Therapists on E
By Kevin Durrheim
The frightening thing about being chased by a zombie is that you cannot kill zombies because they are already dead - living dead. The controversial French philosopher, Jacques Derrida, calls such ambiguous categories 'undecidables'. Undecidables are threatening because they are indeterminate and their ambiguity cannot be brought to order by the logic of binary oppositions: good-bad, true-false, inside-outside, male-female.In zombie movies, it is always left to a higher authority - a magic agent or superior power - to intercede for humans and decide the zombie, returning it to one side of the opposition: a proper corpse or a true living being.
Drugs are undecidables. Pharmakon, the Greek word for drug, means both cure and poison. Judging by the conflicts and debates about drugs in our society it would appear as though this indeterminacy continues.
Ecstasy
The use of Ecstasy, for example, has been linked to psychiatric sequelae (panic attacks, depersonalization, cognitive deficits and psychotic phenomena)(1,2), neurotoxic effects (axon damage, decreased levels of serotonin, Parkinson's disease and even death (3).
On the other hand, reports from the estimated one million people that use E every weekend in London alone tell another story. Users report having become more caring, more in touch with their spiritual nature, closer to nature, and having increased happiness and self esteem (4).
A Bhakti yoga practitioner explains how MDMA (the active ingredient in E) helped guide her spiritual path: "I'm trying to see every experience in life leading us closer to God and bringing out a more loving, harmonious way of being... MDMA's been very useful because it's very heart opening"(5).
Therapists are often called upon as external higher authorities to decide the undecidability of drugs: "These drugs are good, let's encourage their use for depression, psychosis, or insomnia; these drugs are bad, look what they've done to my patients". In this way therapists intercede in undecidability much like 'witchdoctors' do in zombie movies, deciding the undecidable, rendering drugs either cure or poison. Can therapists decide the undecidability of drugs? On what is therapeutic decidability founded?
Ecstasy was first synthesized in 1912, but attracted little interest until the 1970s, when psychotherapists began to explore its potential to enhance empathic understandings of others and emotional release. MDMA has been found to weaken the psychodynamic defences and bring repressed material into waking consciousness.(6)
This and the emotional closeness MDMA users feel towards anyone near to them has lead some therapists to see the drug as a potential elixir for relieving pain and distress for terminal cancer patients, opening clients to their emotions, treating eating disorders, post-traumatic stress disorder, alcohol and drug abuse, increasing self-acceptance and for repairing damaged relationships.
Dr. Samuel Widmer, administrator of the MDMA psychedelic therapy research project in Switzerland, sums up his work with MDMA in psychotherapy, saying: " We have not observed any negative effects, neither of a psychological or physical kind. No addictions to MDMA have been observed after use of MDMA. To the contrary, we have been able to confirm that other addictions (alcohol, medical drugs, heroin, etc) were greatly reduced by MDMA-supported therapy".(7)
By contrast, many therapists argue that MDMA has been shown to be neurotoxic in animal studies. This, together with quasi-experimental human research indicates that a single dose of MDMA may cause neurotoxicity in the human brain, and that the long term functional consequences of this may be depression, mood swings, memory problems, sleep disturbances, and anxiety disorders. The conclusion of a Novartis Foundation discussion meeting on 4 December 1998 in London was "Ecstasy use may cause brain damage".(8)The USA Drug Enforcement Administration banned MDMA in 1985, classifying it as a Schedule 1 drug, along with other potentially dangerous drugs "that have a high potential for abuse and no medical usefulness". (9)
The medical, scientific and therapeutic research leaves us in the same place as we started: Ecstasy is an undecidable. A responsible therapist would not use a substance that potentially causes brain damage; but not using a substance that has been shown to relieve suffering and repair damaged relationships may be equally irresponsible.
References
1. McCann, U.D., Shiyoko, O.S., Ricuarte, G.S. (1996). Adverse reactions with 3,4-methylenedioxymethampheta-mine (MDMA; 'Ecstasy'). Drug Safety, 15(2), 107-115.
2. McGuire, P., Cope, H., Fahy, T. (1994). Diversity of psychopathology associated with the use of 3,4-methylenedioxymetham-phetamine (Ecstacy). British Journal of Psychiatry, 165, 391-395.
3. Ricuarte, G.A., Forno, L.S., Wilson, M.A., et al. (1988). 3,4-methylenedioxymethamphetamine selectively damages central seronergic neurons in non-human primates. Journal of the American Medical Association, 260, 51-55.
4. Saunders, N. (1993). E for Ecstasy. London, 14 Neal's Yard: Published by author.
5. Beck, J., Rosenbaum, M. (1994). Pursuit of Ecstasy: The MDMA experience. Albany, NY, State University of New York Press.
6. Greer, G. Tolbert, R. (1990). The therapeutic use of MDMA. In S. J. Peroutka (ed.), Ecstasy: The clinical, pharmacological and neurotoxicological effects of the drug MDMA.
7. http://www.globaliseasbank.org/1993/1993-78.HTML
8. The Guardian 5/12/98
9. National Institute on Drug Abuse, http:/www.health.org. pubs/caps.NCMDMA.html
Keving Durrheim is an Associate Professor of Psychology at the University of Natal, Pietermaritzburg.
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