Many clinicians only recognize racism as trauma when an individual experiences a discrete racist event, such as a violent hate crime. This is limiting given that many ethnoracial minorities experience cumulative experiences of racism as traumatic. Additionally, such patients may not link current PTSD symptoms to cumulative experiences of discrimination if queried about a single event. Thus, the conceptualization of trauma as a discrete event may be inadequate for diverse populations. Our work in this area is focused on assessment of racial stress and trauma and culturally-informed treatment approaches.
The UConn therapist team for MDMA-assisted psychotherapy for PTSD/race-based trauma (from left): Sara J. Reed, M.S., MFT Associate (study coordinator/therapist); Michael D. Kisicki, M.D. (co-investigator; therapist); Monnica Williams, Ph.D. (lead investigator; therapist); Terence H. W. Ching, M.S. (therapist); Jamilah R. George, M.Div. (therapist).
The Multidisciplinary Association for Psychedelic Studies (MAPS) is a non-profit research and educational organization that is currently sponsoring Phase 3 clinical trials of 3,4-methylenedioxymethamphetamine (MDMA) as a tool to assist psychotherapy for treatment-resistant PTSD. Importantly, MDMA used in these trials is not the same as the street substances known as "ecstasy" or "molly," since these drugs frequently also contain unknown and/or dangerous adulterants. In laboratory studies, pure MDMA has been proven sufficiently safe for human consumption when taken a limited number of times in moderate doses. In fact, MDMA has been administered to over 750 human subjects in clinical studies with only one unrelated adverse event. In MDMA-assisted psychotherapy, MDMA is only administered a few times, unlike most medications for mental illnesses which are often taken daily for several years.
Preliminary studies have shown that MDMA can catalyze powerful psychotherapeutic work in helping people overcome PTSD by reducing fear of traumatic memories and increasing feelings of trust and compassion towards others without causing sensory distortions or inhibiting access to difficult emotions. As such, MDMA could increase the effectiveness of psychotherapy by strengthening the alliance between therapist and patient.
In our site at the University of Connecticut, we are preparing for clinical trials prior to estimated submission for FDA approval in 2021. We are focusing on the recruitment of ethnoracial minority participants who meet criteria for PTSD, with the experience of racism as component of their trauma. Specifically, we are looking to examine whether MDMA-assisted psychotherapy can work similarly for these members of underserved communities, taking into account the impact of cultural differences and the possible need to adapt MDMA-assisted psychotherapy to the needs and culturally-specific traumatic experiences for people of color.
We recognize that doing things the way they have always been done will not be sufficient to open the doors of these therapies to people of color. A culturally-informed approach must be integrated into the current protocols. To date we have enacted the following changes into the MAPS protocol:
These are just a start as we continuing to enact further essential reforms.
Learn more about the larger study at ClinicalTrials.gov
Ching, T. H. W., Williams, M. T., Kisicki, Reed, S. J., & George, J. (2017, November). MDMA-Assisted Psychotherapy for Treatment-Resistant PTSD: MAPS-Sponsored Phase 2 Findings & Cultural Considerations for Phase 3 Trials. Poster to be presented at the 51st Annual Convention of the Association of Behavioral and Cognitive Therapies, San Diego, CA.
Williams, M. T., & Leins, C. (2016). Race-Based Trauma: The Challenge and Promise of MDMA-Assisted Psychotherapy. Multidisciplinary Association for Psychedelic Studies (MAPS) Bulletin, 26(1), 32-37.