The information provided is for general informational purposes only and does not constitute the practice of medicine or other professional healthcare services, including the giving of medical advice. The content of this podcast is not intended to be a substitute for professional medical recommendations, diagnoses, or treatment. The use of information in this podcast is at ones own discretion and is not an endorsement of use given the complexity inherent in these medicines and the current variable widespread illegality of their usage.
MDMA-assisted therapy for PTSD is in the final stages of FDA testing. Clinical trials are reporting a 70 percent cure rate for a condition that claims thousands of lives globally every day and hundreds in the US alone. Until it’s fully legalized, MDMA is still a schedule one drug and it’s saddled with years of misunderstanding, misinformation, and misuse.
In his new book, A Dose of Hope, Dr. Dan Engle shows you the treatment through the eyes of a fictional patient so you can see how it works without ever setting foot in a doctor’s office. You’ll follow in-depth conversations between doctor and patient, learn about the history of MDMA-assisted therapy, understand how and why it helps, and experience the process for yourself, without ever having to take anything.
The treatment presented here is a synthesis of real experiences and stunning results happening today in trials around the world. Whether you or a loved one suffer from PTSD, or you just want to heal something that’s keeping you from living your best life, don’t miss A Dose of Hope.
Drew Appelbaum: Hey Listeners, my name is Drew Appelbaum and I’m excited to be here today with Dr. Dan Engle, author of A Dose of Hope. Dr. Dan, thank you for joining. Welcome to The Author Hour Podcast.
Dr. Dan Engle: Yeah, it’s great to be with you, Drew. Thanks for having me on.
Drew Appelbaum: I’m excited about this one, let’s kick it off, can you give us a rundown of your professional background?
Dr. Dan Engle: Yeah, I am a psychiatrist and neurologist. My background, wow, where do I start? I went to med school where I grew up in San Antonio, residency in psychiatry in Denver, forensic and child psychiatry fellowships, that took me to Portland, I have medically directed half a dozen different centers over the last 12 years.
I’m about to open up my new center, Kuya, here in Austin next month. I have been board certified in psychiatry and neurology, so I have a bit of an expertise in traumatic brain injury and concussion care, as well as psychedelic research, and what I would call, transformational medicine.
Story Moves Culture
Drew Appelbaum: Now, why was now the time to share the stories in the book? Was there something really inspiring for you out there? Do you have an “aha moment” or did enough people come up to you and said, “Dr. Dan, you need to put this down and share this with the world?”
Dr. Dan Engle: Yeah, that’s a good question. I think it was a combination and culmination of a variety of factors. My experience and interest in psychedelic medicine and research goes back 15 years. For the first seven, eight years of that, I guess now about the first half of that, it was all underground research, experiential process. I’ve lived in the jungle for a year, working with a variety of different plant medicines and also starting to study synthetic medicines as well.
Then when my older sister, Trudy, committed suicide about eight years ago–it was largely because of depression and PTSD that drove her alcohol use–I realized at that time, that I couldn’t stay silent anymore, so to speak.
I needed to be more above-board, educating, advocating for these kinds of medicines to be available to the masses, and the best way to do that is to drive public support, and the best way to drive that is to give people information because data moves science but story moves culture.
To be able to share a fictional narrative of somebody going through a process of MDMA support in psychotherapy to help resolve their trauma, was a part of my give back to my sister, my give back to the community, and my desire for everybody to know what’s possible for these technologies and medicines, at this day and age. Particularly given where they’re at in the current political and legal landscape because many of these medicines are becoming legal in the next 12 to 18 months.
Drew Appelbaum: Now, when you said, “Okay, I’m going to write this book, I’m going to share it with the world.” A lot of authors have the same process, they have the idea of the book rattling around in their head and you might even have an outline, you know where it’s going but sometimes during the writing process, by digging deeper into some of the subjects, you come to some major breakthroughs and learnings.
Did you have any of these major breakthroughs or learnings along your writing journey? Maybe by doing research a little deeper into some of the subjects?
Dr. Dan Engle: I could answer that in a couple of different ways. My major breakthroughs and learnings came through my own experiential process. I myself have been through the experience of the dark night of the soul being in the trenches, being in the midst of suicidal depression, largely after I moved back from the jungle and tried to integrate back into society and it was such a big paradigm shift. As physicians, as clinicians, as facilitators, as educators, and advocates, we can only support people going as far as we’ve gone ourselves.
