An Extended Nondrug MDMA-Like

Experience Evoked Through

Posthypnotic Suggestion?

Arthur Hastings, Ph.D.*

Abstract-This research explored whether hypnotic suggestion could produce a subjective mindbody condition similar to that produced by the psychoactive drug methylenedioxy methamphetamine (MDMA, Ecstasy). Twelve participants received posthypnotic instructions to re-experience an MDMA-like state posthypnotically, similar to one in their prior experience, for one hour. Three separate self report measures and qualitative self reports showed that the posthypnotic condition effectively mimicked an MDMA-like experience, lasting an hour at a stable level. Participant ratings in real time and in retrospect ranged from 36% to 100% similarity to a drug-induced experience. The qualitative reports and rating scales enabled a phenomenological description of the subjective experience. Scores on the Tellegen Absorption Scale correlated significantly with the strength of the posthypnotic condition (Spearman rho .87, p = .0003). The participants successfully carried out various intentional activities during this time (e.g., self reflection, talking with partners about relationships, artwork, walking in nature). Applications for this technique as an adjunct to therapy and health treatments are discussed. Keywords-altered drug effects states of consciousness, consciousness. Ecstasy, hypnosis. MDMA, subjective

The purpose of this research was to determine whether posthypnotic suggestions could create an extended (one hour) mind-body condition similar to or mimicking the subjective effects produced by the drug methylenedioxy methamphetamine (also known as MDMA, Ecstasy, and
tThe research team for this study consisted of Ida Berk, Michael Cougar, Elizabeth Ferguson, Sophie Giles, Sandra Humphrey, Kathie McLellan, Carolyn Mitchell, and Barbara Viglizzo, who contributed to the design, planning, and conduct of the experiment. Professors William Braud, and Charles Tart provided valuable suggestions for the design. A presentation of partial data from this study was given at Toward a Science of Consciousness: Tucson 2000 (Hastings et al. 2000). We appreciate funding from the Bernstein Brothers Foundation for Health and Parapsychology. Mr. David Gibson, and Drs. Burt and Belinda Brent. The Institute of Transpersonal Psychology provided curricular support. *Professor, Institute of Transpersonal Psychology, Palo Alto, CA. Please address reprint requests to Arthur Hastings, Ph.D., Institute of Transpersonal Psychology, 1069 East Meadow Circle. Palo Alto. CA 94303-4231.

Adam) for individuals who have had previous experience with MDMA. The study was conducted with participants who had taken the drug at some previous time, but who did not take the drug at the time of the experiment. This research expands on earlier work using hypnosis to produce a brief noidrug state (Hastings 1994), in which hypnotic suggestions were given to participants to the effect they would reexperience the hypnotic MDMA condition for a short time period (10 minutes). Measured with a Likert Scale, the condition was rated as highly similar or identical to the original chemically produced state. The study sought answers to these questions: (1) Can a posthypnotic MDMA-like condition be evoked and extended to last an hour in duration? (2) Can personal therapeutic or psychological work be c a k e d out during the posthypnotic condition? (3) What subjective qualities of

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the drug condition are reproduced in the posthypnotic condition? and (4) What correlations are there with altered state scales, specifically the Tellegen Absorption Scale and the Harvard Group Hypnosis Scale?

DESIGN AND PROCEDURE Met hod The experiment was conducted in two groups. Group 1 consisted of eight participants and Group 2 of four. The participants completed a pre-questionnaire and the Tellegen Absorption Scale. 'The Harvard Group Scale of Hypnotic Susceptibility was administered to Group 1, but not to Group 2 (see below). The participants were then given a hypnotic induction as a group, with hypnotic suggestions to reexperience an MDMA-like state posthypnotically, similar to one in their prior experience, for one hour. They were then returned from the hypnosis. During the posthypnotic condition, they were allowed to engage in their individual choice of experiential activities. After one hour, they were signaled to return to their baseline condition. The individuals completed a post-questionnaire to assess the effects of the posthypnotic experience. Participants The participants were unpaid volunteers. They were required to have taken MDMA at some time in the past with a positive experience. The participants were not asked whether this was under legal or nonlegal circumstances. Overt pathology was a criterion for exclusion. The participants were recruited through word of mouth by the research team ,and with announcements at the institute. All participants were living at the time in the San Francisco Bay area. The research with Group 1 was conducted in 1997, and with Group 2 in 2000. Twelve participants were selected. Consent forms approved by the institutional human subjects IRB explained the research procedure, and indicated that no drugs would be used during the experiment. The participants agreed not to take psychoactive substances immediately prior to the experiment. It was suggested that they eat lightly before the session and abstain from stimulants such as coffee, as these recommendations are often made for persons ingesting MDMA. Setting and Research Team The conditions of the study were arranged to be supportive physically and interpersonally. The locations were two home settings in quiet suburban locations. The research team for Group 1 was practiced in working together with each other and in respecting the individuality of the participants. They had assisted in developing and trying out the procedure. Each participant was monitored by a member of the research team during the posthypnotic condition. As Group 2 was smaller, the author canied out this responsibility during the hour.
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Pre-Questionnaire The pre-questionnaire was constructed to obtain demographic information, a baseline mind-body state, and information on previous MDMA experiences. Questions asked participants to rate (on a 1-7 scale) their current (at that moment) mental state in relation to an MDMA state, and to rate their usual everyday state of mind relative to the MDMA state. One question asked for three words or phrases that described, for them, the subjective qualities of MDMA. These phrases were incorporated later in the hypnotic induction. The pre-questionnaire was designed to evoke a remembrance of the previous MDMA experience as well as gather data on the individual's experiences. Post-Questionnaire The post-questionnaire asked for a written description of the hypnotic MDMA condition, including activities engaged in, the fulfillment of intentions, and insights and learning from the experience. Participants rated the experience on a Likert l - 7 scale for its similarity to the drug state, and rated the fulfillment of their intention for the experience. Thirty possible subjective qualities of the posthypnotic MDMA state were listed, based on reports from the MDMA literature and prior discussions by the research team. Participants rated these effects as to whether they were present and how similar they were to previous MDMA experiences. Real Time State Reports To get real time reports during the posthypnotic condition each participant was asked every 10 minutes for a number from one to seven to indicate the strength of the posthypnotic experience relative to an MDMA experience, with one meaning there was no similarity to the MDMA experience and seven indicating that it was identical. Hypnotic Procedure Hypnosis was induced with a standard relaxation approach. A relaxation induction was prepared and presented by the author to the group. The posthypnotic suggestions instructed that at the end of the hypnosis, the person would begin to reexperience, remember, and recall an MDMA experience. Selections from literature of first person accounts and summary reports on the subjective phenomenology of the MDMA experience were used to create posthypnotic suggestions (Shulgin & Shulgin 1998; Stolaroff 1994; Liester et al. 1992; Greer & Tolbert 1986; Adamson 1985). Using content analysis, the predominant and typical qualities of the drug experience were identified when the substance was used for psychological purposes rather than social recreation. These include reduction of fear and defensiveness, self reflection, feelings of caring and love for others, appreciation of nature, sensations of energy in the body, changes in the passage of time (faster or slower), feelings of transcendence, clarity
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TABLE 1

