During Follow-up and Integration sessions, the therapists are present to answer any questions the participant may have about his or her experiences and offer support and encouragement as the participant processes the intrapsychic realities and new perceptions gained through the MDMA session. The therapists take a supportive and validating stance toward the participant's experience. They also facilitate the participant's understanding of the trauma from insights and perspectives gained from the opening of new channels of emotion and thought, and the clearing of other reactions and thoughts that may have outlived their usefulness. There may be times when the therapists offer insights or interpretations of the participant's experience, but care should be taken to do this sparingly. Participants should be encouraged to exercise their own judgment about what they may or may not resonate with and apply their own experience. The therapists work to maintain the participant's focus on his/her therapeutic goals, work through the memories of the traumatic event(s), and help the participant come to new conclusions about the meaning of these events. The therapists clearly position themselves throughout the therapy in the roles of empathic listener, trustworthy guide, facilitator of deep emotional expression and catharsis, and assistant to participant's bodily wisdom in self-healing.

As empathic listeners, the therapists attend to the participant's account of his/her inner experience and create space for the participant's own meanings or for his/her ambivalent thoughts and feelings about the experience. The therapists offer the appropriate assistance needed for the participant to cope with any apparent ambiguity, while fostering the awareness that it is the participant who is responsible for his/her own healing. The process of MDMA-assisted psychotherapy for the treatment of PTSD continues well after the MDMA sessions are complete. As was discussed at the beginning of this manual, it is hypothesized that MDMA will be a powerful ally for the participant and the therapists. It is further hypothesized that MDMA will assist the participant and therapists in restructuring the participant's intrapsychic realities in relation to the trauma so as to develop a wider behavioral and emotional repertoire with which to respond to anxiogenic stimuli. To reach this goal the therapists and participant embark on integration of the treatment process. The integration of these valuable lessons learned while experiencing a non-ordinary state of consciousness is an essential part of MDMA-assisted psychotherapy