A Really Good Day

by Ayelet Waldman

  What we did was talk. For six hours, we talked about our feelings for each other, why we love each other, how we love each other. We talked about what we felt when we first met, how our emotional connection grew and deepened, how we might deepen it still. The best way I can describe it is that we were transported emotionally back to our relationship’s early and most exciting days, to the period of our most intense infatuation, but with all the compassion and depth of familiarity of a decade of companionship. We saw each other clearly, loved each other profoundly, and basked in this reciprocated love.*4

  The feeling lasted not for hours or for days, but for months. Actually, the truth is, it lasted forever. We’ve done the drug since, every couple of years, when we feel we need to recharge the batteries of our relationship. Though the experience has never again been quite so intense, it has been a reliable method of connection, of clearing away the detritus of the everyday to get to the heart of the matter. And the heart is love. We love each other so much, even when he is chewing almonds and I have to leave the house.

  The empathogenic effects of MDMA have caused a revival of interest in the use of the drug in recent years to combat treatment-resistant post-traumatic stress disorder. In particular, it has been a priority of MAPS, which is funding a variety of research studies to determine, it writes, “whether MDMA-assisted psychotherapy can help heal the psychological and emotional damage caused by sexual assault, war, violent crime, and other traumas.”

  I spoke with Michael Mithoefer, M.D., who, along with his wife and cotherapist, Annie Mithoefer, is carrying out clinical trials to test the safety and efficacy of MDMA-assisted psychotherapy in veterans and first responders with chronic post-traumatic stress disorder that has not resolved with the use of other treatment methods. The protocol of their University of South Carolina studies is similar to those used in the recent wave of psilocybin research. In his earliest studies, Mithoefer and his colleagues first provided each subject with two introductory psychotherapy sessions with trained psychotherapists. Then the subjects underwent two MDMA or placebo-assisted sessions spaced three to five weeks apart, during which they talked through the incidents that had led to their trauma. After only two sessions, PTSD was resolved in 83 percent of the subjects who received MDMA. The results for talk therapy alone? A mere 25 percent. Even more remarkably, the reductions in PTSD symptoms were sustained for the long term, without further treatment. These results are so dramatic that not only has the Department of Defense given its blessing to further research, but there are two Veterans Administration studies now in process.

  Mithoefer described to me the effect of the study on one participant, a firefighter and 9/11 first responder who was plagued by PTSD symptoms. Once, in a fit of uncontrollable anger during a session of PTSD therapy using another method, he tore the sink from the wall of the examining room. When asked what the results of the MDMA sessions were on this man, Mithoefer smiled and said, “Well, our sink is still on the wall.” The reduction of the patient’s PTSD symptoms was profound: he continues to report to Mithoefer that they have not returned. A recent meta-analysis by Timothy Amoroso, in the Department of Psychology at the University of New Hampshire, comparing MDMA therapy to prolonged exposure therapy in the treatment of PTSD, confirms Mithoefer’s results.*5

  Word has spread amidst the network of soldiers returned from war about the efficacy of MDMA therapy. Of the more than one thousand veterans who have reached out to Mithoefer for help, his pilot study was permitted to enroll only twenty. The poignancy and tragedy of these figures cannot be overstated. The need is overwhelming, and people are desperate for help. Veterans have a suicide rate 50 percent higher than that of the general population. Rates for female vets are even worse. There is reason to believe that MDMA-assisted psychotherapy could save thousands of lives.

  MAPS, which funds the Mithoefers’ work, is also funding research investigating the use of MDMA to treat social anxiety in people with autism. For years, many people with autism have been using illegally obtained MDMA for this purpose, without the benefit of guidance from therapists, and have reported improvements in their social anxiety, perception, and ability to communicate. The MAPS-funded study—currently in progress at the Los Angeles Biomedical Research Institute, a joint enterprise of UCLA and Stanford University—is comparing the results of MDMA-assisted psychotherapy sessions on twelve adults with autism, none of whom have ever taken the drug before, with an inactive-placebo control group of similar subjects. The researchers have begun to see effects resembling those reported by autistic people who had used MDMA out of the research context.

