E for Ecstasy by Nicholas Saunders
Appendix 1: Reference Section

98 Can drugs enhance Psychotherapy? by Grinspoon and Bakalar, from American Journal of Psychotherapy, 1986

The authors say that compared to LSD, MDMA is "a relatively mild, short-acting drug that is said to give a heightened capacity for introspection and intimacy along with temporary freedom from anxiety and depression, and without distracting changes in perception, body image, and the sense of self". These effects should be of interest to Freudian, Rogerian and existential humanist therapists, they argue.

MDMA strengthened the therapeutic alliance by inviting self-disclosure and enhancing trust. Psychiatrists suggested it was also helpful for marital counselling and diagnostic interviews. Patients in MDMA-assisted therapy reported that they were released from defensive anxiety and felt more emotionally open, which made it possible for them to get in touch with feelings and thoughts which were not ordinarily available to them. It was easier to receive criticisms and compliments. A patient said that the major difference in psychotherapy that included taking MDMA was "being safe. Nothing could threaten me". A patient who found she was more in touch with her feelings and could express herself more easily 18 months after her last MDMA session is cited as evidence that MDMA has lasting benefits.

The authors say MDMA may also help in working through loss or trauma, supported by the following anecdote. A patient said that after a session where she had grieved the loss of her boyfriend, she was surprised at feeling pleased with herself for having grieved so deeply.

Many MDMA patients claimed lasting improvements in their capacity for communication, such as getting on better with marriage partners. Increased self-esteem was also lasting.

The authors conclude that many pre-industrial cultures use certain psychedelic plants to enhance a procedure that resembles psychotherapy. MDMA was a far more suitable psychotherapeutic aid to substitute for this than the true psychedelics tried in the sixties.