If we’ve been in the trenches and we understand our own suffering, and we understand what it means to really get down on our knees, so to speak, and pray for intervention, to really give over to a sense of faith and something larger than ourselves, to seek help and guidance from mentors and guides in our communities, et cetera, that is invaluable for being able to instigate an understanding of the healing process. I think from that position, anybody telling the story so to speak has an exponentially better ability to tell the story if they’ve been in it.
That’s the first part of that answer. The second part of that answer is my co-writer too, went through their own process and their own healing, and so it was a really rich dialog for us to be able to engage the whole therapeutic storyline and the whole narrative, as well as the associated cast of characters because this is very much a real-world story of a real-world person. Even though it’s a fiction narrative, it’s a summation of so many countless stories of people going through a similar process of uncovering their own deep core wounding, bringing that into the center of the circle of awareness, and being able to heal that and integrate that into a greater experience of wholeness so as to be able to live life in a new way.
Classic and Complex PTSD
Drew Appelbaum: When you sat down to write the book, who in your mind were you writing this book for? Is this for everybody? Is this for folks who are currently in therapy, who are going through depression or trauma and haven’t sought a therapist?
Dr. Dan Engle: No, it wasn’t so much for somebody with classic PTSD. Classic PTSD–typically the characterization as, war veteran, or significant exposure to life threatening events, clear traumatic events, and replaying those traumatic events in the current, even though they happened in the past.
MDMA psychotherapy is very good for classic PTSD, there is an 83 percent cure rate or a magnitude better than the standard of care. 83 percent was that landmark for a study and then subsequent studies have kind of summated to Brownley, which is a mid-70s percent cure rate, not benefit rate, cure rate, which is orders of magnitude better than the standard of care. But when we were talking about the narration and the fiction storyline and the protagonist, we also thought it was helpful to speak about the growing understanding of what PTSD actually is.
That’s well beyond just the classic PTSD and now we’re starting to appreciate something that’s described as more complex PTSD, where oftentimes, in childhood, a variety of what are called ACES or adverse childhood experiences can lead to a similar neurologic ramification and psychological ramification that looks like PTSD, but it’s not the same kind of entry point, it’s not the same exposure to a life threatening event.
This might be more like consistent wounding around rejection, abandonment, the parental structure, or the immediate community not being able to fully meet that young person’s need for love, safety, security, validation, and consistency in providing those emotional needs and psychological needs.
Because we’re starting to learn more and more about this larger landscape of PTSD, we thought it was actually helpful to showcase that because so many people are in the midst of healing these experiences of core wounding, which looks like complex PTSD. Most people don’t even know it because if these experiences started in childhood, then they have colored the person’s life and personal views, self-view, life-view, they’ve colored that the entire time. It’s kind of hard to be able to step out of it if you’ve always been in the midst of it.
Drew Appelbaum: For the book itself, is there anything that readers need to do to possibly prepare themselves to start the book itself, or is there anything that they could do beforehand to maybe get the most out of the book?
Dr. Dan Engle: Yeah, that’s a really good question. What we have started to put together as far as a greater educational platform surrounding the book to address your question are things like reading groups and sharing the experience of the book itself in community. People don’t necessarily read the book in isolation and then put themselves in that first-person perspective and then potentially, recognize that they themselves also have trauma and then go through that recovering of their own trauma in isolation.
That’s too oftentimes what we in the western psychiatric and psychological medical model have tried to do is have people heal in isolation, and we’re not really geared to do that. We thrive in community, and we heal best in community. That’s one way to be able to support people is to have a book sharing club or a book sharing group or shared process around it.
The other is to be in some kind of supportive relationship with somebody who is educated and more experienced in this arena. It doesn’t necessarily have to be formal therapy, unless that’s warranted and obvious to the degree of trauma that somebody might uncover, but it could be a counselor, a mentor, an elder in the community, a guide who understands this landscape more effectively. At minimum, it could be a supportive person or a friend to be able to share the experience with. But that comes back to the experience of community and ideally, we have both an experience of togetherness and belonging, as well as leadership and guidance through the process of uncovering our deeper wounds.
