Facing death, returning to life: A qualitative analysis of MDMA-assisted therapy for anxiety associated with life-threatening illness
William P. Barone, Michiko Mitsunaga-Whitten, Lia Osunfunláyò Blaustein, Phillip Perl, Marisa Swank, Thomas Cody Swift
Frontiers in Psychiatry September 27, 2022 DOI: 10.3389/fpsyt.2022.944849 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Qualitative study using interpretative phenomenological analysis Peer reviewed |
|---|---|
| Population | Adult participants from a pilot phase 2 clinical trial of MDMA-assisted therapy for anxiety associated with life-threatening illness |
| Interventions | 3 4-Methylenedioxymethamphetamine-Assisted Therapy |
| Duration | 3-month follow-up |
| Topics | Anxiety MDMA |
| Keywords | MDMA-Assisted Therapy Life-threatening illness Psycho-existential distress Existential anxiety Death and dying |
| Citations | 14 |
| Key findings | Participants reported that MDMA-assisted therapy helped them process trauma and grief, engage with existential fears, and develop greater emotional resilience and ability to cope with life-threatening illness. |
Abstract
Anxiety associated with life-threatening illness (LTI) is a pervasive mental health issue with a wide impact. A spectrum of traditional pharmacotherapies and psychotherapies are available, but offer varying success in reducing symptoms and improving quality of life. We explore a novel therapy for this condition by assessing prominent thematic elements from participant narrative accounts of a pilot phase 2 clinical trial of 3,4 Methylenedioxymethamphetamine-Assisted Therapy (MDMA-AT) for treating anxiety associated with LTI. Semi-structured qualitative interviews were conducted with a subset of adult participants 3 months following completion of this trial. This qualitative analysis sought to complement, clarify, and expand upon the quantitative findings obtained from the clinical trial to further understand the process and outcomes of the treatment. Interviews were coded and analyzed using an Interpretative Phenomenological Analysis (IPA) methodological framework. Participants described in detail their experiences from before, during and after the trial, which were analyzed and categorized into thematic clusters. Specifically, participants explored what they felt were important elements of the therapeutic process including processing trauma and grief, exploring mystical and existential experiences, engaging with the present moment with reduced physiological activation, and facing illness and existential fears. Outcomes of the treatment included increased ability to cope with LTI, reduced psychological symptoms, improved vitality and quality of life, and feeling more resourced. Participant narratives also showed a reconnection to life and greater emotional resilience in response to trauma and medical relapse. These findings are compared to similar treatments for the same indication. Limitations and challenges encountered in conducting this study are discussed along with implications for theory and clinical treatment.
Comparable studies
Other qualitative studies on MDMA for anxiety, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Patterns, Trends, and Meanings of Drug Use by Dance-drug Users in Edinburgh, Scotland Clubbers in clubs and pre-club bars | 2004 | Cross-sectional survey with focus groups | n = 124 |
| Questions and Concerns About MDMA-Assisted Therapy (MDMA-AT) in Veterans with PTSD Symptoms Veterans receiving healthcare from Veterans Affairs | 2025 | Qualitative study | n = 30 |
| MDMA, PTSD and the amygdala: Promising approach for treating SUDs | 2021 | Interview |
Citations in the library
Cited by 13
- Psychedelics for Patients With Cancer: A Comprehensive Literature Review Annals of Pharmacotherapy January 12, 2023
- Memory, trauma, and self: Remembering and recovering from sexual abuse in psychedelic-assisted therapy Journal of Psychedelic Studies October 9, 2024
- Therapeutic role of psilocybin and 3,4-methylenedioxymethamphetamine in trauma: A literature review World Journal of Psychiatry May 19, 2023
- Acute Subjective Effects of Psychedelics within and Beyond WEIRD Contexts Journal of Psychoactive Drugs September 7, 2023
- Exploring the subjective experience of rave party participants in Israel who consume psychedelic drugs: a qualitative inquiry. Harm Reduction Journal December 6, 2023
and 8 more in the library
Cites 25
- Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial Journal of Psychopharmacology November 30, 2016
- Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial Journal of Psychopharmacology November 30, 2016
- Pilot Study of Psilocybin Treatment for Anxiety in Patients With Advanced-Stage Cancer Archives of General Psychiatry September 7, 2010
- MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Nature Medicine June 1, 2021
- Mystical experiences occasioned by the hallucinogen psilocybin lead to increases in the personality domain of openness Journal of Psychopharmacology September 28, 2011
and 20 more in the library