The Origin Story of MDMA Research: Annie and Michael Mithoefer

Husband and wife team, Michael Mithoefer, MD, a clinical psychiatrist, and Annie Mithoefer, BSN, a registered nurse, are Clinical Investigators for MDMA and PTSD studies at the Multidisciplinary Association for Psychedelics Studies (MAPS). They specialize in treating PTSD with experimental psychotherapy through clinical research and outpatient clinical practice. Between 2004 and 2018, Michael and Annie completed two of the six MAPS-sponsored Phase II clinical trials testing MDMA-assisted psychotherapy for PTSD. Together, they have over 25 years of experience treating trauma patients.

Here’s a glimpse of what you’ll learn:

[1:48] How Michael and Annie Mithoefer began their MDMA research
[7:16] Annie and Michael’s early work in treating trauma with non-ordinary states of consciousness
[13:02] The early days of psychedelic therapy research and integration
[17:10] Annie talks about the legal challenges of MDMA-assisted psychotherapy
[26:07] Obtaining FDA approval for MDMA-assisted psychotherapy
[32:50] The research process and outcome of the MAPS clinical studies for MDMA
[39:34] How psychedelic therapy and research has evolved over 20 years

In this episode…

Psychedelics like MDMA became popular for recreational use in the 60s, leading some psychiatrists and medical professionals to explore these drugs as treatments for PTSD and depression. Yet, the road to legality and acceptance was long and arduous. How did early pioneers of MDMA-assisted psychotherapy pave the way for a groundbreaking new treatment method?

Psychedelic therapy pioneers Michael and Annie Mithoefer knew they wanted to accelerate healing through altered states of consciousness, so they began treating patients using breathwork. After some trauma patients didn’t experience results, the husband and wife team conducted in-depth research into MDMA. Despite scrutiny, legal challenges, and reputational risks, Annie and Michael collaborated with top psychiatrists to bring MDMA-assisted psychotherapy to the mainstream. Their FDA approval process began after conducting rigorous studies involving control and experimental groups. These studies laid the foundation for future psychedelic-assisted treatment programs, benefiting patients with treatment-resistant mental health conditions.

Join Dr. Sandy Newes in this episode of Living Medicine as she interviews Michael and Annie Mithoefer about their pioneering research into MDMA-assisted psychotherapy. Together, they discuss the early days of psychedelic therapy and research, the outcomes of their clinical studies, and why they began their research.

Resources mentioned in this episode:

Quotable Moments:

“I longed for a more collaborative kind of way of helping people approach their suffering.”
“You can trust the person’s inner healing intelligence and support it, not be directive about it.”
“We noticed there’s a significant subset of people for whom the breathwork isn’t doing it.”
“If you talk about the placebo effect… people have a coherent, complex process they can describe.”
“We’re just creating favorable conditions… for healing and then moving that forward using established methods.”

Action Steps:

Educate yourself on non-ordinary states of consciousness: Engaging with literature and resources on non-ordinary states, such as the works of Stan Grof, can deepen your understanding of the therapeutic potential of psychedelics. This knowledge helps bridge the gap between traditional psychiatry and emerging psychedelic therapies, addressing the initial skepticism often faced in this field.
Participate in breathwork workshops or training: Breathwork serves as a drug-free method to explore consciousness and can be invaluable for therapists and individuals alike. This practice offers a firsthand experience of altered states, enhancing empathy and insight when supporting others in psychedelic-assisted therapy.
Develop a collaborative therapeutic approach: Emphasizing collaboration over a directive approach in therapy can foster trust and facilitate healing. This method awakens a person’s inner healing intelligence, allowing for more profound and individualized therapeutic outcomes.
Advocate for research and education on psychedelic therapy: Supporting research initiatives and educational programs can address the urgent need for effective PTSD treatments and enhance public understanding of psychedelic therapies. Active advocacy helps challenge misconceptions and promotes the integration of these therapies into mainstream practices.
Engage with professional networks and communities: Joining communities like the Living Medicine Institute can provide support, resources, and collaboration opportunities with other professionals interested in psychedelic-assisted psychotherapy. This engagement helps address the challenges of isolation and misunderstanding within the broader medical community.

Sponsor for this episode…

This episode is brought to you by the Living Medicine Institute.