Drew Appelbaum: You mentioned the narrative and the writing of the book earlier and I’d love to dive into that. Why did you choose to tell the story from the perspective of a fictional main character as you are writing from your experiences, but you put yourself as a character in the book rather than speak in the first person?
Dr. Dan Engle: Yeah, it’s a good question, we went back and forth with the different writing styles and at the end of the day, it seemed to be presented best and received best if people were able to have their own relationship with the protagonist as an average person–outside of the protagonist being a physician or me or anybody in more of that facilitator role to carry the reader along the storyline of an average person, who is going through a self-reflective process and recognizing that wounding may be present and deeply suppressed or repressed and that there are tools available for uncovering it.
What’s that average person’s thought process? Self-assessing whether or not they’re ready and then being able to share that curiosity and inquisition with their own therapist. This is why part of the book is also I representative of the best kind of preparation process, which is if somebody is going to start getting into this kind of MDMA support and psychotherapy work, it’s ideal to have a therapist support them on the front end, so as to be able to provide that consistency and safety in the arena and environment of being able to process it more effectively and readily.
It essentially takes out the isolation straight out of the gate, and as we got deeper into the narrative and the storyline, it just started to feel better and write better and flow better, so we knew we were on the right track.
Drew Appelbaum: Let’s dig into the actual topic of the book itself. Can you set a base for us, set the foundation, what exactly is MDMA-assisted therapy?
Dr. Dan Engle: Yeah, it’s always good to come back to the basics. MDMA is an amphetamine salt that classically in street drugs and is known as ecstasy, and a lot of people misrepresent and misidentify MDMA as ecstasy. On the street, if you get ecstasy, it could be a variety of different things, and is usually not MDMA, certainly not pure MDMA.
It’s also notable that much of the early ecstasy did have MDMA that accentuates and really instigates that heart-opened experience. MDMA was first discovered and utilized in the 70s and 80s as a therapy aid because it is very good at instigating a neurochemical cascade that opens up the heart, so to speak, and opens up the relational context.
If you have somebody that’s walled off or guarded or armored, oftentimes because of trauma, this is a very good tool for allowing that trauma guard and armor to start falling away. It was very popular as a couple’s therapy counseling aid in the early 80s. People were able to utilize it legally in therapy. Then, unfortunately, it went to schedule one and does not belong in schedule one by the way. Since, Rick Doblin and the MAPS Organization has been a champion for educating communities, educating the grassroots organizations, and funding the research to bring MDMA back into the spotlight as a trauma healing tool.
MDMA in and of itself as a treatment therapy is the best-known treatment by the numbers for PTSD, Post Traumatic Stress Disorder, chronic, severe, treatment-resistant, right? That has a hard time really being addressed effectively in the current standard of care. It’s the most effective trauma-healing tool that we know of on the planet right now, and the degree that many people are experiencing PTSD to a level of severity that significantly disrupts their life and their ability to live themselves into a free, joyful, authentic self-expression of who they are and who they can be in the world–the degree of PTSD that’s present is horrendous.
One hundred to one hundred twenty people commit suicide in the US alone daily. It was obvious, per my earlier mention to you that it was a personal conversation for me and a personal reflection for me when my older sister committed suicide, I realized, “Oh, wow.” This was nine years ago, and more and more research was being appreciated at that time, and I realized, “Oh wow, this is really hitting home. Shit, what am I doing here?”
I know there are effective tools, I didn’t know that that was going to happen for her. She was sober for 14 months, we thought she was doing really well, and then all of a sudden, she was gone. It happened so freaking fast but it really woke me up to my mission and dharma, to be able to step into that education advocacy role now with the data to really back up what we know clinically to be true. It’s an exciting time, and right now MDMA as a therapeutic agent has the opportunity to become legal in the next 12 to 18 months.
Drew Appelbaum: What do you say to people who will even see the theme of this book or hear about MDMA therapy, and they just can’t get the years and years and years it’s been illegal in their heads but internal you know that how helpful it is? What do those conversations look like to the people who are first hearing about this and how often do they change their mind and really go on to experience this?
Dr. Dan Engle: Great question. So, the ability to change one’s mind and then go to an experience is oftentimes a big bridge to gap, or I should say that the other way around, a big gap to bridge, but both because the bridge has happened with education and information and then along that way, the bridge starts getting fed first and foremost by that person’s own unique curiosity. Now, if it is just at an arm’s length like, “Okay, I get the data, I appreciate the movement. I’ll passively support you from afar,” awesome.