Demographics

Participant A B C D E F G H I J K L Gender Occupation

Engineer
Student
Business consultant / writer
Student
Artist /teacher

Novelist/psychotherapist

Acupuncturist~herbalist
Engineering manager
Physicist
Songwriter
Administrator
Physicist

Previous Times MDMA 6 20 200+ 2 25 23+ 4+ 40 20 4 3 10

Last Prior Experience 7 yrs 3 yrs <I yr 20 yrs 3 yrs 5 yrs 5 yrs 5 yrs <1 yr <1 yr 1Y r 1Y r

Setting
Home of friend Therapeutic intentions, with a friend Social Social Home near nature Home, social Personal Home, solo, meditative Mountains Social Social Relationship

of mental processes, improved communication with others, and problem-solving insights. These qualities were incorporated into the posthypnotic suggestions. The suggestions specified that they would take effect after the return from hypnosis, and last for one hour. At that time the MDMA-like effects would stop and the individual would return to a normal condition. Assessments Tellegen Absorption Scale (TAS). The TAS is a 34 item, truelfalse scale that indicates the person's ability to enter psychological states that restructure the boundaries and content of self awareness, in ways that have been described as dissociative, integrative, or peak (Tellegen 1981; Tellegen & Atkinson 1974). Examples of questions are "I can be deeply moved by a sunset" (external focus), "My thoughts often don't occur as words but as visual images." (internal focus), and "When I listen to music I can get so caught up in it that I don't notice anything else." The TAS has been found to be positively related to hypnotic ability (Tellegen & Atkinson 1974).This compares to the MDMA literature, where reports of appreciation of nature, absorption in perception, and enhanced physical sensations are found. The items ask for reports on experiential responses rather than instrumental activity, and it seemed plausible that high scores on the TAS would indicate a similarity to the relaxing of ordinary mind-body structures when reexperiencing an MDMAstate. The scale was used as published by Tellegen, with the exception that the title was given as "Personality Assessment." Harvard Group Scale of Hypnotic Susceptibility (HGSHS). This is a standard scale to measure susceptibility in a group setting (Shor & Orne 1962). The script has 12 test items, from head dropping and eye catalepsy, to amnesia and posthypnotic suggestion. After the procedure, the participants score their responses, with totals ranging o from 0 t 12. Because of the time requirements of the schedule,
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the usual administration time of one hour was shortened to 40 minutes by reducing some of the repetitive wording and pauses in the script.

RESULTS
Demographics Ages of the participants ranged from 3 1 to 72 (see Table 1); this was a mature group of professionals. Three of the 12 participants were in psychological or health professions. All had used MDMA in the past. One individual had been a participant in government approved research projects on the physiological effects of MDMA, and others had personally used MDMA in psychotherapeutic settings when it was legal. This group can be characterized as individuals who were interested in their personal and psychological development; for many of them the use of MDMA was one of the methods for personal growth. The use of an experienced group enabled us to explore the effectiveness of this technique under favorable conditions. This is not a random sample, and the implications for general applicability of this technique will be discussed later. Participant Ratings of the Experience Real Time State Ratings. To address the main question, can an MDMA-like experience be evoked posthypnotically and extended for one hour, there were three separate ratings (by participants) which compared the posthypnotic condition and a drug-produced experience. The first was real time state reports (see Table 2). The real time state reports were taken every 10 minutes during the posthypnotic experience for the first group, and every 15 minutes for the second group (which was deemed adequate, based on the first group) by asking the participant, "What is your level of experience now, compared to an MDMA drug state, on a scale of 1 to 7?'The table shows that the individual levels fluctuated slightly, showing increases and
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TABLE 2
Real Time Similarity Ratings by Participants
Group 1 Minutes
A

