Agony and Ecstasy and PTSD

By Charles H. Elliott, Ph.D.

The anxiety disorder called Post Traumatic Stress Disorder (PTSD) can occur when a person witnesses or is involved in a traumatic experience. In most cases, the person is present at the trauma, but other times the trauma happens to someone very close. The event generally involves a serious threat of death or injury. The person feels intense horror, fear, and helplessness. Here are three examples of PTSD.Although most people don’t have all of these, symptoms of PTSD which occur after a traumatic event include:

• Intrusive and distressing images, thoughts, perceptions of the event
• Recurrent Dreams
• Flashbacks of the event
• Intense distress when reminded of the event
• Over reactive psychological symptoms
• Avoiding talking about the trauma
• Avoiding activities that bring back memories
• Attempts to repress or forget the trauma
• Less interest in life activities
• Feelings of detachment
• Belief that the future is limited
• Increased arousal
• Problems with sleep
• Angry outbursts
• Irritability
• Problems with concentration
• Hypervigilance
• Easily startled

For those with PTSD, cognitive behavioral therapy is a very good therapeutic choice. Like those with OCD, exposure to the feared event is part of the treatment. The problem in the past has been that many people with PTSD avoid getting help because of a strong desire to avoid anything that reminds them of the trauma–and exposure certainly does that.

A few recent studies have introduced a new way to perform exposure. The patient is given 3,4-methylenedioxymethamphetamine (MDMA) during the exposure. Although the studies are preliminary, it appears that MDMA may facilitate exposure.

MDMA, aka, Ecstasy, is known for its positive effects on mood and empathy. The behavioral treatments with exposure and MDMA take no longer (usually 10-12 sessions) than standard behavior therapy. The drug is given under medical supervision only during the session and is discontinued after exposure is complete. Considerably more research is required before we can wholly endorse this approach. However, we thought you might find it interesting to know what’s in the pipeline of possibilities for treating PTSD.

Finally, this should not be tried at home! Nor are we recommending MDMA for other purposes. And we recommend that you avoid Raves as well.

Charles H. Elliott, Ph.D. is a clinical psychologist and a Founding Fellow in the Academy of Cognitive Therapy. He is also a member of the faculty at Fielding Graduate University. He specializes in the treatment of adolescents and adults with obsessive compulsive disorder, anxiety, anger, depression, and personality disorders. Dr. Elliott is coauthor of: Obsessive Compulsive Disorder For Dummies, Seasonal Affective Disorder For Dummies, Anxiety and Depression Workbook For Dummies, Depression For Dummies, Overcoming Anxiety For Dummies, Why Can't I Get What I Want?, Why Can’t I Be the Parent I Want to Be?, and Hollow Kids: Recapturing the Soul of a Generation Lost to the Self-Esteem Myth.