I did MDMA therapy before it was legal. For me it was transformative – but I have some concerns | Rebecca Huntley

To quote Eliza Doolittle from My Fair Lady, I’m a good girl, I am.

I am meticulous with my tax return, obey speed limits and send thank you cards after being invited to someone’s place for dinner.

If you had told me three years ago that I would be breaking numerous laws by seeking underground MDMA therapy for complex post-traumatic stress disorder, I would have scoffed. Let alone admit it publicly and in print.

But here I am nonetheless. Why?

After decades of banning the use of MDMA, commonly known as ecstasy, Australia now finds itself at the forefront of MDMA therapy. Numerous clinical trials investigating the potential for these drugs to treat PTSD, alcoholism and long-term grief is ongoing or imminent.

And, in a controversial world firstsince 1 July 2023, some Australian psychiatrists are licensed to prescribe MDMA for post-traumatic stress disorder, or psilocybin for treatment-resistant depression.

But my journey began before any of that. Before any of this was legal.

At age 50, I found myself at a plateau with my conventional approach to therapy (seeing a psychiatrist regularly) and with my own regimen of mental health self-care (walking, meditation, yoga, time in nature). I worked overtime trying to process the violence and abuse I experienced in my childhood, as well as a stillbirth and two miscarriages I had in my 30s. I worried that “mental health treatment as usual” wasn’t helping me progress away from anger and toward acceptance.

On the advice of a psychologist friend, I started reading up on trauma and its impact on the brain and the body – books like Gabor Mate’s The Myth of Normal and Bessel van der Kolk’s The Body Keeps the Score. These authors write about the potential of psychedelic drugs such as MDMA to help people with PTSD and complex childhood trauma.

Interesting, but not eye-catching information for me. I have never drunk ecstasy, not even in my misspent youth.

And then another friend told me that she had a session with an alternative therapist who offered underground MDMA therapy; through the treatment, she said, she was able to “relive” a particularly traumatic experience she had as a child, and was able to comfort her child self as a loving parent would. I was intrigued because this friend was like me – measured, evidence-based. A good girl. I was concerned enough about my mental health plateau to try it.

I contacted this person, who we’ll call Julia, via email. But before she would meet me, I had to fill out a long questionnaire; pages of personal and medical information. She was working out if I was the right fit. Was I ready?

I researched the drug and how it works: by flooding the brain with serotonin, which calms the amygdala – the part of the brain that processes fear and anxiety. This suppresses your fight or flight response, allowing some people to explore past experiences without the usual reactivity.

(Importantly, mileage may vary; this type of treatment will not necessarily be a safe way for everyone to explore past traumas—and there may be additional distress for those whose experience does not match their expectations.)

Over a number of Zoom calls, Julia emphasized not the drug but the process — three sessions spread over six months, with emotional and physical preparation and aftercare. She didn’t overpromise. The drug was a facilitator of a process that would not “cure” me, she told me. What I brought to it, the work I was willing to do before and after, that’s what mattered.

The first session would run from 10:00 am to 4:00 pm. I would take one capsule of the drug at the beginning, and then she would offer me a second after a few hours. Julia arrived with a backpack containing MDMA, a curated soundtrack for our eight hours together, and a notebook to jot down anything I might say.

I had no point of reference for what the drug could do to me, and a healthy dose of skepticism about alternative approaches to health. And yet for me the experience was transformative.

It was like being drawn into a deep, warm ocean of emotion, being moved from memory to memory through a rift, those forgotten, repressed, reworked to be more palatable.

Tears streamed down my face for hours as I visualized and felt acutely what lay beneath all my anger. A deep sadness for both my parents, for all the pain they endured as children and throughout their lives. Of course, the only way away from anger is empathy, compassion. I knew this intellectually, but in the aftermath of taking MDMA I could almost feel it on a cellular level.

This session was followed by two more MDMA sessions over a six-month period with Julia, with numerous integration sessions and support from my friends and long-time psychiatrist (who was non-judgmental and curious about my experience). I began to move away from the plateau, re-enthusiastic about my familiar regimen of psychiatric care, hikes, time in nature and so on.

With Australia a world leader in the adoption of MDMA therapy, I find myself in a unique position. I have experienced the potential of MDMA to play a role in healing, but I am also deeply concerned about the risks, especially if prescribed or experienced without trained professionals.

I’m worried like some in the psychiatric communityabout making this therapy available before we have a more robust evidence base for its use and a long-term safety profile of the drugs; and about lobby groups, not expertsleading the way forward.

There is also the question of who gets access to the treatment, and how to identify those for whom it might be detrimental (aside from the risk of a bad trip, not everyone has the safety nets I had: a secure family, socio-economic and cultural privilege , and a lot of therapy behind).

Will the people who benefit most from this be able to afford the treatment, which in some cases they are costs $24,000 per person? (Currently, there is not enough evidence for the therapy for the government to subsidize it.) Will those who do receive the therapy have access to the necessary wrap-around care after the treatment is over, and what does the best support and care look like?

While underground MDMA therapy has been entirely positive for me, I worry that all the enthusiasm for this approach opens up a trap we often fall into when it comes to addressing our complex mental health problems: the mistaken belief that there is a miracle drug out there is; that just taking a pill will cure what makes us.

• Sassafras: A Memoir of Love, Loss, and MDMA Therapy by Rebecca Huntley is published by Hachette ($34.99)

• In Australia support is available at Beyond Blue at 1300 22 4636, Lifeline on 13 11 14, and at MensLine on 1300 789 978. In the United Kingdom, the charity Pay attention is available on 0300 123 3393 and Kinderline at 0800 1111. In the US, call or text Mental Health America at 988 or chat 988lifeline.org