Mean
4.00 4.67 3.92 5.92 6.50 7.17 4.67 4.50 5.17

B C D E

F
G H Group

S.D. .32 .41 .60 .38 .54 .40 .8 1 .54

Group 2 Minutes
I J K L Group

0 2.5 5 5 5

15

2.5 5 7 5

30 3 6.5 7 6

45

2 6 7 5

60 2 6 6.7 4

Mean
2.40 5.70 6.54 5.00 4.91

S.D.

.42 .67 .87 .70

declines over the hour, but remained stable, as indicated by the low standard deviations.Participant F, who also reported the strongest effect, gave the number 8 at the 60 minute time rating, saying that the strength of the posthypnotic condition was higher than the usual drug-induced state. Similurily Ratings. Participants were asked in the post -questionnaire to retrospectively provide a single, global overall rating of the posthypnotic condition in comparison to a drug induced experience (see Table 3). The ratings of similarity ranged from 2.5 to 7, with the group mean at 5.04. Ratings o Subjective Qualities. Using the model of f states of consciousnesscreated by Tart (1975) the post-questionnaire listed 30 different phenomenological effects of MDMA, to be rated on a 1 to 7 Likert scale. Participants retrospectively rated how similar their experiences were for each item compared to a drug-producedcondition (seeTable 4). The individuals' ratings of the qualities ranged from 1 to 7. The means for all participants ranged from 2.77 to 5.58. Some of the qualities are not relevant for all individuals because they were not present in prior MDMA experiencesfor the participant,and of course the individual's choices of activities affected the subjective effects. The three "similarity" ratings (real time, overall similarity, subjectivequalities) show consistencyacross different times of evaluation, and across differing intentions for using the experience. Ratings above the halfway mark are taken to indicate that the posthypnotic condition is more similar than dissimilar, and hence we consider the data to confirm that the subjective MDMA experience was reevoked in its physical and mental qualities through posthypnotic suggestion. Some individuals were more responsive and others less, as would be expected.
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To explore the ability to use the hypnotic MDMA experience for personal therapeutic or reflective work, the post -questionnaire also asked participants to rate to what extent their intention for the session was fulfilled (seeTable 3). Ratings ranged from 2 to 7, with a mean of 5.33. It appears that for at least nine of the participants, the session enabled them to fulfill their intended purpose in a satisfactory way. The activity was the choice of the participants. The procedure did not include any systematic direction, although there were art materials, music, quiet areas, and access to nature.

QUALITATIVE ANALYSIS Personal Accounts The participants wrote qualitative accounts of their experiences. Following are examples of their purposeful (i.e., instrumental rather than experiential) activities during the posthypnotic condition. Reviewing personal life situations: Several of the participants reported reflecting on personality concerns, self identity, existential questions, and interpersonal matters. Experiencing nature: Seven or more of the participants went outdoors and spent some time in the natural surroundings. Listening to music: Six or more of the participants reported listening to the music provided during the session. Talking with a partner about relationship issues:TWO couples were amongthe participants.They kept themselves somewhat separate from the others and talked
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TABLE 3
Retrospective Ratings of Similarity to MDMA and Fulfillment of Intention
Participant
A

0 C

D E F G
H I
J

K L Mean (SD)

Similarity to MDMA 4 5 4 6 6 7 6 4 2.5 5 6 5 5.04(1.25)

Fulfillment of Intention 5 5.5 3 7 7 7 55 . 3 2 6 7 6 5.33(1.76)

about their relationships. Shamanic journeying: One participant listened to a shamanic journeying tape, and said that she had encountered her grandmother and a power animal (see Harner 1980), and gained insight into blocks to intimate relationships. Cultivating creative abilities: One participant wanted to cultivate her creative abilitj. She took art materials and drew a picture she described as St. Hildegard levitating,with adoveaboveher head.Shesaid this was the first art she had done since she was six years old.

for others, enhanced communication with others, and appreciation of nature.

Composite Subjective Experience The ratings given to the list of subjective effects confirm that the posthypnotic condition paralleled the drug-produced experience. Using a qualitative content analysis, the following themes were found most frequently in their written self reports and are consistent with the ratings. Feelings of happiness, joy, bliss, ecstasy Calmness, peacefulness Feelings of safety Feelings of love People oriented, affection for people, empathy Accepting aspects of themselves not accepted before Time slowing down, feeling unhumed Feelings of wholeness and unity Nature becoming more vivid, appreciation for nature, unity with nature Energy rushes, waves of energy in the body Physiological sensations The written reports and the ratings of qualities portray a composite phenomenological experience of feelings of safety and well-being, slowed time, physiological sensations of intense happiness, physical and mental energy, mental clarity, reduced fear and defensiveness, empathy

