A Salon interview with Dr. Charles Grob:
Last week, an essay in the Psychologist, a magazine published by the British Psychological Society, called into question the validity of recent research on the effects of Ecstasy. Its publication drew loud and immediate reaction from the British press, which printed stories under headlines like “Ecstasy Not Dangerous, Say Scientists.” The study’s authors demanded, and received, a retraction from at least one newspaper (the Guardian); but the question the researchers had hoped to raise — whether MDMA may have medical benefits — was lost in the din. And not for the first time, according to Dr. Charles Grob, a longtime researcher of MDMA and hallucinogenic drugs and one of the study’s three authors.
Grob, the head of adolescent and child psychiatry at the Harbor-UCLA Medical Center in Southern California, is also the editor of a newly published collection of essays, Hallucinogens: A Reader
, which explores the social and psychological worth of such drugs. Speaking from his office, Grob spoke about the essay he coauthored, the current war on drugs, and the history of Ecstasy, which he believes has therapeutic benefit — not to mention potential as a facilitator of peace in the Middle East.
Anna, from annatopia
, wrote this piece
about Grob and MDMA and emailed me, pointing me to it and curious about my reactions. Among other things, she asked me if I had ever used it (in my work, she hastened to add). Here’s an (edited) version of my response:
— I haven’t gven MDMA in my work, but that’s mostly because I specialize in treating severely ill, nonfunctional, hospitalized, and often psychotic patients. I’ve known some of the researchers and clinicians who have used it clinically. I support entheogens/empathogens in general but think my patient population doesn’t have the ego strength, as the “walking wounded” do, to benefit from them. More than that, it takes a lot of thoughtful courage to buck the dominant cultural norms about illegal, hallucinogenic drugs being dangerous and degenerate. Although I ask that of myself, I wouldn’t ask that courage of my patients in their current suffering.
— I agree absolutely about distinguishing therapeutic and recreational use. Except for one thing; you have to tolerate the bad with the good. This is a longer-standing issue, as Grob’s reader about hallucinogens indicates. Leary and Alpert were Harvard psychologists; LSD was/is a valuable tool for psychic exploration too, as other hallucinogens, if taken with reverence and intellectual curiosity, but if you give people the freedom to do so you also give them the freedom to trivialize its use as a means of just “getting high”. (Funny, I never thought of what LSD gives you as a “high”!)
If one of the dangers of MDMA is how often the ravers take it, the thing about an exploratory/therapeutic approach is that it will result in limiting one’s exposure, as Anna and Dr Grob rightly point out, and taking it in the context of a psychotherapeutic relationship. You want to assimilate the information it gives you about yourself and the world, which takes time. You grow from it, which means there might be diminishing returns from dropping it over and over. And if you’re interested in taking an exploratory/therapeutic approach, you’re usually a person who is committed to taking good care of yourself, which means you’ll limit the adverse impact of frequent, repeated dosing. That’s one of the things that bothers me about the ravers’ use — that with no limits on the magnitude of their indulgence, they’re really really at risk of health complications and ‘suicide Tuesdays’. The self-destructive image of recreational use is deserved, but there isn’t going to be a substantial risk of cardiac or neurotoxic complications from judicious, intermittent, informed use.
However, when you’re talking about recreational Ecstasy users, one issue is that they are often taking a lot of different drugs — it’s kind of a poly-drug-use scene. They often take high dosages. They’re up all night, they’re sleep deprived, they’re nutritionally deprived, they’re basically taking the drug in the most adverse environment you could possibly imagine: Hot, stuffy, crowded clubs, not replacing fluids, exercising all night. That will accentuate the likelihood of an adverse response.
The only environment I can think of that’s worse would be taking it in a hot tub.
But make no mistake about it — and probably even moreso if you try to regulate it into a controlled drug available only under a health practitioner’s prescription — you’ll get the recreational use fist-in-glove with the serious, therapeutic/exploratory. However, I don’t *blame* the ravers for the war against MDMA. As much as those who wage war on recreational drugs point to specific adverse outcomes, sudden deaths, bad behavior, etc., of users, these are not the *causes* of their convictions; they are after-the-fact justifications. Deeper-seated cultural norms — uhhh, prejudices — determine that! IMHO, don’t vent your spleen against the ravers, they are not the ones who ruin it for you. They’re just caught in the crossfire.
In my work as a trainer and supervisor of psychiatric residents and other mental health trainees, I ask them to look at why clinicians, as a rule, dislike treating drug abusers. I think it has something to do with the fact that we are people whose personality structure involves an investment in deferring gratification for goals we find more valuable in the long term. As such, we are rubbed the wrong way most by the classes of patients who, for hedonistic or other reasons which seem diametrically opposed to our mindset (I don’t actually think most of the drug abusers we treat in the mental health field are motivated by uncomplicated pleasure-seeking, but that’s the first assumption about them), appear unwilling to defer indulging or gratifying themselves. (Of course, that’s not the whole story; we are also dissed by our well-intentioned efforts to help being rebuffed.) Mental health professionals are generally similarly distressed by happy manic patients. (Some manics can be irritable or dysphoric instead of euphoric, and we have considerably less difficulty with those.) There is a similar anti-hedonistic streak in the work- and productivity-ethic-driven culture at large, for similar reasons.
While the ravers don’t deserve our resentment,
I mean, if we follow to the letter this “Just Say No” mandate, and then if the kid isn’t wise enough to follow the “Just Say No” edict, are we saying he deserves whatever adverse effects he experiences?
they do probably deserve our empathy. It saddens me that so many people have no idea that their own minds can be an object of contemplation and study for themselves, like holding a jewel up to the light and marvelling at its scintillations. Instead they treat themselves as trivial playtoys. Their loss.
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