  Annie and Michael Mithoefer recently received formal FDA approval for MDMA conjoint therapy with couples in which one member has PTSD. Their interest in couples therapy stems from their personal use of MDMA in a therapeutic context before the drug was placed on Schedule I. They found it so useful to enhancing communication and resolving conflicts in their marriage that Mithoefer told me he believes criminalization is a real loss for the practice of couples therapy. Having a partner respond with the kind of honest, loving empathy MDMA facilitates is profoundly restorative to a marriage.

  I asked Mithoefer whether he imagined that his new study, if successful, might lead beyond the confines of PTSD treatment to the treatment of the mundane communication difficulties of typical couples such as my husband and me. To my surprise and delight, he was confident that one day we might be able to undergo legally prescribed MDMA-assisted couples counseling. He said that his hope is that, by 2021, MDMA will be removed from Schedule I, and that prescriptions will be allowed. He anticipates that the FDA might confine use to licensed clinical settings, in a manner similar to methadone treatment, but he pointed out that even if the FDA approves MDMA only for use for PTSD, off-label use is likely to be allowed.*6

  Why, though? I asked. Won’t the FDA and DEA seek to limit a drug like MDMA as much as possible?

  There, he told me, is where Big Pharma might prove useful. It is in the pharmaceutical industry’s financial interest to encourage widespread use of products, and so it has lobbied aggressively to prevent any limitations on off-label use for any drug. Mithoefer imagines that Big Pharma won’t even allow this narrow wedge in the door—the thinking being, if the FDA limits off-label use of MDMA, it will set a precedent for other drugs to be so limited. Others in the field, however, are less optimistic. They point out that the FDA occasionally does approve drugs with off-label limitations. They believe that MDMA, even if approved, is likely to be so limited.

  But if Mithoefer is right, my husband and I need only wait five years to perform our marriage-recharging ritual legally!

  Still, I don’t want to wait. I know from experience that taking MDMA would allow us to continue and accelerate the process of recovering and reconnecting that began after our last argument and has continued in therapy. However, it has been a long time since I’ve been able to obtain MDMA. My friend network has dried up, and by all accounts, what’s available on the black market now is so badly compromised and toxic that even if I were willing to buy drugs from a dealer, I’d be afraid to take them. Even more important: one of the things I tell my children, perhaps the critical part of my harm-reduction message, is that drug interactions can be dangerous. Don’t mix drugs, I insist. Don’t mix alcohol and marijuana, don’t mix antidepressants and mushrooms. Definitely don’t mix LSD with MDMA. Even if the LSD is just microdoses. Even if you really miss MDMA. I feel like I am my own parent and my own child; I am straining our relationship, but still I must insist.

  I’ve been honest with my children about MDMA. I’ve told them it’s been helpful to their father and me, that it’s a very special drug, though their peers use it foolishly. I’ve warned my children that the vast majority of what is called MDMA or Molly on the market is either methamphetamine or something more toxic. If they do MDMA, they must test it first. If they cannot establish through testing that a drug is pure, they must not risk taking it.

  I’ve also counseled my c
hildren about the dangers MDMA poses to body temperature regulation and water toxicity, and explained that this is why they must not use the drug at a rave or a party, but only in a small group in a cool room. Or, better yet, one to one, with someone they love. And then I’ve gone beyond harm reduction to life enhancement, and explained to my children that MDMA is one of those rare experiences that are at their very best the first time you do them. About what else in life can we say that? Not sex, that’s for sure! I believe that with whom you do MDMA for the first time might even be more important than with whom you have sex for the first time. Ideally, you’d have sex for the first time with someone you love, after serious contemplation and discussion, but, whatever happens, chances are it’s not going to be great. And even if by some miracle it’s wonderful, even if you happen to be one of the infinitesimal number of women who orgasm in their first sexual encounter, sex only gets better the more practice you have. The opposite is true about MDMA. The first time you use MDMA is the most profound, and tolerance inevitably develops.