Assessments TAS. The norm for the Tellegen Absorption Scale is considered to be 19.6, thus this group mean of 24.92 indicates that these participants are more capable of perceptual fluidity than a random sample, with 75% of them above the norm (see Table 5). Persons high on the scale are considered to be more responsive to experiential modes of absorption (like effortless experiencing), in contrast to instrumental activities (Tellegen 1981). HGSHS. The Harvard Group Scale of Hypnotic Susceptibility was given only to the first group of eight because the preliminary data for Group 1 showed no correlation with the ratings of the effects, and because there was feedback that the items of the scale were inappropriate (see Table 5). Five of the participants were higher than the norm, which indicates that they were able to enter a light to medium trance. The mean of 7.88 is close to the group norm of 7.39 given by Shor and Orne (1962). Correlations Correlations were calculated among the TAS, the HGSHS, the participants' retrospective overall similarity ratings, the means of the real-time rating reports for each participant, the means for the ratings given by each participant to the 30 qualities, and the ratings for the fulfillment of intention (seeTable 6). TheTAS correlated with the similarity ratings at .89 (Pearson r, p = .0001)and .87 (Spearman rho, p = .0003). The TAS also correlated significantly with the fulfillmentof intention rating, at .90 pear son,^ =.0006), and .84 (Spearman, p =.0006). Statistically significant correlations were found among all the data sets except for the HGSHS. The HGSHS, contrary to expectations, was not significantly correlated with similarity or other ratings.
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TABLE 4

Ratings of Subjective Phenomenological Qualities of the Posthypnotic Condition

Item Mean (SD)

Sense of well being, safety Appreciating nature Quiet, peaceful Reduced fear, anxiety, defensiveness Seeing beauty Openness and trust Enhanced perceptions Thinking with clarity Overall emotional similarity Experiencing inner light Waves, flows of body energy Sense of self, identity, personality Relaxation of personal boundaries Increased empathy Overall mental processes

5.58 (1.51) 5.50 (1.51) 5.42 (1.68) 5.38 (1.64) 5.33 (1.67) 5.29 (1.57)

Transcendence of self Solving problems and issues Actions and behavior Enhanced self insight Desire for movement, dancing Heart opening, loving, caring Physical energy level Open communication w. partner or another Honesty, frankness More awareness of body sensations Spiritual state, unity, sense of divine Euphoric, happy, or joyous Laughing, giggling, playful Decrease of physical pain Numbness, jaw clench, trembling Overall Mean

4.82 ( 1.72) 4.82 (1.72) 4.79 (1.75) 4.75 (2.01) 4.73 (2.10) 4.71 (1.86)

The correlation between the similarity ratings and intention ratings, as would be expected, was significant with a Pearson r of .89 @ = .0006) and a Spearmen rho of .90 @ = .0001). This indicates that the stronger the posthypnotic state was in similarity to MDMA, the more there was fulfillment of the participant's intentions for the session.

DISCUSSION
In terms of the research questions, the findings of this study show that an MDMA-like state can be produced through posthypnotic suggestion for at least some individuals (question 1). The posthypnotic condition has sufficient strength and stability to continue for an hour and to be used purposefully (questions 1 and 2). The purposes were consistent with behaviors reported in MDMA settings: experiencing the natural surroundings, listening to music, introspection, working on life problems, talking with a spouse or partner., The subjective effects were deemed by the participants to be similar to a drug-produced MDMA experience (question 3). The effects correlate highly significantly with the Tellegen Absorption Scale, but not with the hypnotic susceptibility scale (question 4). Both the qualitative reports and quantitative analysis converge in these findings. In addition to the ratings and reports, an energetic change in the participants was noticed during the experience. When the posthypnotic condition came into effect we observed that the overt group behavior, body language, and talk were noticeably reduced in activity, giving the impression that the individuals were more inner focused. Two participants went into separate rooms. Others talked quietly with each other and the team members. Several went outside into the garden or for short walks at various times.
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These results are supported by other reports on the use of hypnosis in creating or affecting drug-like states. Fogel and Hoffer (1962) reported a case i n which hypnosis was used to interrupt and to re-evoke an LSD experience, first with the drug and then without it. A single participant, a good hypnotic subject, was administered 100 pg of LSD-25. The LSD experience developed in the expected way with perceptual and mood changes. At 160 minutes she was hypnotized and told to return to normal after waking. At that point perceptual changes diminished, and her thought processes and mood appeared normal, except that she felt sensitive to touch. She was rehypnotized and told to return to the LSD experience, and there was a return of the visual changes and usual effects. The hypnotic instruction to return to normal was repeated at 180 minutes, and there was "no evidence of any abnormality" (Fogel & Hoffer 1962: 14). The suggestion was reversed and she returned to the drug experience with full effects. In a second experiment three weeks later, the subject was hypnotized and told to have the same experience she had the previous time, and the usual perceptual and thought changes occurred without LSD, including her pupils dilating to 2/3 of the diameter of the iris. Levine, Ludwig, and Lyle (1963) used hypnosis combined with LSD for treatment of substance abusers. The hypnosis was used just before the drug ingestion with suggestions that during the drug experience the patients would become aware of the factors that contributed to the addiction. During the drug state they were directed toward their childhood, traumatic incidents, and family relations. The researchers reported that the resulting state appeared to be different from states produced solely by hypnosis or drugs. The results were said to be increased emotional feelings, improved responsiveness to the therapist, better insight,
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TABLE 5

