MDMA Use in Psychotherapy: Switzerland


Despite ongoing attempts by mainstream media to demonize MDMA as a dangerous drug, there is plenty of evidence demonstrating its effective use in psychotherapy. During the 70’s, MDMA was used in marriage counseling and on individual patients by a small circle of pioneering psychiatrists, most notably Ann Shulgin and Philip Wolfson. They were impressed by MDMA’s ability to help several patients achieve “breakthroughs” where conventional therapy failed. However, this innovative experimentation came to a halt when MDMA was banned by the U.S. government in 1986. According to Nicholas Saunders,“In December 1985, a group of psychotherapists in Switzerland obtained permission to use psychoactive drugs in their work including MDMA, LSD, Mescaline and psilocybin. They formed The Swiss Medical Society for Psycholitic Therrapy, and besides treating patients with these drugs, members take one of the drugs together at twice yearly meetings.” Say what? The doc doses too? But of course! The general consensus was that doctors administering psychotropic medicine had to be thoroughly acquainted with its effects, though they did not do this while treating patients simultaneously.

The following is an excerpt from an interview conducted by British author Nicholas Saunders with Swiss psychotherapist, Dr. Marianne Bloch, from his book, E for Ecstasy. In my opinion, it is one of the most balanced, truthful, fascinating books ever published about the benefits, effects and dangers of Ecstasy. It was considered so controversial that it has been banned in Australia since 1995. Saunders was a social activist and entrepreneur, having started the successful enterprise of Neal’s Yard in Covent Garden. He also self-published and distributed “Alternative London,” an encyclopaedic guide for young people living in London with tips on squatting, communal living, creative budgeting and alternative thinking. After his tragic demise in a car crash in 1998, Saunders legacy lives on in his work, providing factual information so that people are empowered to make informed decisions in their quest for self-knowledge.  

Introduction Copyright © 2012 Frankie Diamond. All rights reserved.

Italics: Nicholas Saunders  Normal: Dr. Marianne Bloch

Do you use LSD as well as MDMA?

No. Although I have permission to use LSD, and use it for myself, I have decided only to use MDMA with patients. LSD lasts too long, both for the patient and myself. In my own experience, I like LSD much better in a one-to-one setting. I don’t like LSD in a group, and therefore I don’t want my patients to use it in a group either.

What is the problem with using LSD in a group?

I become too sensitive. There were too many stimuli for me – I guess it depends on one’s personality. The more I was able to allow things to come through, the more difficult it was for me to handle them. In a one-to-one setting it was OK, but I don’t want to do it with patients.

Do you do individual work with MDMA or just group work?

I do both. Mostly I use MDMA in a group, but when there is a patient who needs complete attention I use it individually.

What are the particular advantages of using MDMA? For instance, is there a particular character type or problem that it is suitable for? Is it perhaps only suitable when clients reach a block?

I use it with patients who are in an intense psychotherapeutic relationship with me. I usually start after six months or a year of ongoing therapy. Most of my patients come every week for individual therapy, and monthly to my Grof holotropic breathing weekends.* Among them are a few who I select who I select for MDMA therapy as well. These are mostly patients who have difficulties with their feelings…so they are mostly character-armoured people.

Aren’t all patients character-armoured people?

Yes, but there are some who have much weaker armour. For instance, oral people.* Their armouring is not as hard to get through.

So you use MDMA with the people with the hardest character armour.

Yes, I prefer to work with MDMA with people who have very hard character

Nicholas Saunders Photo: Anja Saunders

armour. These are, for instance, women with bulimia and some compulsive characters and depressive patients.

What about other groups such as people who have suppressed a memory of a trauma? 

Yes, that is another group. For instance I had a woman patient whose problem was Bulimia, but then it came out that she was abused by her father, although she had no recollection of it beforehand. With MDMA she said, “Oh, there is some incest problem,” and I was very surprised as she had not mentioned it before, and now with the MDMA it comes out clearer and clearer. This person is completely out of her body, how shall we say it, yes completely detached from her body feeling and her emotional feelings.

Does the MDMA help her to become more integrated?

Yes, it helps a lot. It’s the method that helps her most to integrate and to get into her body. She is much less armoured in normal life than she was before, but she is still armoured and this blocks her from feeling her body. Very often she says, “I can’t feel my legs,” but on MDMA she says, “I feel good, I can feel my body.” It seems to have something to do with energy flow.

If you had not used MDMA with this client, presumably she would have made some progress just with the body work, massage, touch and expressing emotions?

 Yes, but I am not sure that I would have come to that deep knowledge about her background, the incest problems with her father. It was so deeply covered, she had no idea it existed.

Did it take a long time to come out? Was it in the first MDMA session?

It was in the second. She had MDMA sessions alone because she was so frightened, and later she had sessions in the group.

How often do you run an MDMA group?

Twice a year.

That is very infrequent. Is that a policy or is that because it takes so much time?

I decided that because of the toxicity patients should not take it more than four times a year.