  Do it like we did, I tell my children. Don’t waste that first experience. Save it for your soul mate. I anticipate that they will take this advice about as readily as they take my advice about what to wear, whom to date, and whether to get a tattoo, but I wish they’d listen to me on this one. Because your first time really should be special.

  * * *

  *1  Once, I picked up an economist at the Roxy and went back to his place. I’d use the word “pleasant” to describe the experience, though. Not “glorious.”

  *2  This is in stark contrast to LSD, for which, as I’ve stated before, there are no verifiable fatalities.

  *3  And, yes, I realize this is perhaps expressive of a certainly excessive if not near-pathological frugality, but I’ve always been penny-wise, pound-foolish. Witness the number of shoes in my closet, all of them bought on sale, most either a half-size too small or too large.

  *4  I realize that for some of you the prospect of talking for six hours about your relationship seems like the very definition of a bad trip. If so, MDMA is not for you. Actually, I take that back: MDMA is especially for you. Hundred bucks says your spouse would agree.

  *5  T. Amoroso and M. Workman, “Treating Posttraumatic Stress Disorder with MDMA-assisted Psychotherapy.”

  *6  Off-label drug use is when a doctor prescribes a drug that is approved for treatment of one condition, to treat a condition for which that drug is not officially indicated. For example, Zoloft is an antidepressant, but it is also sometimes prescribed off-label to help men who suffer from premature ejaculation. This, I think we can all agree, is a win/win.

  Day 23

  Transition Day

  Physical Sensations: None.

  Mood: Fabulous. Truly delightful.

  Conflict: None.

  Sleep: Adequate.

  Work: Decent.

  Pain: None!

  Transition Day is a joy. It’s a delight. I’m nearly giddy with pleasure, though this has much to do with the fact that for the first time in over a year I am pain-free. My frozen shoulder has thawed! It doesn’t hurt! I still have restricted range of motion—I can’t yet buckle my bra in the back—but I don’t care. I don’t care if I have to spin my bra around to bring the buckle to the front for the rest of my life. The absence of pain is a marvel. A miracle.

  Humans live forever on the Hedonic Treadmill; whatever our life experiences, whatever our transient miseries or joys, we eventually revert to a mood set-point that depends not on circumstance but on individual predisposition. Lose your legs in a car accident, win the lottery—it makes no difference. Within a few years, hedonic adaptation will take over, returning you to your personal set-point of contentment or misery. That is, except if you suffer from chronic pain. Research has shown that chronic pain is among the only experiences that have the capacity to shift your happiness set-point toward the unhappy end of your spectrum. This does not surprise me. If someone offered me a million dollars to go through the last eighteen months of pain again, I’d not only refuse, but I’d cram that money up the person’s ass, in low-denomination bills. This shoulder has not only made me miserable; it’s made me miserable to be around. But today? Today is glorious. It feels better than a million dollars.

  Which is a good thing, since today I’ve been investigating an area of LSD research that is so outrageous, so horrible, that I have to find a tremendous equanimity to keep from spouting off like a wild-haired, lunatic conspiracy theorist. It’s all I can do not to drag a soapbox out to Sproul Plaza on the UC Berkeley campus and start ranting about a CIA program, run by Nazis, that gave LSD to unsuspecting citizens.

  Instead, I’ll allow myself a little bit of ranting on the page.