Tellegen Absorption Scale and Harvard Group Scale of Hypnotic Susceptibility

Participant A B C D E F G H I J K L Mean (SD) TAS 25 23 16 32 31 33 30 19 II 30 25 24 24.92 (6.86) HGSHS 8 3 8 11 11 10 5 7 NA NA NA NA 7.88 (2.85)

and a more positive outlook. In this case the direction of the drug experience appeared to respond to the hypnotic suggestions. Several studies by Aaronson (1967) are informative in showing the capability of posthypnotic suggestions to create altered consciousness states that are similar to the phenomenology of MDMA. Aaronson's approach was to use suggestions that radically altered perception of the surroundings, and then assess the effect on subjective mood qualities. One suggestion was that the perception of depth would expand. In this condition the subject became very happy. Colors seemed intensified, sounds crisper, and lines more distinct. In contrast, a suggestion of reduced depth perception produced hostility and withdrawal. In a repeat of the expanded depth study, the subject felt he was in a world of super beauty and joy. His mood was euphoric. These features are similar to characteristics reported in some MDMA experiences and in the present study. Aaronson (1969) also created a hypnosis induction which attempted to evoke the experience of the great void or space described in the Buddhist meditation tradition. Anecdotal reports from graduate students who used the induction are that it had strong effects on their subjective states. Most of Aaronson's work was with a small number of talented subjects, and would not be expected to be true of a general population. The findings of this present study suggest that this kind of responsiveness to hypnosis is likely to range from a high level of effect to none at all. There are indications in this literature that repeated hypnotic inductions increase the effects of suggestions for altering sensations, moods, and perception. Even without hypnosis, it sometimes is possible to evoke a drug-like condition without the drug. A study by Jones (1971) on the social "high" found that some experienced marijuana users who believed they were smoking marijuana cigarettes felt the usual effects even when the psychoactive component had been removed. There are
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anecdotal reports that people talking with each other about a past MDMA experience will sometimes spontaneously begin feeling some of the effects. Given the effects of the hypnotic induction and the social context in the present study it seems that both aspects may play a role in producing the nondrug condition.

Subjective Qualities The ratings given to the subjective qualities may be useful in MDMA theory and research as a map of some of the phenomenology produced by MDMA, remembering that the circumstances were conductive to positive qualities in the experience, including the intentions of the participants, the setting, the tone of the research team, and the structure of the procedure. Different settings, such as active social events or situations with different interpersonal dynamics, could produce more interactive effects, more physical energy, and negative emotions. For example, paranoia and anxiety in MDMA experiences have been reported from a survey of users taken in clubs, bars, cafes and malls (Cohen 1995). There were negative reactions in this present situation from three of the participants of feeling self conscious about being observed, a sense of being bugged by the team member following the person, and initial discomfort from a personal reaction to one of the participants. Two participants felt disappointment and frustration that the posthypnotic condition was not at a high level of strength. Euphoria is often mentioned as an effect, and given as a motivation for users to take this drug (Cohen 1995; McCann & Ricuarte 1993). In this study's list of qualities, euphoria was grouped with happiness and joy (with a mean = 4.55). Participants also gave high ratings to several other qualities which could also be considered motivation for the experience, such as sense of well being, feelings of safety, self insight, problem solving, reduction of fear, and transpersonal aspects such as seeing beauty, feelings of
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TABLE 6

Correlations
HGSHS
TAS
n=12 .44 (0.26) .60 (0.1 1)

Similarity
.89 (.0001)* .87 (.0003)*

Intention
.90 (.0006)* .84 (.0006)*

Real Time
.83 (0.0008)* .81 (0.0014)*

Qualities
.79 (0.002)* .73 (0.008)*

HGSHS
N=8

Similarity Intention Real Time

Note: Upper figures are Pearson r correlations. lower figures are Spearman rho correlations. The figures in parentheses are probability values. * Indicates slatistical significance.
I

.91 (<.0001)* .86 (.0003)*

unity, inner light, and transcendence of self. The responses to the subjective qualities might provide clues to the biochemical and psychological dynamics of the MDMA experience, which are more complex and subtle than a global label of euphoria. The level of mental clarity (mean = 5.18) reported by these participants suggests that in this situation the ego remained relatively intact and capable of rational, reflective thought processes and continuity of memory. This has also been noted by Riedlinger and Riedlinger (1994) as an advantage in therapeutic process. Perhaps because of this ego state, there appears to be less state bound memory with MDMA, and the transference of learning to the ordinary mental state is more possible. There are anecdotal reports (though no research studies) of the use of MDMA for personal and practical problem solving, in which the maintenance of thinking and evaluative processes and the reduction in defensiveness appeared to facilitate insights for solutions. Some first-person accounts of the MDMA experience in the popular literature contain reports of nonordinary, transcendent, and mystical experiences, similar to accounts in the religious and mystical literature. 'These include experiences of inner light, energy flows in the body, identity with nature, intense ecstasy, and unity experiences.Some of these qualities were reported in this study; however, there was no individual whose experience was totally mystical. Because in the study setting the focus was on the psychological, a full transcendent experience would be less likely. Pahnke's study with psilocybin demonstrated the potential of facilitating a transcendent drug experience with strong intention and setting with resulting long term positive effects, and it raises the possibility of using a posthypnotic procedure for the same purpose (Doblin 1991; Pahnke & Richards 1969). Of course, a mystical experience, whatever its nature and
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source, is generally regarded as fortuitous and not automatic even when encouraged by meditation, ceremonies, or other traditional means, and we would expect the same to be true of hypnotically facilitated states.

