Mind Body Health & Politics
Mind Body Health & Politics
Beyond 'Ecstasy'

Beyond 'Ecstasy'

Dr. Michael Mithoefer on the Promise and Perils of MDMA-Assisted Psychotherapy

Dear Friends,

You may have heard scary media reports referring to the psychedelic medicine known as MDMA as “Ecstasy.”

Ecstasy is framed by the misinformed media as a dangerous and habit-forming party drug, that turns teenagers’ brains into Swiss cheese with just a single use.

However, breakthrough research is revealing a more nuanced understanding of this compound. I’ve known since my first experiences with it in the 1980s that MDMA can help heal trauma when used responsibly.

Psychiatrist Dr. Michael Mithoefer is a pioneering psychedelic therapy researcher, who I interviewed for my first book, Psychedelic Medicine back in 2016. His groundbreaking work with the Multidisciplinary Association for Psychedelic Studies (MAPS) demonstrates MDMA’s remarkable effectiveness when combined with therapy.

He and his wife, Annie, conducted MAPS-sponsored clinical trials testing MDMA-assisted psychotherapy for PTSD related to crime, military veterans, firefighters, police officers, and couples. He served as Medical Monitor for several Phase 2 trials that led to FDA breakthrough therapy designation. Since 2012, he and Annie have trained and supervised research therapists in ongoing MAPS clinical trials. He is board certified in Psychiatry, Emergency Medicine, and Internal Medicine, and is a Fellow of the American Psychiatric Association. He also received training in Grof Holotropic Breathwork, Internal Family Systems Therapy, and EMDR. He is an Affiliate Assistant Professor at MUSC and a Clinical Assistant Professor at Columbia University.

Dr. Mithoefer provides rare insider perspective into this exciting frontier of psychedelic medicine, having guided hundreds of MDMA sessions.

While showing great promise for healing, Mithoefer notes that MDMA is not simply a “feel good” pill or panacea. Rather, he views it as a catalyst to enhance psychotherapy. It can open access to intense emotions – ecstasy, yes, but also pain. Anxiety may flare temporarily as old wounds surface. However, with proper set, setting, and therapeutic support, overwhelming anxiety can shift into self-insight.

As Dr. Mithoefer explained, “MDMA tends to hold anxiety or other difficult feelings at bay enough for people to process experiences in a way instead of being overwhelmed by anxiety.” By lowering defenses, MDMA provides a window into normally repressed feelings necessary to resolve trauma.

Unrealistic expectations could lead some to use it in uncontrolled settings with greater risk of adverse effects without therapy to integrate experiences.

Proper preparation and integration is essential, Dr. Mithoefer emphasizes:

“If you didn't have that perspective and you didn't have a way to help people talk about and process what's coming up, I think they could be in danger.”

His balanced caution demonstrates why MDMA research requires meticulous care under medical supervision.

I hope Dr. Mithoefer’s insights leave you as inspired as I am about MDMA research furthering human potential. Please help support MAPS’ pioneering work by sharing this episode with others curious about psychedelic therapy.

Golden light,

Dr. Richard Louis Miller

Show notes:

The Renaissance of Psychedelic Medicine

  • Community central to psychedelic therapy

  • Historic parallels from 1960s backlash to current renaissance

  • Promises and perils of integrating psychedelics into mainstream medicine

Maximizing Benefits and Minimizing Risks

  • Importance of transparency about adverse effects

  • Cardiovascular effects versus anxiety reactions

  • Careful screening and preparation of participants

  • Maintaining therapeutic boundaries

The Subjective Effects of MDMA

  • Intensification of emotions, pain, and ecstasy

  • Temporary increase in anxiety and suicidal thinking

  • Not a magic pill, but a catalyst for psychotherapy

Looking Ahead to Expanded Access

  • Training therapists in psychedelic medicine

  • Providing legal access beyond research

  • Avoiding unrealistic expectations about MDMA

  • Fostering integration over frequent use

Links and references:

Explore More MBHP

NOTE: The podcast is always freely available thanks to our paid subscribers. Please share this post to show your support for transparency. The following transcript distills the key points from this show into a condensed form. It is meant as a reference - listen to the full episode for an accurate rendition of the conversation.

