Stage Three: Therapist Preparation

In addition to standard training in the psychotherapeutic treatment of PTSD, therapists would substantially benefit from personal experience with non-ordinary states of consciousness. Preferably, this would include personal experience with MDMA in a therapeutic setting. If this is not possible for legal or medical reasons, a series of sessions using Holotropic Breathwork (a non- drug method for working with non-ordinary states) would also be beneficial. This personal experience is important for several reasons:

  1. It will increase the therapist's level of comfort with intense emotional experience and its expression.
  2. It will provide first hand validation of and trust in the intelligence of the therapeutic process as it arises from an individual's psyche.
  3. It affords the therapist familiarity with the terrain and flavor of non-ordinary states of consciousness. This can be invaluable to the therapist's effort to understand and empathize with the patient's experience.
  4. Therapists familiar with non-ordinary states of consciousness should also be familiar with features of the experience that the patient might find most helpful or particularly unsettling. Additionally, the therapist has an intrapersonal working knowledge of the integration process related to this type of therapeutic process.
  5. The patient's sense of security and treatment alliance will be enhanced if the patient is aware the therapist has had a similar kind of experience.
At the start of therapy, the therapists encourage the participant to share his/her purpose and intention for the therapy experience. During the session the therapists are aware of this intention and may under some circumstances redirect the participant's attention to it. However, the therapists should be guided by, follow and support whatever course the participant's own emotional process takes, rather than trying to impose upon it some predetermined course or outcome. The therapists are charged with maintaining a high level of empathic presence throughout the therapy session. This empathic presence supports the participant in staying with his/her inner process when it is important to do so. Furthermore, this empathic presence allows for the therapists to appropriately respond to the participant's non-verbal behavior, have a dialogue with the patient when necessary, and offer physical touch when indicated.

During MDMA sessions, the therapists enlist the medicine's qualities to enhance the therapeutic experience. The therapists respect the medicine's "apparent facility in inducing heightened states of empathic rapport" (Grob et al, 1996, p. 103) and operate within the previously discussed ethical guidelines and established parameters of treatment. The therapists should understand the importance of their own mental set vis a vis this therapy and have a clear understanding of their own beliefs related to the use of MDMA as an adjunct to therapy. The following section will discuss the three steps in Phase II: MDMA sessions.