Physical Effects Several of the participants reported physical effects that are often associated with MDMA: clammy hands, skin sensitivity, jaw clenching (nausea sometimes occurs but was not reported). However the item of negative physical effects received a low mean of 2.77 on the qualities measure. The hypnotic induction had included a statement that the person did not need to feel uncomfortable physical sensations, and "You will not feel muscle clenching, or numbness, or coolness, or trembling." These muscle reactions occurred for some participants despite the hypnotic instruction. One person expected that a painful shoulder would feel better, but this did not happen. Two others indicated they felt less pain. This is one area of effects that had mixed responses. MDMA is known to increase blood pressure and heart rate. We did not check for these, but this would be useful to do in future research. Since these physiological responses occurred in the posthypnotic condition, one implication to pursue is that posthypnotic suggestions may have evoked the biochemical effects of MDMA, such as an increase in serotonin and dopamine levels in the brain. This is consistent with the findings of Domangue, Margolis, Lieverman, and Kaji (1985) that serotonin levels rose after hypnotic suggestion to reduce pain in arthritic patients. Tellegen Absorption Scale The strength of the posthypnotic condition on all three ratings correlated high1y with the TAS. These strong correlations imply that the qualities measured by the TAS facilitate the effects of the posthypnotic condition. This
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result is consistent with findings in a study by Pekala, Wenger, and Levine (1985), in which the TAS scores were found to correlate with the subjective qualities of various conditions, including inward and absorbed attention and positive affect, qualities which were reported in this present posthypnotic condition. Higher TAS scores can be taken to indicate the individual's ability to flow into the posthypnotic MDMA experience. It would also be expected that individuals with low TAS scores would be less responsive. Given this correlation, the TAS scale could be used for screening for individuals who will respond to the hypnotic technique for evoking the nondrug state. Further research is recommended to identify other measures which correlate with the effectiveness of this technique.

Harvard Group Scale of Hypnotic Susceptibility The HGSHS showed no correlation with the main posthypnotic effect in Group 1, and for this reason it was omitted for Group 2. Several participants complained that the items of the scale distracted them, and one said he was helped to relax. It may be that the 40-year-old language and challenge tests of the HGSHS were dissonant with the participants, some of whom were familiar with guided visualization, Jungian active imagination, and other evocative subjective practices. On the other hand, the hypnosis itself appeared to be effective, and the TAS has been correlated with hypnotic susceptibility, so a plausible suggestion is that this particular administration did not adequately assess the hypnotic suggestibility of the participants, whether because of the inappropriateness of the instrument for the group or some aspect of the presentation. Other measures of hypnotic susceptibility could be explored in future research. Brain-Mind Issues Changes in subjective states, according to the physical reductionistic paradigm, are assumed to be the result of chemical and mechanical changes in the brain. These physical events bring about changes in conscious experiences: MDMA enters the bloodstream and affects the brain to produce the altered state of consciousness. However, in this experiment there was no MDMA, and the causes were not physical, but words and symbols. Yet, the state of consciousness appears to be the same. Obvious questions about interactions between the brain and conscious experience are raised by this study, which implies that the effects of the drug are not necessarily dependent on the presence of the drug itself. This poses the question of what is happening. That the brain is producing MDMA is unlikely, because the chemical is not one that the body produces naturally. One theory might be that some reserves of MDMA from a previous experience have been stored in the body in some way and are released by the hypnotic suggestions, but there is no research that would support
Journal of Psychoactive Drugs

the idea of cellular storage. Further, there appear to be no differences arising from length of time since previous MDMA experiences. Since one would expect body stores to decline over time, this evidence speaks against the posthypnotic condition being caused by residues of the drug being reactivated. Hypnotic suggestions can affect physical conditions, physiology, sensations, perception, emotions, and thought processes. The mechanisms for these actions are not understood, and to attribute the effects to hypnosis is explaining one unknown with another. However, the paths of mechanism in each case could have some similar elements. It could be that the hypnotic suggestions affect the chemical and physical states of the brain to cause the same changes as does MDMA, thus producing the similar condition. Another possibility is that the qualities of the MDMA state are remembered at a higher cortical level of brain functioning and are reproduced in or superimposed on conscious experience without necessarily affecting the physical substrate (as the drug does). An intriguing and open question is whether the posthypnotic condition was really the same as an MDMA-produced experience. Was it similar, that is, having qualities with some resemblance, or was it identical (except perhaps for the blood chemistry)? The term "similar" is ambiguous in these matters. From an empirical standpoint, there are no accepted objective criteria (e.g., physiological measures) that are logically necessary and sufficient to establish the presence of a subjective MDMA experience. Even a condition produced by the drug can vary from individual to individual, so one can not identify "the" MDMA experience. 'There have been no detailed studies of the phenomenology of MDMA or its altered state configuration that could be used for comparison. This research is the only one we know of that uses this method of analysis to compare a contrived state with one produced by MDMA. In the model used by Tart (1975), a state of consciousness is composed by various subsystems such as memory, perception, emotions, and perception arranged in a particular configuration. The level and content of the systems becomes the criteria for the state of consciousness. The phenomenology of these conditions deserves further attention, and the phenomenological approach used here could be applied to psychiatric drugs and addictive experiences as well.

