MDMA vs Psilocybin Assisted Therapy

MDMA and psilocybin are two psychedelic substances that are showing great promise in the field of psychotherapy. So let’s explore the key differences and similarities between using MDMA versus psilocybin in a therapeutic context.

What is MDMA?

MDMA (3,4-Methylenedioxymethamphetamine) is a synthetic psychoactive drug that was first synthesized in 1912 by the German pharmaceutical company Merck. However, it wasn’t until the 1970s that MDMA started being used recreationally.

In the 1980s, some therapists recognized MDMA’s potential to assist in psychotherapy sessions. They found that it could help clients open up emotionally and discuss trauma in a meaningful way.

However, in 1985 MDMA was made illegal in the US. Despite this, some therapists continued to use it underground in therapy sessions. Now, after decades of prohibition, MDMA-assisted psychotherapy is back in clinical trials and showing great promise for treating PTSD.

How Does MDMA Work in the Brain?

MDMA affects the brain by increasing the activity levels of three key neurotransmitters:

Dopamine – contributes to feelings of euphoria and emotional bonding with others
Norepinephrine – increases alertness and arousal
Serotonin – enhances mood and feelings of trust and intimacy

Importantly, MDMA also decreases activity in the amygdala. The amygdala is responsible for regulating fear and strong emotional reactions. By quieting the amygdala, MDMA allows clients to revisit traumatic memories without getting overwhelmed by fear or pain. This creates a window where they can process trauma in a calm and emotionally engaged state.

“MDMA calms down that fight and flight mode so you can directly go to that trauma and resolve it and look at it and realize that you’re an adult now. “

What are Magic Mushrooms (Psilocybin)?

Psilocybin is the naturally occurring psychedelic compound found in certain species of mushrooms, often referred to as “magic mushrooms.” Magic mushrooms have an ancient history of ceremonial and therapeutic use by indigenous cultures across the globe.

In the 1960s, psilocybin research was undertaken at Harvard and other major universities. However, once it became associated with the counterculture movement, it was made illegal in the 70s.

After decades of being banned, scientists have once again begun studying psilocybin as a treatment for depression, anxiety, addiction, and more.

How Does Psilocybin Work in the Brain?

When ingested, psilocybin is broken down into the active compound psilocin. Psilocin acts on the serotonin receptors in the brain and induces a psychedelic state of consciousness.

Some key effects of psilocybin include:

– Altered sensory perception – visions, synesthesia
– Mystical states of oneness
– Emotional release
– Novel perspectives on life situations

“Psilocybin will also make you feel that it is much easier to feel your emotions without resistance.”

Rather than dampening brain activity like MDMA does, psilocybin amplifies brain connectivity across regions. This allows people to access parts of their psyche that are normally segregated.

Key Differences Between MDMA vs Psilocybin

Now that we’ve covered the basics of how each one works, let’s compare some of the key differences between MDMA-assisted therapy versus psilocybin-assisted therapy


MDMA – Administered in a therapist’s office, with eyeshades and music. The client mostly focuses inward.
Psilocybin – Can take place outdoors in nature, at a retreat center, or in a therapist’s office. Music or silent meditation. More interaction with the therapists/guides.


MDMA – Effects last 4-6 hours from ingestion. Therapy sessions typically last 8 hours.
Psilocybin – Effects last 4-6 hours. Sessions are usually shorter, around 5 hours.

Mystical Effects

MDMA – No visual hallucinations. Sense of closeness with others.
Psilocybin – Full psychedelic visuals common. Mystical states of oneness with the universe.

Emotional Experience

MDMA – Feelings of trust, empathy, love. Reduced fear and anxiety.
Psilocybin – More unpredictable emotional range – joy, sadness, fear are possible.

Memory Recall

MDMA – Allows trauma memories to be revisited without distress.
Psilocybin – May spontaneously bring up repressed memories through visions.

Therapeutic Approach

MDMA – Talk therapy oriented.
Psilocybin – Less talk therapy, more inner exploration and spiritual connection. Therapists provide gentle guidance.

Fear Response

MDMA – Decreased amygdala activation reduces fear/anxiety.
Psilocybin – May temporarily increase anxiety as unconscious material emerges.

“MDMA therapy is the gentler approach and psilocybin therapy is a more spiritual approach.”

While they have their differences, MDMA and psilocybin assisted therapy also share some important similarities:

Key Similarities Between MDMA and Psilocybin

– Both substances induce an enhanced state of introspection and emotional openness.
– Both can help release repressed emotions and memories.
– Both can provide new perspectives on past traumatic events.
– Both take place in a therapeutic setting with preparation and integration.
– Both involve developing a close therapeutic alliance with guides/therapists.

