An Interview with Andrew Weil, M.D.
JH: Do you think that MDMA has anyplace in alternative medicine?
AW: I don't know that I would put it in alternative medicine. I think it has a place in medicine. I wouldn't make a distinction there. For me, the interesting thing is that if the set and setting are properly attended to, MDMA can produce a state of great relaxation and lack of defensiveness in which the body behaves differendy. You see that chronic pain can disappear and that habits can disappear. It can show people that there is a possibility that they're not obliged to have certain symptoms. The experience can motivate them to figure out other ways to maintain that symptom-free state.
JH: Let's talk about relaxation first. How do you think that MDMA can be helpful there?
AW: Many people walk around in states of chronic tension and much of their discomfort is due to that. Just to have an experience of what it feels like to be completely relaxed can show them that their experience of their bodies can be different. I think many people have never felt complete relaxation.
JH: One thing that also happens in an MDMA-induced state is that there is enhanced attention to posture and breathing, which also can be very helpful.
JH: You have emphasized the importance of deep breathing. Practitioners of the Alexander technique are particularly fond of MDMA for opening up the ribs and enhancing the ability to take deeper breaths.
JH: What about the body image issues—people really looking at their bodies or taking an inventory of their bodies in a different way?
AW: MDMA can give you a chance to have a new perspective on your body, and, again, that's part of breaking old habits. For that reason it can be a very valuable experience, assuming that the experience is structured in some way. Another area that I've been very interested in is allergies. Allergies often disappear during an MDMA experience. They may come back at the end, but it shows people that there's a relationship between mental state and allergies. This can motivate them to figure out how to work on that.
JH: Do you have any anecdotes about people using MDMA in any particular instances?
AW: I have one patient that I worked with for some time, a young man who had rheumatoid arthritis that had required a couple of hand surgeries. He took MDMA about once a month and felt that it put him completely into remission. He began working with other patients who had rheumatoid arthritis. I have worked with people who have overcome allergies—cat allergies, hay fever—as a result of the MDMA experience. I have seen many people who have dealt successfully with problems like chronic back and neck pain and digestive problems as a result of using MDMA.
JH: What is your opinion about the use of MDMA in palliative care?
AW: I have less experience with that. I know of some cases of people with advanced cancer who felt it was very positive for them. It helped them come to a sort of resolution with their lives and complete emotional work that they had to do with other people.
JH: I was hoping to touch on the potential for MDMA to be used as an analgesic [painkiller].
AW: A major component of pain is the subjective experience of it. MDMA changes your perspective about what is going on in your body, so it can help people develop a new relationship with chronic pain in which it is less of a discomfort.
JH: And what about the impact of fear and anxiety on pain perception?
AW: That's a huge component of pain. If the experience is structured properly, MDMA induces an extremely low anxiety state, which can dramatically lessen that aspect of pain. Often, there is a great deal of carryover after that experience.
JH: Do you see insight as a tool to assist in physical healing? For instance, if MDMA is used in a psychotherapeutic setting, and a person comes away with a better understanding of self-defeating or self-damaging behavior in terms of lifestyle, do you think that could help someone with his or her health issues?
AW: Yes. I think that gaining insight is the easy part; the harder part is applying it.
JH: The integration?
AW: Yes. Integration may require some work and help, so that the experience doesn't just get boxed up and put into the past. But I definitely think that during the experience, one can gain insights into the nature of one's problems.
JH: Or potentially the symbolism of certain physical symptoms? AW: Yes.
JH: What about the recreational or the pleasurable component of MDMA? Most people want to separate the recreational and the therapeutic aspects of MDMA.
AW: I don't make much of a distinction. I think recreational experiences can be therapeutic.
JH: Fm so glad you said that. I believe that as well—for instance, the therapeutic effect of play or joy.
AW: I think that's an important aspect of heath, and it's something that a lot of people in our culture don't do for themselves. I have seen many people with MDMA experiences become childlike and recover an aspect of themselves that they had lost. I think that's very valuable. But I don't have any familiarity with MDMA in the context of raves.