Limitations The positive results found in this research can not be expanded to a general population. This was a select group, in terms of having personal experience with MDMA, in its familiarity with self reflection, and in the members' interest in working with an MDMA-like experience. Further, there were degrees of effect, and variations in the configuration of the phenomenology, even among the 12 participants, so it can be assumed that with a wider demographic and
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Posthypnotic MDMA-Like Experience

personality range the variations would increase and a smaller proportion would respond with the MDMA-like experience. It could be speculated that the posthypnotic treatment might not be effective on persons fearful or unfamiliar with hypnosis, or individuals whose use of MDMA has been in unsupportive, recreational, and negative situations. Our setting was intended to be positive and supportive, and this can be assumed to have influenced the results. There may also be demand characteristics (e.g., expectancy, group compliance, or experimenter effect) to which the participants were responding. It may be that some of these factors contributed to the re-evocation of the MDMAlike state along with the hypnotic treatment. This is not a mechanical procedure or a chemically driven state, but one which is embedded in interpersonal support and motivated participation, and these conditions should be included in applications of this technique; as they vary, so would the effects.

IMPLICATIONS Psychotherapy The participants' activities and the phenomenological ratings suggest that a posthypnotic MDMA condition can facilitate certain therapeutic work, personal reflection, and insight. The participants' ratings and reports agree in indicating that their personal intentions were accomplished or that their experiences were personally productive. The reports included feelings of acceptance of self, insights into personal issues, communication about relationships, clarity on Iife directions, and resolution of self-judgments.While some of these accomplishments may seem trivial or obvious, these exact issues are often critical themes in the course of psychotherapy and personal existential issues. In treatment protocols there would be a therapist or counselor working with the individual; this was not the case in the present study. However, there are reports of therapists using hypnosis therapeutically in conjunction with psychoactive drug experiences. A case report by Golden (1986) describes using hypnosis to treat a patient who had felt panicky and out of control during a negative LSD experience. Golden gave suggestions to reexperience the LSD condition and the perceptual changes (e.g., hands disappearing), then used a cognitive-behavioral approach within the recall of the experience to teach the patient to relax, then to learn to control the perceptuaI distortions by inducing and then dissolving them. A more psychodynamic or insight approach was used in the treatment reported by Levine, Ludwig, and Lyle (1963), mentioned above. The methods for working psychologically with intense mind-body states require special techniques (Greer & Tolbert 1998). If MDMA or similar drugs are authorized for training and use in psychotherapy, it would be worthwhile to explore the use of the posthypnotic experience for therapy sessions (which would be after the individual has
Journal of Psychoacrive Drugs

experienced at least one session with the chemical itself).

Participant D in this study had taken MDMA only two times
more than 20 years previously, but re-evoked the MDMA
experience at a high level. This suggests that the hypnotic
technique can be effective with minimal prior experience
with the drug.
If MDMA were to be used as an adjunct for psycho-
therapy, some therapy sessions following an actual drug
administration might use a hypnotic induction rather than
the actual chemical. This would enable the time frame to
be less than the three to five hour span of MDMA effects,
and perhaps reduce the side effects that have been reported,
such as increase in blood pressure, muscle aches, nausea,
and feelings of depleted energy. Given the concern about
possible neurotoxicity of MDMA, the posthypnotic tech-
nique would reduce cumulative exposure, while enabling
therapeutic work. Other reported uses for MDMA, such as
posttraumatic stress, pain reduction, couples therapy, de-
pression, and therapeutic insight (Stolaroff 2004,1994;
Doblin 2002; Greer & Tolbert 1998; Riedlinger &
Riedlinger 1994; Liester et al. 1992), might utilize this
hypnotic methodology.

Psychopharmacology The similarity of a hypnotic technique to a condition-

ing technique in pharmaceutical treatment is evident.
Conditioning techniques have been used to enhance the
effectiveness of drug therapy on lupus, in one procedure
allowing the actual drug to be given only half as frequently
when used with a conditioning protocol, and with positive
effects on the immune response (Olness & Ader 1992). It
may be that some variant of this hypnotic approach could
be used to potentiate drug effects in chemotherapy, psy-
chiatric treatment, and pharmacological treatment.
Addictive Behaviors Would this hypnotic technique be of value in treating
drug addictions? The hypnotic procedure could perhaps
provide support during withdrawal and detoxification, en-
abling the individual to better withstand the mental and
physical stresses of withdrawal or even to significantly re-
duce them. There is little research on the effectiveness of
hypnosis with individuals who are addicted to drugs, and
one question would be how this procedure might be tai-
lored as a part of a treatment strategy. Research on the
phenomenology of the drug experience could provide use-
ful information on fine grain dimensions of addictive effects
that might be amenable to hypnotic suggestion.
CONCLUSION

