Ecstasy Begets Empathy

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.

How did you, and the other authors of the study, end up being described as Ecstasy advocates in the British and American press?

We never said it wasn't dangerous. Clearly, Ecstasy use in today's recreational drug scene is full of risks. There's no doubt about that, and the writer of the specific Guardian article, for example, never bothered to read our article and never bothered to talk to any of us. They just sensationalized without any facts behind them.

It looked like a horrible situation when those newspapers published their articles, but since then there have been corrections. I got ticked off when I saw the Guardian article. I think it looked like a horrible situation at first, but instead it has been an opportunity to get more accurate information about medical applications out there.

You do seem to advocate Ecstasy as a therapeutic tool. What are some of the drug's uses in that setting?

I don't like to use the term "Ecstasy" when I'm talking about medical applications. Ecstasy could be anything. It's a terrible, terrible term. And by the way, do you know how the name came about?

No. How?

By the late '70s, it was being used by underground therapists, mostly on the West Coast. By the early '80s, when the secret had gotten out, there was a small but growing recreational drug scene in Austin [Texas] and California, and an enterprising dealer decided there was money to be made. He decided to market it under its most salient feature.

The most salient feature of MDMA is actually empathy. Which is, of course, why it's so alluring to psychotherapists, because empathy between a patient and a therapist is one of the strongest positive predictive outcome measures you could have, right?

So here's this guy, he's trying to sell this drug, and it's not selling because people who buy drugs don't particularly care for or understand empathy. So he goes back to the drawing board and decides, "I need a better name, one that will grab people's attention." So that's how Ecstasy got its name.

How did you first become interested in MDMA as a potential therapeutic tool?

I had written some articles on hallucinogens, and I thought it was a shame that psychiatry had abandoned research in the area. I started hearing anecdotal accounts about MDMA, so I thought this might be a more accessible area to study.

Ecstasy didn't have the hype at that point, in the mid-'80s, that hallucinogens had, and it perhaps had some advantages over a drug like LSD, in that it was milder, easier to control, and facilitated introspection and articulating feelings. It appeared to be effective on people who were alexithymic -- you know what alexithymic means? It means "without words for feelings." [In "The Sopranos," Tony Soprano is diagnosed as alexithymic, among other things.]