which is also found in ecstasy.

Brigitte, mother of one child, has always shunned drugs. But the work of a psychologist friend – trained to use MDMA in a clinical trial – gave him confidence. This friend therefore taught her how to proceed on her own, without putting herself in danger.

The experience left Brigitte amazed. “It produces a huge emotional, sensory and sexual explosion! All your barriers are falling! You feel so safe that you automatically want to reveal your vulnerability and listen to the other without anger or judgment. »

“I had never experienced such deep intimacy and trust in my entire life. »

After almost 40 years of prohibition, the approach that Brigitte and Dominique tested in secret is reborn in broad daylight.

A psychologist and professor from Toronto, Anne Wagner, has just obtained approval from Health Canada to study, on 30 couples, the effects of a treatment combining psychotherapy and MDMA.

She will recruit her subjects in the fall, if the ethics committee of the Remedy (mental health research) Institute, where the study will take place, allows it.

Prior to the criminalization of this unique substance in 1985, researchers reported similar success among dozens of couples1.

In 2017, Ms. Wagner followed in their footsteps with another psychologist from Toronto by going to treat six couples in South Carolina, as part of a pilot trial duly approved by the American authorities. A world first with promising results.

Its Canadian study will be five times larger. But as in the United States, one spouse of each couple will have to be in a state of post-traumatic shock. Because the effectiveness of MDMA to treat this disease has already been the subject of an encouraging study2, and since then, Health Canada has provided access to it on a case-by-case basis.

During a two-month psychotherapy, two sessions of MDMA will occur under supervision, to better bring out the buried feelings and memories of the participants. For eight hours they will lie down – blindfolded and wearing earphones – and be able to dive into themselves and converse.

What we avoid — like discussing an affair — perpetuates the problems. Finally getting out of this impasse can therefore be very restorative.

At the end of the sessions, Anne Wagner will compare the state of the participants to that of a control group, who will receive the same drug-free psychotherapy.

In Quebec, a few dozen psychologists have learned from organizations how to supervise individuals who obtain hallucinogens themselves in the hope of getting better.

About 75 North American psychotherapists visited Montreal in November 2019 to take training from Fluence, an American organization founded by researchers to teach how to proceed ethically and without breaking the law. “No therapist can provide MDMA or be present when people are taking it,” says trainer Andrew Rose, who lives in the metropolis.

It is a question of preparing its clients well for the intensity of the emotional discharge that awaits them. Then to promote the integration of what they have experienced.

“The experience can destabilize them and leave them raw and vulnerable, so it’s better to support them than to reject them,” argues Andrew Rose.

MDMA shines the light on your problems, not magically erases them, he warns.

Brigitte and Dominique are lucky. Their experience has brought them so close together that they repeat it a few times a year. Always in small doses, alone and without alcohol. “The next day, we look each other in the eye again,” says Brigitte. Our emotional and sexual complicity is constantly progressing. We feel more in love than when we started! »

The process is not always so successful. A few participants in the Multidisciplinary Association for Psychedelic Studies (MAPS) trials have publicly stated that their treatment (individual, in their case) only made their dark thoughts worse.

MAPS – which is funding the approved study in Toronto – therefore states on its website that “MDMA-assisted psychotherapy is not suitable for everyone and carries risks, even in a therapeutic setting”.

“You have to be careful,” concludes Andrew Rose. But the alcohol and painkillers that people take every day to forget about their difficulties cause much more damage than hallucinogens. »

Outside of clinical trials, MDMA remains difficult to obtain and can be cut with harmful substances, warns psychologist Joe Flanders, one of the pioneers of the therapeutic use of hallucinogens in Montreal and assistant professor at the University McGill.

Anyone who ventures there must therefore obtain a chemical analysis kit. And avoid consulting anyone, he advises.

In 2022, when he developed a training program for Numinus, a network of clinics specializing in these treatments, Joe Flanders found that 35 other organizations were offering courses – sometimes very brief or superficial. “We see a bit of anything,” he said. The lack of standards is a serious problem when a tool gives so much power. »

According to a scientific article, MDMA creates the ideal biological conditions to repair a relationship, by increasing key substances3 such as oxytocin, a hormone that promotes attachment and trust, serotonin, a neurotransmitter that stabilizes mood , and cortisol and norepinephrine, which can increase arousal and motivation (and anxiety). MDMA often increases the urge to touch and be touched. In addition to reducing the activity of the amygdala, the brain structure of fear, points out psychiatrist Nicolas Garel, who has legally treated patients with hallucinogens.

He therefore considers it theoretically possible that MDMA proves beneficial in couples therapy: “But the evidence is almost zero. We don’t have a rigorous study. The researcher finds it hard to imagine, anyway, how a doctor could prescribe MDMA to a couple: “We do not prescribe pharmacological interventions for so-called relational problems. In the United States, where the race for profits is intense, an anesthetic supposed to break down resistance, ketamine, is administered to couples during retreats in spa-like clinics – which are springing up like mushrooms. Canadian physicians in general are more cautious with off-label prescribing of abuse-prone substances, Dr. Garel said. “At this level, it’s the Wild West out there!” »

Although illegal, MDMA can already be prescribed to patients in exceptional cases. Here’s what you need to know about it.

When an individual suffering from a serious illness cannot be treated otherwise, Health Canada can authorize a doctor to prescribe MDMA, although it remains illegal. Over the past 18 months, the Ministry has accepted 17 of 30 requests submitted to the special access program, he wrote to us.

On July 1, Australia became the first country in the world to allow its doctors to fill an MDMA prescription without going to the authorities first.

Their American colleagues could imitate them by the end of the year, if the next results of the Multidisciplinary Association for Psychedelic Studies (MAPS) – which funds the trials – turn out to be as positive as in 2021.

In addition to university hospitals, a few private clinics – such as Numinus in Montreal – treat patients who have been granted special authorization to receive MDMA.

Because the latter increases emotional intensity and sensitivity to the environment, the setting must be calm and reassuring, explains psychiatrist Nicolas Garel, who uses hallucinogens in research and in the clinic. ” That makes all the difference. This is why the treatment rooms are beautiful and welcoming, with plants and light. »

“After a few hours, the acute effects of MDMA wear off, but for several days it continues to exert a subtle influence,” notes Joe Flanders, the only Quebec psychologist to have used it to treat post-convulsant shock. trauma in a clinical trial.

“The emotional openness it creates lasts for up to two weeks,” he says. Over time, it can continue to increase harmony in a couple. »

The psychologist François Saint-Père treats (without MDMA) many lovers on the verge of breaking up. He knows how demanding changing their dynamic is. “Often when I meet them, it’s been bad for years. They attach their spouse to something aversive. The repetition of his little behaviors heightened their emotional reactions. So they are no longer interested in him, no longer reveal themselves and accuse each other or counterattack. »

“If a substance like MDMA breaks down those barriers and breaks that deadlock, it can produce a positive juxtaposition experience, which will consolidate another emotional memory. It’s like reprogramming. »

Ecstasy purchased on the black market is typically mixed with mystery drugs and swallowed unsupervised, which among other things increases the risk of heat shock or, sometimes, psychiatric problems. During repeated intakes, amateurs can also develop cognitive deficits, reports psychiatrist Nicolas Garel.

Nothing similar has been observed in clinical trials, however, he says. The participants’ blood pressure and temperature rise slightly: “But all the medical monitoring is done. »

For fragile people, who are particularly at risk of psychosis or a heart attack, MDMA remains contraindicated.