JH: I think that as a cultural phenomenon, it's impressive. One of the salient features of a rave setting is the sense of community. There is a theme of connection—notjust to oneself or to one other person but to an entire movement or community and even to every person on the planet, the "global village.'"
AW: Right. Maybe fifteen years ago I was teaching a seminar that was partly on psychedelics, and we had an afternoon devoted to MDMA. I was saying to this group that the idea of taking this drug and going indoors with a huge crowd of people and blaring music seemed to me to be a waste of the potential of the substance. A woman from England said she disagreed and that many of these people were soccer toughs who would be out beating up people. It was much better to have them engaged in this kind of activity. I had never thought of it that way, and I can certainly see the value of that.
JH: One of the things that I notice among psychiatric patients, which is very sad, is how disconnected and socially isolated they are. I think it's unhealthy. The isolation feeds into the illness. Then, because they are ill, they tend to be even more cut off from society, and the effect snowballs. I believe that it can be quite therapeutic for people to have a sense of self-acceptance, or to feel accepted by a group.
JH: Self-love is also therapeutic. A lot of people's maladaptive behavior can come from self-hatred.
AW: Definitely. A common theme of the MDMA experience is that things feel "all right." People feel all right with themselves and with other people, and they drop a lot of their judgments. If that could be carried over into life, I think it could be very useful.
JH: One of the things I say about an MDMA experience is that you should take notes. Bring something out of the experience with you.
JH: The quality of acceptance or forgiveness that people experience with MDMA can be valuable. Would you say that in some medical conditions, there is an element of anger or fear or guilt?
AW: Definitely. I think all of those kinds of states translate into body states.
JH: So it would probably be therapeutic to have an experience where those emotions are markedly lessened. What is your take on "psycho-neuro-immunology"?
AW: It is a field that's very well established. It's been around for three decades, and there is a vast body of research on it. The problem is that it's made very little impact on thinking and practice in conventional medicine. It's had all sorts of resonance with the general public as a result of books and TV shows. At the University of Arizona in the immunology course, for instance, the word "psycho-neuro-immunology" isn't even mentioned. There is a lack of connection between this body of research and the public's enthusiasm for it, as opposed to the actual day-to-day application in medicine.
JH: Do you see MDMA having anyplace in that field?
AW: Absolutely. What I mentioned to you about allergies is so striking to me. I can imagine taking an allergic patient and doing, say, ten sessions with decreasing doses of MDMA until, by the last sessio^,§|e person isn't taking any. This is a way to teach patients to unlearn tMsAlfrgies.
JH: Do you have any opinion about the issue of MDMA being synthetic, as opposed to natural, in terms of its use in alternative medicine?
AW: If there were a totally natural substance that had the effect of MDMA, I would use it, but there isn't one. MDMA is semi-synthetic; it's pretty close to a natural substance, but it's got a slight twist.
JH: Meaning safrole, sassafras, nutmeg...
AW: It's closest to safrole and myristicin and things of that sort. It's just a slight twist on a natural molecule. That, to me, is not such a big deal. I wouldn't make a major distinction there—and again, I wouldn't relegate MDMA to the world of alternative medicine. I think it can be used in medicine generally.
JH: I have heard you speak of optimism as a healing tool. For most people, the MDMA-induced state is chock full of optimism.
AW: Right. There is a psychologist at the University of Pennsylvania named Martin Seligman who studies the states of helplessness and optimism and the effect they have on health. Optimism is a behavior and an attitude that can be learned, and I think that it has many consequences in terms of how our bodies function and how our minds work. I think that just having the experience of it, seeing that there is a mental perspective from which things can look positive, is very useful—especially if you haven't had that perspective in a long time. The basic point is that mental states translate into physical states. And one of the great values of the MDMA experience is that it can show you very concretely how a shift in your mental state can produce dramatic responses in your body. Often, this has significant carryover into daily life.
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