At least you’re no longer in this kind of scenario. At least one ideally would no longer be prejudiced against the movement because of historical propaganda. The war on drugs was very effective. I grew up in the middle of the war on drugs. I remember being a kid and watching a Friday commercial, “This is your brain on drugs,” and it left an imprint. It was very effective and so my presentation of this kind of information is very different depending on the group that I’m talking with.
I lecture often to groups of physicians, and if I am lecturing to a group of clinicians, it’s very important to start with data–to not be an evangelist approximately because I can get super animated about the need for this to become legal, and being a salesman doesn’t always work, especially if you are in the midst of skeptics because it gets their spidey sense up even further. So, I just lead with data.
Because too, clinicians, we should be driven by data, and be driven by the neutral curiosity to be up to speed on the best data, as opposed to being prejudiced to old information and resistant to hearing something new that might challenge our previously held beliefs. If I can just present data and stay with data, most skeptics will get curious, and the deeper I go into the data, many people will say, “Well, where’s this data been?”
I say, “Well, it’s growing more and more in the research because now we’re getting more and more centers, we’re getting more and more power, we’re getting more and more of the funding stream to support it. It’s been a movement for 30 years, almost 40, since it went schedule one.” Then the next question is often times, “Well, if it’s so good, why isn’t it available now?” And then we have to get into the legality, and then the next question is, “Why did it become illegal?”
Then you just open up a larger conversation into the entire propaganda of the war on drugs, and why that happened, and that oftentimes gets really juicy. People get very fired up about the political agenda around curtailing certain information or presenting information in a particular way to serve a particular outcome.
At that point, some people will get a little ruffled and table the conversation. Other people who may have been die-hard skeptics now become advocates.
Because also my question to them is, “Do you know anybody that’s committed suicide?” and half of the room will raise their hands, and I say, “Okay, of the people that you know, how many are in your close network? Friends, family, immediate?” Then about 20 to 25 percent of people will raise their hands. That’s happening more and more because actually, we’re starting to appreciate, “Oh, if so and so actually committed suicide, that may have been a drug overdose, and I thought that was addiction related.”
Now, we’re starting to appreciate more and more that all addiction is related to trauma too. Now, we’re actually talking about PTSD as well. It becomes this larger conversation, so if I could just lead with data, and then allow people to opt into their own level of curiosity and how deep down the rabbit hole they want to go, then the conversations oftentimes tailor themselves.
Drew Appelbaum: Now, your co-author Alex Young, is also as you mentioned a fiction writer and is writing this under a pseudonym, can you tell us about their personal experiences with MDMA and how it helped them?
Dr. Dan Engle: Yes, she’s decided to stay anonymous for a variety of different reasons. She’s known as an author in other arenas, and the legality unfortunately right now is still schedule one, so to keep everybody in that safe zone, we thought it was better that she just remained in that pseudonym position. Her experience was also profound because she has had her own personal process of healing trauma through MDMA support of psychotherapy.
That experience of her own trauma recovery and her own healing was able to significantly inform how the book was written, how it was delivered, the storyline itself, and the associated characters in her life are similar to the characters in the protagonist’s life and vice-versa. Again, it comes back to that same kind of experience for facilitators too. We can only present, truly present well what we’ve gone through ourselves, and we can only help people go as far as we’ve gone.
Drew Appelbaum: Now, after somebody reads the book, what impact do you hope that it will have on a reader and then do you hope that somebody takes some steps afterward, certain steps after reading the book, and some changes in their life or some decisions?
Dr. Dan Engle: Well, yeah. There is a big buffet of options. I suppose at minimum, my desire is to instigate curiosity. Again, just to come back to this is information and this is a storyline written that is specific to one protagonist, yes. In many respects, it’s a summation of countless people’s experience living under the veil of complex PTSD, and not really even knowing it.
If we can instigate curiosity and offer people more of an invitation to get into the conversation of what complex PTSD looks like, and who are the great writers and speakers like Rick Doblin of the MAPS Organization–the list is long of people who are well-known in this space and who are carrying more and more of a broad spectrum conversation into the normalization of the PTSD healing process and that it doesn’t mean a life sentence.
Everything is healable, especially in community, especially when it is validated and brought into the center of the circle of awareness and shared with others.