LMI is a training, resource, and membership program educating providers about the legal and safe use of psychedelic-assisted psychotherapy.

To learn more or participate, visit https://livingmedicineinstitute.com.

Episode Transcript

Intro 00:03

Welcome to the Living Medicine podcast, where we talk about ethical medical use of psychedelic psychotherapy teaching skills, examining the issues and interviewing interesting people. Now let’s start today’s show.

Dr. Signi Goldman 0:19

Hi, this is Doctor Signi Goldman, your host for Living Medicine, where we interview clinical and medical professionals in the evolving ketamine and psychedelic assisted psychotherapy space. Recent interviews we’ve done are with Ron Siegel from Harvard on mindfulness and psychedelics, and Dick Schwartz, the founder of Internal Family Systems, on non-ordinary, or potential spiritual content in psychedelic Sessions. So please check those out. Today we have part one of a recent interview Sandy did with Michael and Annie Mithoefer, the prominent and well-known MAPS researchers talking about their experience, their life story, and their views on where psychedelic medicine is heading from their perspective. This episode is brought to you by Living Medicine Institute, a growing professional network for the psychedelic assisted psychotherapy community. For more information, go to LivingMedicineinstitute.com. Let’s get started with part one of Sandy’s interview.

Dr. Sandy Newes 01:18

I am Doctor Sandra Newes, mostly referred to by Sandy of the Living Medicine Institute, and I am delighted to be here with you to Michael and Annie Mithoefer. But I thought that it would be nice just to, you know, give you all a chance to say a little bit about who you are and how you even got into this work. Like, how did you meet Rick Doblin? How did you get interested in MDMA work? Who were you before that and what drew you to it in the first place? Like, how did you know kind of the origin story? How did this even come to be?

Michael Mithoefer 01:48

So I, you know, I went to medical school in 1973, in Charleston, South Carolina, thinking I wanted to Working as a doctor in a small town, I ended up instead deciding to go into emergency medicine. You know, not psychiatry, but regular emergency medicine. So I practiced that for ten years, and I found it exciting and gratifying for a while. But after a while, I felt belonging to have a different relationship with people. You know, I was always doing things to people, which is very useful. If someone’s not breathing, you can put a tube in and make them breathe. It’s great. But after a while I longed for a more collaborative kind of way of helping people approach their suffering. And of course, I had my own curiosity about my own consciousness. So I thought, well, I think ten years in the ER is enough.

What should I do with the medical degree? And I, Andy and I were both in college in the 60s. So, you know, it’s interesting, you know, I wasn’t in college in the 60s. You were you were in college in the early 70s? Yeah, I am old, but not older. I am older anyway. You know, you always get a pass because, of course, you took psychedelics in college in the 60s, which is what we did. I did, and it was close behind. And, you know, I came away from that not really understanding it, but having the idea that these were really important experiences. And in some way they changed my thinking about consciousness and reality in some very deep ways. And then I decided, well, now I need to do something more useful. So, you know, when I was casting about for something more useful to do, I certainly, you know, I was thinking a lot about those experiences back in the 60s. And then I came across an article about Stan Grof, a psychiatrist. Yeah. And I and so I went to the I read this article.

It was a short thing, and It was. I was just fascinated by it. So I went to the medical school library at Charleston and to see if they had any of his books, and they had beyond the brain. I checked it out. I was the first person to ever check it out. Really? There were no stamps. There were no stamps in the back of the books. But it was there in Charleston, South Carolina, in the medical school library. So when I read that, I was like, wow, this explains so much of my experiences, including some very difficult ones back in the 60s. And so I thought, okay, he’s a psychiatrist. I think that’s what I want to do. And so I found, I wondered, is this guy still alive? And so I made some calls and I found out he’s alive and he has a training program. Awesome. So I applied to psychiatry residency and the groff transpersonal training at the same time. Oh, wow. I did not know. And I started them the same month because my first month of psychiatry rotation, I took a vacation time and went to my first breathwork workshop with Stan Goff and Christina Groff and Jack Kornfield. So, you know, it was an amazing experience because what Stan was doing, the way he was approaching healing with the breathwork, which was all based on what he learned with LSD, but he discovered you can also do this without the drugs, which is in itself a really important point, right? So, but he was teaching how he learned to work with people with LSD and what they taught him about what they needed. And so that was what the breathwork was based on. So I had this interesting thing of going back and forth over. I did the breathwork training over the next several years, and I’d go from 1 or 2 weeks at a time and then come back to psychiatry residency. And I could see the contrast, you know. everybody at work thought psychiatry was evil. Everybody in the Psychiatry Institute of Psychiatry thought lying on the floor with your patients and while they were hyperventilating, was like malpractice. And that’s the.