Mind Body Health & Politics is a reader-supported publication. To receive new posts and support my broadcast, consider becoming a free or paid subscriber.



  • Mind body health and politics. Dr richard louis miller.

  • The mission of mind body health.

  • Greeks and Romans experimented with republics before the american revolution.

  • Eternal vigilance is the future.

Dr. Richard Miller 0:01

Welcome to Mind Body Health and Politics. I'm your host, Dr. Richard Louis Miller. Our mission is to enhance your physical and emotional well-being and encourage community. We believe that community is the healthiest and most effective way for us to live. As humans, we are friendly tribal animals who like to cooperate, collaborate, and enjoy each other's company. We love doing things together, from sewing circles to poker games to watching football games. Eating together, chatting, and spending time with family and friends is important to us.

But we must also be aware that there is a small percentage of people who are different. These people are predators and dominators. They ruled in the past with clubs and have continued to rule through history. Kings and warlords led countries, and people were subjects to their will. Eventually, republics were created where everyone was equal before the law. However, democracies and republics are not permanent and must be taken care of like a garden. We must be aware of those who seek to rule as subjects rather than having us be citizens.

These are challenging times, and many Americans are struggling to put food on the table. Nonetheless, we must remember to vote and take care of our democracy and republic. As Thomas Jefferson said, "Eternal vigilance is the price of liberty."

On today's show, we have Dr. Michael Mithoefer, a psychiatrist and the principal investigator for the MAPS MDMA study. This study is making history in the US and on the planet. Welcome to Mind Body Health and Politics, Michael.

The renaissance of psychedelics and its cultural effect. 4:55

  • Healing happens in community.

  • The renaissance of psychedelics and its cultural effect.

  • Two competing ideologies, the social Darwinist and the social humanist.

  • The two competing ideologies of medicine.

Michael Mithoefer 4:55

Thank you, Richard. It's great to see you and have a chance to talk. I just want to clarify that I'm not the principal investigator for all the map studies. In the more recent ones, I've played more of a support role, but I have been the principal investigator on a number of them. I really liked what you said. A couple of things you mentioned seem to apply to psychedelic therapy, which is what I'm most interested in my work life. As Bessel Van der Kolk says, healing happens in community. In my opinion, the kind of process people are having using these medicines therapeutically is much bigger than just a treatment for a disorder. It involves their relationship with the people around them, making the community very important. Also, even though we don't have a king anymore, the reason we're not many decades further ahead in this research is that Richard Nixon decided that these medicines were illegal. So there's a parallel there too.

Dr. Richard Miller 6:23

Yes, the good news is that he was thrown out of office, but the bad news is that he caused a great deal of damage. When he declared the "war on drugs," it was really a war on people, specifically people of color and those who were called "hippies". This focus on drugs rather than individuals set us back significantly.

Listen to this episode with a 7-day free trial

Subscribe to Mind Body Health & Politics to listen to this post and get 7 days of free access to the full post archives.

Mind Body Health & Politics
Mind Body Health & Politics
Dr. Richard Louis Miller is an American Clinical Psychologist, Founder of Wilbur Hot Springs Health Sanctuary, and broadcaster who hosts the Mind Body Health & Politics talk radio program from Mendocino County, California. Dr. Miller was also Founder and chief clinician of the nationally acclaimed, pioneering, Cokenders Alcohol and Drug Program. Dr. Miller’s new book, Psychedelic Medicine, is based on his interviews with the most acclaimed experts on the topic. Mind Body Health & Politics radio broadcast is known for its wide ranging discussions on political issues and health. The program’s format includes guest interviews with prominent national authorities, scientists, best-selling authors, and listener call-ins. The programs offer a forum and soundboard for listeners to interact with the show and its guests. We invite you to listen to the latest broadcasts below or visit our many archived programs. We’d love to hear from you on political and health issues!