Episode 37: MDMA and Couples with Dr. Anne Wagner

 

“I envision a day where people would be able to choose to do MDMA-assisted psychotherapy in a safe context to be either able to heal from something together or to grow together, and to support the relationship.”

In this episode of the Numinus podcast, Dr. Joe speaks with Dr. Anne Wagner. Anne is a Toronto-based psychologist and couples therapist, a researcher studying MDMA-assisted therapy, and the founder of Remedy Centre. Remedy is a social venture that provides individual, couples, and group therapy and reinvests the profit from these services into the Remedy Institute, which is “a new charity focused on supporting mental health innovation & research, including with psychedelics, training for aspiring mental health professionals, as well as low to no-cost therapy services for marginalized communities.”

She is the principal investigator on a pilot trial studying the impact of MDMA-assisted Cognitive Processing Therapy (CPT) on PTSD and is planning a study that will examine the impact of MDMA-assisted Cognitive Behavioural Conjoint Therapy (CBCT) on PTSD.

If you’d like to donate to the Remedy Institute, please check out: canadahelps.org/en/charities/remedy-institute

Dr. Joe and Dr. Wagner spoke about:

 

Here is more information on subjects mentioned in this episode:

 

More quotes from Dr. Anne Wagner from the interview:

“We’ve been doing the first trials that have been anything other than the inner-directed supported approach. So there’s a lot to ask, and a lot to investigate.”

 

“​​Not only does bringing someone along with you on your healing journey provide support, but it also provides the partner with their own support and healing.”

 

“It’s been really interesting seeing folks work with MDMA to help as a catalyst for that meaning-making process.”

 

“People take turns of who is struggling and who is okay. And that can be something that is really nice where they learn to ride the waves of that together.”

 

“I really try to help people frame their ideas around not expecting to have an expected outcome.”

 

Here are some highlights of their conversation:

Before we get to the trial that you’re planning, I want to ask you a quick one about the study going on right now. What’s interesting is that you described it as like a meaning making framework and so it’s very cognitive. And the trends and the buzz and all the excitement is around relational therapy, somatic therapy. Like these are the things that are bubbling up for me in terms of what approaches are being used in psychedelics. And this is a very cognitive approach. 

I’m just curious how you think about that in the sense that I don’t know how many times I’ve heard like, ‘well, you can’t just do like cognitive therapy with someone doing MDMA. It’s just not somehow adequate to touch the depths of the experiences people are having.’ So just really curious about your thoughts there.

I respectfully disagree with thoughts that are the impressions that are there around it. And I think it’s partly because of the–it is possible to do cognitive therapy in a way that feels stiff and disjointed and doesn’t go into the depths. But I think if you’re delivering it in a way and working with the participant in a way that’s bringing in all of their experiences, it’s an incredibly rich way of working with everything that comes up.

And so of course, like even though it’s cognitively focused in terms of meaning making, we’re working with emotions, we’re working with sensations, we’re working with behaviours. It’s not excluding any of those components.

And it’s helping folks not only work with what has happened and the interpretation of what’s there, but also what’s happening now and what’s going into the future. It allows for the sense of my everyday life. ‘Oh, this is how this is going to change and this is how I can implement it.’ And that we find really effective.

It’s been really interesting seeing folks work with the MDMA sessions to help as a catalyst for that meaning making process because there is so much meaning making that happens in the MDMA sessions. And you’re just providing a bit of a frame to help that continue afterwards. So I always think of that as the catalyst.

 

I came up with this analogy the other day that has stuck around for me. I’d be curious if you’re on board with it. If you get a bacterial infection like strep throat or something. Your body could probably heal it, right? No problem. You’re healthy, you have a functioning immune system. It might take a little bit longer and you may not feel so great, but you can probably handle it. Or you can go to the doctor and get a medicine to help your body heal some health problems. 

And I’ve started to think about maybe psychedelics in general or MDMA for couples where there may be something broken or something challenging happening in the couple that if they were to go for walks and go out for dinner and whatever, take the time to invest in themselves, they could probably heal through it. But MDMA is a medicine that might help speed up or deepen that process in some way. Which means that there may be situations in some future state where you can go to the clinic with your partner and get MDMA couples therapy to accelerate healing that might otherwise happen organically. Your thoughts on that? 

Yeah, I do think that that’s a possibility. I think the medicine analogy is an interesting one because I actually had this conversation earlier this week with someone who was raising the point that I think sometimes people think that the taking of the pill is the thing that will cure them and be helpful. And it’s actually nothing. Like as far as we know, there isn’t anything inherent yet in the taking of that pill with MDMA in particular, that would have that effect.

It’s the psychotherapy, the psychological process that happens after that would create that shift. So I do think, though, that the experience, the MDMA session as being something that can help speed it up. It can help you do a good piece of work, a good chunk of work in a quick period of time. That’s true. And so that’s where I think it could exactly be really helpful.

I envision a day where people would be able to do that and choose to do that as something to either–with support and in a safe context–be able either to heal from something together or to grow together in a different way and to support their relationship. That would be fantastic to have that capability and that possibility.