Dr. Sandy Newes 06:06

Day when it was really there was much more of a split. There was much more medical doctors do the body, you know, like you all might do the emotional, but those things are not related. We stay in our lane, right? Yeah.

Michael Mithoefer 06:17

And I was seeing actually these people all have both sides have something valuable. But I also was very struck by I don’t see people at the Institute of Psychiatry doing something that I want to do. I see Stan Groff doing the kind of thing I want to do. So. Well, you.

Annie Mithoefer 06:35

Also happen to be working with people with dissociative identity identity disorder and PTSD. I was a.

Michael Mithoefer 06:41

Clinical chief of the trauma services. So that associative disorder service.

Dr. Sandy Newes 06:46

So where is that?

Annie Mithoefer 06:48

When he was at the medical university in his his training.

Michael Mithoefer 06:51

So as it happens. So we we knew we wanted to work with Non-ordinary non-ordinary states of consciousness for their healing potentials, Stan Grof says. But we felt we had to do that without drugs.

Annie Mithoefer 07:03

But back up, because once you became a psychiatrist, that’s when we started working together, right? Yeah. Before that we had not worked together. Yes. So. And he was.

Michael Mithoefer 07:13

A coronary care nurse. Yeah.

Annie Mithoefer 07:14

Hum.

Michael Mithoefer 07:16

So, so.

Annie Mithoefer 07:16

We started working together and doing breathwork groups for. We did those for ten years. Yeah.

Dr. Sandy Newes 07:23

So you co-led them.

Annie Mithoefer 07:25

Yeah, we co-led them and we saw some patients and then just some people from the community. Yeah. Yeah.

Michael Mithoefer 07:31

So yeah our, our practice pretty soon became mostly trauma. And many people would come to office to the office for looking for help. And you know, I’d start seeing them and then suggest the possibility of breathwork and they’d do that or people would come to breathwork and then they’d want more integration. So they’d come to do some integration in the office. So our practice was always very informed by working with this model of the working with the healing potential of helping people shift consciousness.

Dr. Sandy Newes 08:05

Just to give some context, what years ish is that?

Michael Mithoefer 08:09

It was 91 when I started my psychiatry residency. Okay.

Annie Mithoefer 08:13

And we started working together, probably doing breathwork groups.

Michael Mithoefer 08:17

Yeah, in Vermont and then later in 96.

Annie Mithoefer 08:21

Yeah.

Dr. Sandy Newes 08:22

That is so interesting because that is now I know at the time I sort of started to move in some of those directions too, but and it was hard. And now I understand that it was because it was very cutting edge to do this integration. So you all were really at the forefront of that particular thing, like way before the MDMA work. Yeah.

Annie Mithoefer 08:42

Integrating and especially states of consciousness.

Dr. Sandy Newes 08:44

With traditional psychotherapy and psychiatric nurses.

Michael Mithoefer 08:49

And that’s really what I mean. We’ve learned so much of that from Stan. We also had a lot of our own experience with trauma, but it was still based on this basic idea we’d learned from Stan that you can trust the person’s inner healing intelligence and and support it and not be there to support is very, very important, but not to be directive about it, not to think you know what the person needs. So that’s the core of all of this to me. So we learned that from Stan and from our own experiences because.

Annie Mithoefer 09:17

Okay, so fast forward. Yeah, I.

Michael Mithoefer 09:19

Just want to say part of the breathwork training that I wasn’t really expecting, but was immediately apparent. The most important part was doing your own work. Yeah, that’s where we really learned what it’s like to be in those places with that setting, with someone there and to support you and how much support you want and how much autonomy you want, that kind of thing. So yeah. Yeah. So then so we’re doing it was great. People were having amazing healing with the breathwork. And and we had no interest in being researchers. We were clinicians. Right. But over time, we noticed there’s a significant subset of people for whom the breathwork isn’t doing it. And these are all people.

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