Additionally, some key benefits of MDMA and psilocybin therapy include:

– Reduced symptoms of PTSD, depression, and anxiety
– Increased sense of meaning and life purpose
– Improved quality of life and relationships
– Lasting personality changes and growth

“I think both are amazing healing substances. And I would say maybe if you have PTSD, MDMA can feel safer for you. And it’s easier for you, because when you’re in PTSD, that fight and flight mode is activated all the time. So it will give you that feeling of, finally, I can just relax for a moment on MDMA, and it will be very easy for you to get into childhood trauma.”

Who is MDMA Therapy Best For?

MDMA-assisted psychotherapy seems especially well-suited for treating PTSD.

By lowering activity in the amygdala, MDMA provides a window where those with PTSD can process traumatic memories without being re-traumatized. For many suffering from PTSD, MDMA may offer the first opportunity to really heal from past trauma.

Additionally, MDMA therapy can help with:

– Anxiety disorders
– Emotional blocks
– Couples therapy
– End of life anxiety

However, for those currently struggling with severe depression or suicidal thoughts, caution is warranted with MDMA. The “come down” after the MDMA experience can exacerbate depression temporarily. Professional medical guidance should be sought first.

Who is Psilocybin Assisted Therapy Best For?

Research has found psilocybin therapy to be remarkably effective for treating major depressive disorder and anxiety, especially in those resistant to other treatments. The mystical states of consciousness and shifts in perspective induced by psilocybin can lead to lasting increases in openness and optimism. This mechanism of action makes it well-suited for overcoming the pessimism associated with depression.

Psilocybin therapy may also help with:

– Obsessive compulsive disorder
– Eating disorders
– Cluster headaches
– Demoralization in terminal illness

However, those with underlying psychotic disorders or schizophrenia should avoid psilocybin due to the risk of exacerbation.

How to Get Psilocybin or MDMA Therapy

At present, the options for getting legal access to MDMA or psilocybin therapy remain limited.

MDMA is still in stage 3 clinical trials, the final phase before potential FDA approval as a medication. Enrolling in a clinical trial is currently the only legal way to experience MDMA-assisted therapy in the US, Canada, and Europe.

Psilocybin has made more progress in terms of legal access. In Oregon, licensed facilitators can now legally provide psilocybin services. In Canada and the Netherlands, psilocybin assisted therapy retreats operate in legal grey areas. Psilocybin retreats are fully legal in Jamaica.

Underground therapists also provide illegal MDMA and psilocybin-assisted therapy in most major cities. However, dangers exist without professional oversight, so caution is advised.

Hopefully, as research continues to demonstrate their safety and efficacy, MDMA and psilocybin therapy will become legally accessible to all who need it.

“Both MDMA and psilocybin are in the process of being legalized for therapy soon, because both of them are in the process of being legalized for therapeutic settings. And psilocybin has already been legalized in Oregon for therapeutic settings.”

Integrating the Psychedelic Experience

Whether you undertake MDMA or psilocybin-assisted therapy, integrating the experience afterwards is crucial.

Therapists recommend:

– Journaling about your experience and insights
– Expressing yourself creatively through art, music, dance
– Talking with your guides/therapists to process the session
– Meditating on how to incorporate your takeaways into daily life
– Getting support from loved ones
– Making concrete lifestyle changes aligned with your new perspectives

Ongoing integration practices help ensure that the healing and growth catalyzed during the MDMA or psilocybin session continues to unfold into tangible positive change in the weeks and months after.

In Conclusion

While MDMA and psilocybin therapy share many commonalities, they also have distinct differences in their therapeutic mechanisms and applications.

Both offer immense healing potential for those suffering from psychological conditions like PTSD, depression, and anxiety. When used responsibly in controlled settings, these psychedelic medicines can occasion life-changing experiences of growth and self-discovery.

Moving forward, rather than demonizing substances like MDMA and psilocybin, our society would benefit from harnessing their transformational power and making them into allies on our collective journey of awakening.

“I personally think these are two amazing substances that I am very happy that I have worked with, both for myself, and I’m looking forward to both of them being legalized for therapy soon, because both of them are in the process of being legalized for therapeutic settings.”

*Let us know in the comments if you have any direct experience with MDMA-assisted or psilocybin-assisted therapy. We would love to hear about your experiences!*

Find out more about our psilocybin assisted therapy sessions and psilocybin assisted retreat.

Photo by Kylli Sparre.