Typically I'd be in favor of psychotherapy first and pharmaceutical assistance second or as a supplementary procedure; not a replacement. I'd go as far to carry that sentiment over to many other medical and psychological conditions as well. However, the fact of the matter is that medications can provide assistance to our profession and towards easing a person's stuggle with their suffering.
In the specific instnace of MDMA, as ***** pointed out, many other narcotics are used within the medical realm that would be highly illegal if used on the street. The problem I see here is not in the legallity of use but in reliance, regulation, and distribution. There is a quite significant difference between a prescription for marajuana or a prescription for cocaine and/or the in-procedure use exclusively by medical professionals. This would be one of my main concerns with the use of ecstasy, LSD, or (insert "illicit substance").
One of my larger concners would be the over-eagerness of supporters. It seems to be a freightening trend that as soon as a new medication is relased from a pharameutical company with any "cooberating" evidence for a research study that there is a cult-like bandwagon effect. This has been seen in recent history with SRI (serotonin reuptake inhibitor) medications. As with anything, there are politics involved. A shocking one is the way in which funds are transfered from pharmeceutical companies to researchers to sponsoring physicians... but that is a topic for another day.
I'm also cocnerned about a dependence on the drug(s). This is a two-fold approach. My concern is for both the use by "professionals" and "patients." I would be concerned that users may become dependent on the drug (even something as simple as ibuprophen[Advil] or acetaminophen[Tylenol]) and think of it as the primary curative facillitator rather than other therapeutic interventions. In terms of coping with struggle, other "crutches" can develop out of "need" as well; maybe its alcohol, food, laziness, impulse spending, or any other method of dissociating from a problem. I think that this dependence could aslo develop with the practitiioners. I have seen many antipsychotic drugs used in both strictly medical and psychiatric hospitals ... (cough) aggressively. While some situations warrant use of the drugs in this fashion their side effect of making a patient "docile" can frequently be abused. In addition to this general abuse, I wonder if the "therapeutic" ability of the world's counselors will come to rely on drugs more than their ability to connect with and manifest something powerful by a soley "non-synthetic" means.
I would have similar feelings towards EMDR or other more "cognitive" based measures. As ***** mentioned in class, I agree that, as a (future)psychotherapist I do not feel I have the training or education in neurology to adequately apply these measures in "good conscience." Depending on one's educational orientation as a "psychologist" I think this could aslo be true. Personally, I would be disgusted and feel totally empty if I were to hang my ability as a therapist on neurological, cognitive, or behavioral mechanisms alone. Speaking for myself, that "just aint my style" and the practice of medicine isn't (or won't be) my job. Perhaps a tool in a bag of tricks, but how would you feel if you were the client who found out that that's what you meant to your therapist, a trick in a bag?
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