 

Connect with Dr. Joe on FacebookTwitter,LinkedIn and Instagram

Connect with Dr. Anne Wagner on Twitter and LinkedIn.

Follow Remedy Centre on Instagram.

Follow Numinus on FacebookTwitterInstagramLinkedIn, and YouTube

To Say It or Not to Say It: 3 Tips

It’s no secret that good communication is the secret to happy relationships–at work and at home. In her book “Real Happiness at Work,” mindfulness teacher Sharon Salzberg devotes an entire chapter to mindful communication. Her three-pointed strategy is simple and effective: before you speak, consider whether or not your comment is true, useful, and kind.

Is it true?

How many times do we say things like “My boss never listens; seriously, literally every time I open my mouth, she interrupts!” or “I think my colleague is losing it. I sent him that document a month ago and he hasn’t even acknowledged it.” We conveniently fail to recall the few times our boss listened closely, or that our colleague emailed once or twice to say that he was overwhelmed and would get to the document as soon as possible. In non-work contexts, we may also be prone to untruths: “When I told my dad we couldn’t make it, he pretty much bit my head off!” Is it true? Or did he express surprise and disappointment? That is, is there a more accurate and truthful way to express what happened?

Is it useful?

If a new person is joining your team at work, is it useful to tell him that you feel your boss doesn’t listen? Is it useful to tell a colleague that another colleague seems to be behind on her work? If you and your partner already feel stressed out about not being able to attend a family function, it is useful to amplify stress by mentioning your dad’s reaction? Before you speak, ask yourself what would happen if you simply didn’t make that particular comment. Maybe it’s not useful.

Is it kind?

Maybe it’s true that your colleague is behind on her work, and maybe you think it’s useful for your other colleagues to know about it–but is it kind to say that you think she’s losing it? Maybe there a better way to express it. Maybe it’s true that your partner was twenty minutes late picking you up and maybe it would be useful for him to know that you were frustrated, but is there a kinder way of saying it than “Wow, nice of you to finally show up”?

What happens to your communication when you keep in mind “is it true, useful, and kind?”

The Blame Game

When we argue with our partner, we usually walk away feeling like they were wrong, and we were right.

As we clench our fists and feel the tension in our shoulders, angry thoughts race through our minds: They shouldn’t have spoken to me that way! They should have picked up the dry cleaning! They should have remembered our anniversary!

We’re angry and we feel righteous and justified in our anger. The trouble is, when we walk away feeling “right”, we are also walking away from our partners.

One part of us feels like we won, but deeper down we know that if there is a tension between us and we are distant rather than close, that nobody has won in this situation.

Funny enough, what we know from attachment theory and years of research with couples, is that all of these disputes are actually partners’ attempts to connect to and feel closer! So how is it that that in our attempt to get closer to each other, the result is just the opposite? And if being right is in fact our ultimate goal then why, when we walk away feeling “right” don’t we feel the joy, elation and satisfaction that winning generally brings?

Frequently, when working with couples, I ask, “What is it that being right will do for you? How will it help if your partner says he or she was wrong?” Ultimately what comes up is that we want to feel that our partner understands us, and more specifically, that they understand how their actions or lack of action impacts us.

When we feel our partners don’t understand how we feel, or see our perspective, it can feel frustrating and  lonely. When our partner promises to help us with something and then forgets, we say, “I can’t believe I reminded you ten times and you still didn’t do it!” when what we really want them to know is that when they forgot, this made us feel unimportant and at the bottom of their priority list.

When our partner raises their voice and calls us lazy or stupid, we may snap back, “You’re a monster, just like your father!” when what we really mean is “your words sting, it hurts when you talk to me that way.”  

The trouble is, that in our attempt to be “right,” rather than pulling our partner close so that they can see our hurt, our blaming stance pushes them away and makes them feel the need to defend themselves.

As humans, when we are under threat, all of our energy goes into surviving that threat, and our ability to tune into our partner’s emotions becomes zilch.

In my couple sessions, when one partner turns and shares how hurt and vulnerable they feel, they are often surprised at the empathy this pulls from the other partner.

Suddenly their partner can lower their shield of defense, because they are no longer facing an attack.

Instead they see that the person they love is in pain. The message shifts from “you’re wrong” into “you are so important to me, and therefore your words and actions impact me a lot.”

This new message pulls for closeness, understanding and soothing, rather than defensiveness and stonewalling. Often when a new message of vulnerability replaces a blaming message, partners say, “Wow, I didn’t know you felt that way, I really feel like giving you a hug right now.”

Sitting in the therapist’s chair watching this scene unfold, I often feel my eyes tearing up, touched by this special moment of connection between two people. So next time you find yourself walking away from your partner feeling “right”, I encourage you to ask yourself whether being “right” is really what you are longing for?

If so, then I would encourage you to stick to your position. But if what you are longing for is in fact to feel understood, soothed and held by your partner, I would encourage you to take the risk to share your softer feelings.

You may just be surprised by the response you get.