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This...x1000.
So much this.
Do they have to keep taking psilocybin to maintain the 'therapeutic effect' in that study? "I no longer feel the overwhelming compulsion to wash my hands every 5 minutes, Doc...the Clockwork Elves and the clowns do it for me." Proposed mechanism of action? From a less silly angle, is the hypothesis that the patients have some sort of 'aha' cognitive reorganization about the absolute nature of reality or something? Do they undergo some sort of cognitive restructuring exercises after the trip? I could see it helping to lower death anxiety, perhaps (or at least provide one hell of a distraction), for terminally ill patients in the few weeks and days before death, but the 100% efficacy for treating OCD seems a stretch. The only intervention with a 100% 'cure' rate for mental illness is a guillotine. And I wouldn't recommend it.
Let's go one step further and do dismantling designs examining some of the more politically-driven 'interventions' implemented in recent years through (or supported by) the VA system such as full-time adult 'caregivers' for those with PTSD, service dogs, support animals, various percentages of service-connection (and associated monthly income), suicide 'awareness' campaigns (walking around in circles trying to dispel suicide as a human phenomenon), etc. Increasingly, the particular 'interventions' (at the individual or group/organizational level) that are being offered appear to be driven more by politics, public relations, and Facebook/Twitter popularity than by established clinical science or common sense. Instead of hiring and supporting more front-line providers (psychotherapists (with caseloads), physicians, etc.), the VA is creating new specialty niche (non-provider [i.e., people who don't carry caseloads or see veterans for treatment]) positions for 'champions' for 'awareness' of interpersonal/domestic violence, say. As a practicing clinician, I'm quite enough 'aware' of domestic violence in the lives of the patients I see and its impact on those around them. I don't need more 'awareness' of this issue. I don't need another set of mandated forms, policies, procedures, checklists, or points of failure surrounding this particular clinical issue (in the forest of the 50+ important clinical issues that veterans presenting for mental health care are struggling with). I need other people employed by the VA who have clinical licenses to roll up their sleeves and join me in the trenches and carry a caseload of clients and provide treatment.
Agreed. I'm skeptical of anything that claims to be 100% in any field of medicine. I don't know the literature on MDMA, but to make a claim that anything results in removal of symptoms or diagnostic classification with 100% accuracy is an extremely high bar that nothing else has yet to meet in psychological treatments - with the exception of EMDR from the practitioners I talk to about their use of it 😵
I tend also to resort to the basic logic of...if any claimed 'miraculously successful cure' were truly that successful...why isn't it more widely disseminated and practiced? I mean, if someone showed me a technique that doubled my response rate in the folks who have PTSD and come to see me for therapy, I'd be pretty damn motivated to migrate into that approach. Any truly successful technique that beats what's currently utilized and called 'best practices' or 'first-line treatments' for X condition would not remain 'fringe,' or restricted to a sliver of the practitioners in the field for very long.
Agreed.
Yes! Let's bump this thread 🙂
To add to that, the MDMA is simply the catalyst, the person the active inner healer, as supported by the psychotherapy, which is the container. Thus, I would suggest editing the thread to show as MDMA-Assisted Psychotherapy for PTSD to be accurate.
