By: Sulfato Gómez
III Conference on Entheogens. Barcelona, 1998
MDMA in therapy: A rigorous protocol for exploring the shadow without fear
The therapeutic dose used with MDMA is 120 mg, although 100 mg may be used for the first time. If the patient wishes, a 40 mg supplement can be taken an hour and a half later; this will not intensify the experience, but it will extend it.
It is crucial that before the session, the therapist establishes a verbal contract with the patient, looking them in the eye and remaining aware that they are speaking not only to the patient’s conscious mind but also to their unconscious, which will absorb the information. The contract must include the following rules:
1) All sexual sensations are permitted and may be verbalized and discussed, but no sexual activity will be initiated during this session.
2) All feelings of aggression, hostility, and anger are permitted and must be discussed, but without acting against me or my possessions, with the exception of agreements we have previously reached.
3) If you, the patient, were to see the friendly door of death and realize that by taking a step you could cross it and leave this life, you will not do so during the session. You will not harm life in that way with me because that would hurt me, and we will not hurt each other.
4) You will swear to accept these rules without any restriction.
The first rule is obvious and requires no commentary.
Regarding the second, the therapist must make it possible to express anger, the desire to kill, and all feelings of aggression and violence when memories arise in the patient. Cushions, pillows, old sheets, and the like can be used, upon which the patient can express these feelings by hitting and tearing; how to do this must be agreed upon beforehand. A special room should be available for the session where it is possible to scream and hit.
It is a matter of life and death. By making the verbal contract, it is registered in the unconscious mind; it knows there are rules. The door of death is real; it takes many forms, almost all of them gentle. It is not seductive, irresistible, or trapping in nature, but it is often sweet. Its message is: “Here is the way back home for when you decide to return.” If the patient is very depressed, they might decide to leave, but the contract they have made is enough to prevent it. Some people have decided to leave and have been brought back, but at least one did not return. This happened in France, and the therapist had not made the prior contract with the patient. This is a disaster for the therapist, as it can ruin their professional and personal life; that is why this point is so important.
The session lasts about 6 hours, sometimes 8 or 10, and depends not only on the type of substance but also on the type of problem, whether psychological or spiritual. Often, in the experience, emotional or spiritual confrontations begin at the very end.
Most sessions involve intense work during the 6 hours, but if a vital struggle occurs at the last moment, the therapist must continue the session until a resolution is reached.
The psyche moves on its own; it does not need to be directed. The therapist is there to help the patient, dedicating themselves body and soul to being their support and guide when necessary. When the patient says they are tired, that is a sign that their psyche is closing the doors, and then, and only then, should the therapist begin to close the session.
MDMA as an entactogen: Accessing the shadow without fear
MDMA is an entactogen; that is, it allows one to touch inward, to access the internal. It is a drug of internal vision. One of the ways it acts is by eliminating fear when one encounters the shadows, so that instead, a peaceful acceptance of everything—no matter how negative it may seem—and an unusual compassion for oneself appear. Thus, an acceptance of all aspects of one’s nature occurs: the loving and the despicable, the generous and the thief, etc. Its effect can be compared to being cradled in the loving arms of God, and this is one of the most healing experiences that exists.
Once this total validation of who one is is felt, defensive habits begin to fall away. The therapist must remember that the shadow is there in them and in everyone for a reason: self-protection and defense, not only of the physical but also of their unconscious image, so that it has a certain degree of acceptance. The child created these barriers to survive. MDMA will suggest changes without rejection or guilt.
The degree of internalization depends on the patient’s will, the will to look the shadows—the closed, repressed aspects of their nature—in the face. Throughout the session, they are asked to confront their demons, the gatekeepers in Buddhist terminology. What one thinks they are going to see—a series of unacceptable entities—can lead to a state of fear that has no parallel in life. No person should be led to that without the therapist telling them that THIS IS NOT THE WHOLE TRUTH OF WHO THEY ARE, EVEN IF IT IS AN IMPORTANT AND ESSENTIAL PART.
Before the session, before entering these territories, there should be much discussion with the patient about not only the nature of the shadow but also compassion for the child, and why they developed a series of patterns and emotional responses in that world. In this preliminary discussion, the therapist’s experience comes into play, as well as their powers of persuasion, before asking the client to perform a session.
The therapist must also have walked that path
As for the therapist, they must have felt that sensation in the stomach of opening a few parts of their essence. They should have been helped in turn by a friend or therapist who knows how to lead them through the terror of the shadow and bring them out; only such a therapist can transmit what is necessary on the journey. This must be discussed with the patient first; it is essential for them to feel safe and comfortable.
Occasionally, when the psyche announces the destruction of an image, when the survivor (the one who remained after the defenses) feels the footsteps of those monsters they have left out of sight, there may be no response to the substance, or a nervous state may be created that covers all effects like a blanket.
There are other aspects in which MDMA therapies differ from other therapies or spiritual growth techniques. The therapist must set aside all preconceptions as much as possible; they must learn from a new part, a new facet of the universe. The patient is a completely new being to them; they must be prepared for a new symbology and with maximum attention to glimpse the emotional and spiritual structure and the rules of that unique human being in front of them.
It must be remembered that the patient’s psyche, like that of every human being, has a component that helps them: the self-healer, or their higher self, or guide, or superintendent, or whatever we want to call it. This must be told to the patient, because it will help them activate it.
Another fundamental rule is that, whether with a patient or a friend, one must feel something very close to love for the other person; one cannot be strictly intellectual, there must be something deeper, at a visceral level. This cannot be forced, as we already know, and one must have an internal vision sincere enough to see if one has a true feeling. If there were feelings of aversion, the therapist must be prepared to investigate the reasons for those feelings, and if they cannot resolve them, they should refer the patient to another therapist.
That connection with the ability to care for the patient, which they will have experienced on previous occasions, should have led the therapist to take steps within themselves that have led them to the place of mystical participation. If the session is held in a truly appropriate place, such as a natural space, they will have already felt that brotherhood with every plant, animal, insect, and every living being on previous occasions, and will have felt how everything is related; they will have felt that everything is alive and that everything carries within it that same spark that they carry inside, which all beings share and which is the Source of Life and everything that exists, that we are all highly individualized parts of the same conscious being.
They must have compassion, even love, for that being in front of them, the patient, seeing them as a spiritual being identical to themselves, with an individuality that makes them new and different, unique.
