Medicine Assisted Therapies: A Promising Frontier
Medicine assisted psychotherapies combine pharmacological agents with tailored psychotherapeutic modalities and show real promise in addressing trauma at multiple levels, especially relational and developmental wounds.
MDMA Assisted Therapy in PTSD
Two large Phase 3 trials (MAPP1 published 2021, and MAPP2 published September 2023) showed that 67% to 71% of participants receiving MDMA with therapy no longer met DSM‑5 criteria for PTSD by study endpoint, compared to 32%–48% in placebo‑with‑therapy groups. Importantly, the treatment was generally well tolerated, with no serious adverse events in MDMA groups (some occurred in placebo groups).
In August 2024, the FDA rejected the New Drug Application for MDMA-assisted therapy for PTSD, citing concerns about trial design, potential unblinding, underreported adverse events, and a lack of independent therapist oversight. They called for an additional Phase 3 trial to confirm safety and efficacy.
This decision contrasts sharply with the findings of the Dutch State Commission on MDMA, which reviewed the same data and in May 2024 recommended national approval under clinical supervision, citing strong efficacy and an acceptable safety profile. (Click here for access to a free online presentation on the findings).
For a deeper dive into the FDA’s rationale and how it differs from the Dutch approach, read our companion blog post.
Relational‑Developmental Impacts (Bessel van der Kolk’s analysis)
Trauma expert Bessel van der Kolk conducted secondary analyses on the Phase 3 data, focusing on relational/developmental trauma populations—approximately 84% of participants had histories of developmental trauma. MDMA‑AT significantly improved domains like alexithymia (difficulty identifying/verbalizing feelings), self‑compassion, identity stability, emotional regulation, and interpersonal trust versus therapy‑alone groups. Van der Kolk called these changes both “spectacular” and aligned with deeper levels of healing beyond just symptom reduction,
Ketamine and Ketamine Assisted Therapy for PTSD
Ketamine, an NMDA receptor antagonist, has demonstrated rapid anti‑PTSD effects, even in treatment‑resistant cases. Meta‑analyses and randomized trials show fast reductions in symptom severity, often within hours or days, lasting up to one or two weeks per administration cycle.
Combining ketamine with trauma‑focused psychotherapy has yet further potential: meta‑analysis found meaningful symptom improvements and good feasibility in PTSD treatment contexts, although sample sizes remain small and more rigorous trials are needed. A 2023 pilot study showed ketamine given before exposure therapy might enhance reconsolidation of traumatic memories, improving extinction learning
Recent reports also highlight ketamine assisted therapy in Ukraine, helping veterans rapidly process trauma and foster resilience through structured psychotherapeutic support
Why CMAT’s Approach Is Particularly Aligned - Relational Somatic Therapy & Internal Family Systems—
At the Centre for Medicine Assisted Therapy, we intentionally pair medicines like MDMA, Psilocybin (for clients approved through Health Canada’s Special Access Program) or Ketamine with therapeutic models that honor trauma's relational and developmental roots:
Relational Somatic Therapy: Works with both relational and bodily memory of trauma, supporting bottom‑up regulation and embodied safety.
Internal Family Systems (IFS): Helps clients gently access and integrate dissociated parts formed in developmental trauma, supporting identity repair and self‑compassion.
This combination is especially well‑matched to healing relational‑developmental wounds—amplifying the deep capacity for connection, self‑regulation, and emotional safety unlocked by medicine assisted experiences.
In Summary
Trauma spans incident, relational, systemic, and intergenerational forms—even without meeting PTSD criteria.
PTSD, per DSM‑5, is narrowly defined but often excludes relational and oppression‑based trauma.
MDMA‑assisted therapy Phase 3 results (67–71% remission) show striking effectiveness and safety, including deep shifts in relational and self‑experience domains
Ketamine‑assisted therapy offers fast‑acting PTSD relief and may enhance extinction of trauma memories when combined with psychotherapy
Pairing these with Relational Somatic Therapy and IFS aligns precisely with relational‑developmental trauma needs, supporting deeper, integrative healing.
At CMAT, this holistic approach offers hope—not merely symptom reduction, but transformation in how people relate to themselves and others, reclaiming safety, belonging, and self‑compassion.
— By Dr. Devon Christie, MD, RTC, CMAT Co-Founder & Medical Director
