Piece of Mind: Mental Health & Psychiatry · Piece of Mind: Mental Health & Psychiatry

Episode 15: Not just a party drug: MDMA therapy for people with PTSD

·38 min·2 clips

In MAPS phase 3 data, 67% and then 71% of MDMA patients no longer met PTSD criteria.

Catherine opens the conversation with Dr Matthew Hoskins. She introduces his Cardiff-based work on MDMA-assisted therapy for PTSD, along with his role as a consultant psychiatrist in traumatic stress and psychiatric intensive care. Matt is an expert in the effects and use of drugs to manage PTSD, with studies commissioned by the World Health Organisation and the International Society for Traumatic Stress Studies, and he is the principal investigator for a clinical trial of MDMA-assisted therapy for PTSD in Cardiff. The discussion stays close to the practical question of what people mean when they talk about psychedelics. Matt distinguishes classical psychedelics such as LSD and psilocybin from other medications, and he notes that the experience itself can be hard to describe, even ineffable, which is one reason early clinical work treated these substances differently. The episode also points back to much older indigenous practices. Matt says the Western story is really a rediscovery, not an invention, and that there is a long history of healing use that stretches back thousands of years. From there, the show turns to MDMA therapy itself. Matt explains that the approach was based on a lot of 1970s work on LSD therapy and was adapted from the way LSD therapy was done back then. The setup is specific rather than loose or open-ended. Two therapists stay with the person throughout. Before any medicine is given, there are usually a few preparation sessions of 60 or 90 minutes, where everyone gets to know one another and talks through what might come up. Those preparation meetings are about setting expectations. They cover what difficult material might surface, how to sit with it, and how to lower the intensity if things get too much. The drug session then feels different by design. The team in Cardiff used a clinical room at the Heath hospital that they dressed to make it look more like a day spa, with soft furnishings and fake plants, so the setting itself would support the work. Matt also places this research alongside his wider interest in psychedelics and cannabis in mental health. He has been in this space for a while, including becoming the first clinician in Wales to use psychedelic ketamine therapy in 2021. The conversation ends by pointing listeners toward Traumatic Stress Wales for resources and contact details. It is a patient, clear guide for anyone who wants the research context before making sense of the headlines.

As heard by us

A calm, careful look at how MDMA-assisted therapy is being tested for PTSD.

This episode treats MDMA-assisted therapy for PTSD as a clinical question, not a headline. Matt Hoskins walks through the Cardiff trial with enough care that the preparation sessions, the two-therapist setup, and the calm hospital room feel like part of the treatment itself.

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Why you'd press play

You get a careful map of MDMA-assisted therapy for PTSD, from prep sessions to the clinical drug session.

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