  At the end of World War II, the U.S. military set up an agency called the Joint Intelligence Objectives Agency, whose mandate was to implement Operation Paperclip, a program in which U.S. military and spies fanned out across Europe, seeking German scientists and engineers to bring home to America. Even before the war with Germany had ended, the Cold War was in full swing, and the U.S. government was desperate not just to obtain the knowledge these men held, but to keep their ideas, research, and abilities out of the hands of the Soviets. President Truman was adamant that no actual Nazis be brought back to the States, but the generals and spies ignored this edict from their ostensible commander-in-chief. When confronted with Nazi war criminals like the infamous Wernher von Braun—inventor of the German V-2 rocket and dedicated exploiter of slave labor, who was personally responsible for flogging and torturing people, and whose program resulted in the deaths of tens of thousands—the army and intelligence services whitewashed records, expunged files, and erased evidence of Nazi Party membership. They not only brought the most evil of criminals back to the United States, but gave them the highest of security clearances.

  Among the scientists brought back to the States were Nazi chemists who had experimented on prisoners at Dachau, using mescaline. The newly created Central Intelligence Agency, eagerly searching for biological weapons that could both start large-scale epidemics and be used to target individuals for assassination, found out about these Dachau experiments. Their interest was piqued, even though the experiments were, by all accounts, failures. Torturer-physicians like the Nazi Colonel Hubertus Strughold*1 had tried to use mescaline to elicit absolute obedience in their victims, to no avail. Nonetheless, the spymasters eagerly embraced these physicians and their experiments, and arranged for them to continue their work in the United States.

  When Brigadier General Charles Loucks, chief of the Operation Paperclip scientists, heard about LSD, he tasked his Nazi physicians and chemists to work with the CIA to research the potential of LSD as a mass poison and a means of controlling human behavior. The resulting project brought together the Army Chemical Corps and the CIA in an unusually cooperative endeavor. They teamed up in operations code-named Bluebird and Artichoke to develop what they called “unconventional interrogation techniques” using LSD and other drugs. For nearly twenty years, these programs and the CIA’s large-scale mind-control program, code-named MK-ULTRA, tried to weaponize psychedelic drugs.*2 Among their methodologically suspect studies was one in which they set up brothels in San Francisco and New York designed to lure men whose drinks would then be spiked with LSD; their behavior was observed through one-way mirrors, as if they were some kind of twisted focus group. It’s not clear what the CIA sought to learn from these “studies,” beyond answering the question of what the effects of LSD are on an unsuspecting subject under peculiar conditions. The CIA also surreptitiously dosed their own officers, ostensibly to determine what might happen if an enemy agent was secretly given LSD, or if a CIA agent was so dosed by the enemy. Nothing useful was gleaned from these experiments, though many people suffered psychic and emotional discomfort, some of it long-lasting. One can hardly imagine a worse set and setting for a psychedelic experience.

  Among the unwilling and unwitting victims of this “research” was
a scientist named Frank Olson, a bacteriologist working for the CIA on biological and chemical weapons. In 1953, a week after being secretly dosed by his supervisor, Olson was believed to have thrown himself out of a thirteenth-story window. The CIA claimed that the LSD caused Olson to suffer a paranoid nervous breakdown. Olson’s family, however, believes that he was murdered, probably because during his LSD experience he gained insight that led him not only to refuse to continue his work in germ warfare, but to threaten to expose the government program. According to Olson’s family, the CIA murdered him to keep him from divulging details about the use of biological weapons by the United States in the Korean War.

  Given what I’ve learned about how the risks of LSD have been wildly overstated, and given what we know about the CIA’s role in overthrowing governments, assassinating world leaders, and setting up black sites around the world in which to torture perceived enemies, not to mention its practice of conducting unethical LSD experiments on uninformed subjects, I find the family’s explanation more convincing than the Agency’s.

  Olson’s death, whether it was suicide or murder, had little discernible effect on the CIA’s continuing LSD research. According to testimony before Congress, the CIA partnered with no fewer than eighty academic and medical institutions to study LSD in order to develop it into a tool of war and assassination. This research had an unintended consequence: it introduced thousands of subjects of these various studies, among them Ken Kesey, to the drug. Unfortunately, fearful at the prospect of congressional investigation and public disclosure, the CIA destroyed the bulk of its documentation of the MK-ULTRA experiments. We know some of what they got up to, but much of their nefarious activity will forever remain a secret.