My desire is to instigate curiosity, support people’s educational investigation, and point them in the right direction to advocate for this work. Therefore, for people to be personal advocates of this work through their own support of organizations like MAPS and through the variety of other associated and parallel legal changes that are happening.
For example, there is a huge movement right now to decriminalize psychedelics nationally, which I think is an important growing edge in social justice because there are so many people in the privatized prison system with petty theft of single-use psychedelics and serving long-term sentences. This is just one area, if people get educated and become advocates that we can support the reclamation of the war on drugs that didn’t help the availability of making these therapies accessible to those that need them the most.
One organization that I’ve started with the support of others is thankyoulife.org, which is a non-profit funding stream to be able to support people to access psychedelic therapies at a level of readiness. Once they send in an application, they go through an evaluation process, et cetera because ultimately at the end of the day, we don’t want the cost of treatment to be a barrier to entry.
Right now, we haven’t created the new medical model and the insurance reimbursement model to support the utilization of these services at scale, and that is something that needs to change too. Because so many people who have PTSD, even if MDMA is legal, wouldn’t be able to afford it at the current medical structure. There are so many different parts that need to still fall into place. This is just one and this is one of the bigger ones, which is education and advocacy.
Then once people get a sense of where it’s at and where it needs to go, so full access is available, then people can self-select on how they want to be supportive. It could just be as simple as writing up your local political representative and saying, “I’ve heard of this therapy. Do you know anything about it? First and foremost, it’s schedule one, so can we decriminalize it and, where is it at in legalization?”
MAPS is the big organization supporting this research and the entire process of reclassification from schedule one with the federal government into a softer classification where it can be used as a prescription therapeutic. That’s a great way to funnel people’s education and interest back to MAPS, and there are many other organizations that are supporting in similar roles to MAPS.
Again, if we can educate people and then we can advocate, and then we can build communities around healing, which are more of these transformational medicine centers, now we’re not just seeing a change in the social climate. We are seeing a change in the entire way medicine itself is offered particularly to heal trauma and to help us reclaim a sense of healing that many people haven’t experienced yet.
Drew Appelbaum: I do want to mention, it’s really great that you did this. You did add further reading notes in the book and you also have lots of references and sources on MDMA in case anybody reads the book and still wants to do further research or continue passing along the message.
Dr. Dan, I just want to say we touched on the surface of the book here but writing a book on this subject, which is really going to help so many people, and moving this message forward and projecting about the efficacy of this research and these therapies is no small feat, so congratulations on having this book published. I know you have a lot of accolades, but you can add author to your resume now.
Dr. Dan Engle: Yeah, thanks so much Drew. I appreciate your support in that arena and thank you for doing what you’re doing to help us get the message out.
Drew Appelbaum: Yeah, you’re welcome. This has been a pleasure and I’m excited for people to check out the book. Everyone, the book is called, A Dose of Hope, and you can find it on Amazon. Dr. Dan, besides checking out the book, where can people connect with you?
Dr. Dan Engle: Yeah, thanks for asking. As I mentioned earlier, I am opening up my clinic, Kuya, in Austin, Texas next month. It is a center for transformational medicine, where we are on deck to be able to offer MDMA support of psychotherapy, so this is a support in psychotherapy when these become legal in the next 12 to 18 months. As a center of transformational medicine, it also opens up into a community process and we’re wanting to set a new standard of healthcare and mental healthcare in the landscape, so that’s one.
Full Spectrum Medicine is a coaching and integration platform to be able to work with people if they’ve gone through medicine experiences and need to be able to integrate and land the plane in a good way. Dr. Dan Engle is my personal site. Soul Centered Medicine is an orientation to what we recognize that the healing happens at this level of soul or this deep level of self.
All of these organizations, Full Spectrum Medicine, Soul Centered Medicine, Transformational Medicine, are all telling the same story from different points of view or concentric circles spreading from inside to out. I think we’re in the midst of an exciting time in this whole psychedelic medicine renaissance. It’s a privilege to do my own small humble part in the collective.
Drew Appelbaum: Well, we are all appreciative of what you’re doing, and thank you so much for coming on today and giving us some of your time. I wish you sincerely best of luck with your new book.
Dr. Dan Engle: Thank you, Drew, take care.
West of Wheeling: Jeffrey Tanenhaus