Now that new research shows that MDMA is not so toxic, do you think you might give it more often?

No, for me it is enough. Actually I don’t want to use more drugs than I have to. I also get results with breath work and body work. With some patients, these methods work well. It is the hard core ones who sometimes need a push.

Before the [legal] restrictions were put on, how many people were there in your MDMA groups?

Twelve. I didn’t want to take more. And I always work with my colleague, another woman therapist.

What doses do you give people?

125 mg.

You don’t vary doses according to body weight?

Earlier, yes, there were some small patients and they got 100 mg.

Do you find MDMA is much stronger for some clients than others?

I don’t find so much difference, no. Some take a longer time to get into it.

Do you give it in one does?


Do you take it yourself, or does your assistant?


Do you take it in a ritual way?

We just pass it around and take it. And then we eat some chocolate.

Oh! Chocolate?

Yes, it speeds up the effect of the drug.

Really? How is that?

Albert Hoffman [the discoverer of LSD} told me about it with reference to LSD, and he said that there are some receptors that it speeds up, and now we do it with MDMA and it seems to me that it works. They always have to take their orange juice, their pills and the chocolate. I think it has something to do with endorphins.

How long does it take to come on?

About half an hour. After they have taken the pills they lie down and my co-therapist continues to play the monochord.

Do you have any rules or agreements about how clients interact with one another or with yourself? How do you run a group?

Mostly I say that the patients are by themselves. They lie on the mattresses in their space; it’s something that has to do with internal work and they have to stay by themselves. But lately I have started to say, “Why don’t you mix a bit.” Maybe they were looking around and would say, “This person seems to be very sad,” and I would say, “OK, if you feel like going over to this person who you think is sad you can do so.” I mean, I encourage them to communicate with each other. But this is new, in the beginning I wanted to keep each of them separate, just going into their own space.

How do you deal with the situation where the person might be feeling sad but actually not want someone to approach?  Do they have to ask before moving?

Yes. A patient who feels they want to go over to another has to ask: “I would like to get closer to you, how is it for you? Do you want me or not?”, and the other person has to decide. I tell them that they all have to be very honest. They have to feel for themselves what they want.

So after people have started opening up, what do you do next?

Then I play music on tapes. Mostly meditative music but also some with bass, rhythmic bass – it stimulates some feelings and activity. It’s completely different to the music I use in holotropic treatment, because there the music is actually the ‘drug’ that stimulates the activity. With MDMA, the stimulus comes from the chemical substance, so the music has a different intent in each setting.

Do you use different kinds of music to stimulate people in different ways? To bring up aggression, for instance?

Yes, and sometimes also anxiety.

What kind of music stimulates anxiety?

It’s some kind of dramatic music.

Film music from a thriller?

That’s right. But people require different stimuli. I mean, it’s not only music which stimulates feelings, but also contact. Sometimes it’s very important that closeness between a patient and myself brings up a feeling of anxiety, because they are afraid of closeness.

Even on MDMA?

Even more so. I remember an obsessive-compulsive character who was never in touch with her feelings of closeness, and the last time with MDMA she really got in touch by being close, having close body contact and also eye contact. The first time she felt her panic by being close.

Can you give me a few more examples of when MDMA has been particularly useful?

One patient was an extreme stutterer who had been in therapy for a long time. With MDMA, she could really talk about her history for the first time – because before she was only able to write things on a slip of paper. With MDMA she spoke about her father, how she was held back and not accepted as a child, and all of her emotional feelings came u p in regard to this theme.

So on MDMA she was able to talk freely?

Yes, it was incredible. It was also incredible how her body opened up. She started to breather dramatically, and then sounds came out, and she could talk without difficulty. But it was also significant that after the MDMA session her stuttering came back. It was not as bad, but she continued to stutter.

So MDMA didn’t cure the stutter, but enabled her to talk about her pain concerning her father.

Exactly, and this opened up a different area that could be worked with in ongoing psychotherapy afterwards. Material came up that was not known about before. And so this opened up certain feelings.

I’ve heard it said that you can’t feel love until you have learned to love yourself. Do you believe that?

I think so, yes. I believe in it. That only when you are really in contact with yourself, are you open enough to let love flow out.

Do you think that people are suggestible on MDMA?

Not at all. I think they see things as they are more clearly. For instance, the Bulimic client I mentioned had thought she had invented being abused by her father, but on MDMA she saw it was true. She saw it very clearly.

Are there other problems with using MDMA? Perhaps patients get too close to you?

The transference problem is the same as with body therapy, but the situation of transference becomes more clear to a patient on the drug. They can see their projections more easily. When they come up to me during the MDMA session and say, “I love you so much!”, I respond by saying, “See whether this love is something to do with you. Could it not be your newly discovered love for yourself?”

*Stanislav Grof has developed a method using hyper-ventilation and music to create an altered state of consciousness similar to that experienced under LSD.

*Oral people are those whose early needs have not been met adequately. They tend to have a feeling of emptiness which they try to fill by the attention of other people.


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