*
This study used posthypnotic suggestion successfully to produce a nondrug subjective state, judged by 75% 0 the participants as very similar or identical to that of a Pre vious MDMA experience. Statistically significan
282
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Posthypnotic MDMA-Like Experience

correlations were found among three Likert scale measures of the strength of the posthypnotic condition, and these were in agreement with qualitative reports of the participants. The Tellegen Absorption Scale correlated with differing levels of response. The length of the posthypnotic MDMA experience was determined by the hypnotic suggestions and the strength remained stable during the hour. The methodological technique of rating the elements of the evoked condition enabled phenomenological mapping of the experience. The posthypnotic condition appears to be useful in facilitating tasks such as problem solving, personal re-

flection, and interpersonal communication, with the understanding that this applies to people who have already had experience with MDMA. The findings raise intriguing issues about mind-body relations. Implications for the use of this technique for psychotherapy, chemotherapy, pharmacological treatment, and addiction appear worth pursuing. Further refinement of the posthypnotic approach, applications of the phenomenological analysis, identification of other psychological correlates of the main effect, and health applications are suggested.

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Aaronson. B. 1969. The hypnotic induction of the void. Paper presented at the meeting of the American Society for Clinical Hypnosis. San Francisco. CA. Aaronson. B. 1967. Distance, depth, and schizophrenia.American Journal o Clinical Hypnosis 9: 203-07. f Adamson. S. (Ed.) 1985. Through rhe Gareway of the Heart: Accounrs of Experiences wirh M D M A and Orher Empathogenic Subsrances. San Francisco: Four Trees. Cohen. R. 1995. Subjective reports of the effects of the MDMA (Ecstasy) experience in humans. Progress in Neuro-psychophannacologyand Biological Psychiarry 19 (7): 1137-45. Doblin, R. 2002. A clinical plan for MDMA (Ecstasy) in the treatment of posttraumatic stress disorder (PTSD): Partnering with the FDA. Journal o Psychoacrive Drugs 34 (2): 185-94. f Doblin. R. 1991. Pahnke's "Good Friday Experiment": A long term follow-up and methodological critique. Journal of Transpersonal Psychology 23 (1): 1-28. Domangue, B.B.; Margolis, C.G;. Lieberman, D. & Kaji, H. 1985. Biochemical correlates of hypnoanalgesia in arthritic pain patients. Journal of Clinical Psychiatry 46 (6): 235-8. Fogel, S. & Hoffer. A. 1962. The use of hypnosis to interrupt and to reproduce an LSD-25 experience. Journal of Clinical and Experimenral Psychoparhology 23: 11-16. Golden. W. 1986.An integration of Ericksonian and cognitive-behavioral hypnotherapy in the treatment of anxiety disorders. In: E.T. Dowd & J.M. Healy (Eds.) Case Studies in Hypnorherapy. New York: Guilford Press. Greer, G. &Tolben, R. 1998. A method of conducting therapeutic sessions with MDMA. Journal of Psychoactive Drugs 30 (4):3 71-79. Greer. G. & Tolbert. R. 1986. Subjective reports of the effects of MDMA in a clinical setting. Journal ojPsychoacrive Drugs 18 (4): 319-27. Hamer, M. 1980. The Way of the Shaman: A Guide to Power and Healing. San Francisco: Harper and Row. Hastings, A. 1994. Some observations on MDMA experiences induced through posthypnotic suggestion. Journal of ~ i ~ c h o a c r i v e Drugs 26 (1): 77-83. Hastings, A,; Berk, I.; Cougar, M.; Ferguson, Giles, S.; SteinbachHumphrey, S.; McLellan, K.; Mitchell, C. & Viglizzo, B. 2000. An extended non-drug MDMA experience evoked through posthypnotic suggestion (Abstract from Toward a Science of Consciousness Conference Proceedings. Tucson. AZ). MAPS Bulletin 10 (1): 10. Jones, R.T. 1971. Tetrahydrocannabinoland the marijuana-inducedsocial "high," or the effects of mind on marijuana. In: A.J. Singer (Vol. Ed.) Annals of rhe New York Academy of Sciences: Vol. 191.
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New York: New York Academy of Sciences. Levine, J.; Ludwig. A. & Lyle. W. 1963.The controlled psychedelic state. American Journal o Clinical Hypnosis 6: 163-64. f Liester, M.; Grob, C.; Bravo, G. & Walsh, R. 1992. Phenomenology and sequalae of 3.4-methylenedioxymethamphetamine use. Journal of Nervous and Mental Disease 180 (6): 345-52. McCann. U. & Ricaune. G. 1993. Reinforcing subjective effects of (+I-) 3 4-methylenedioxymethamphetamine ("Ecstasy") may be separable from its neurotoxic actions: Clinical evidence. Journal of Clinical Psychopharmacology 13 (3): 2 14- 17. Olness, K. & Ader. R. 1992. Conditioning as an adjunct in the pharmacotherapy of lupus erythematosus.Journal of Developmeriral and Behavioral Pediarrics 13 (2): 124-25. Pahnke. W. & Richards, W. 1969. Implications of LSD and experimental mysticism. Journal of Transpersonal Psychology 1 (2): 69-102. Pekala, R.; Wenger, C. & Levine, R. 1985. Individual differences in phenomenological experience: States of consciousness as a function of absorption. Journal of Personality and Social Psychology 48 (1): 125-32. Riedlinger. T. & Riedlinger, J. 1994. Psychedelic and entactogenic dmgs in the treatment of depression. Journal of Psychoacrive Drugs 26 (1): 4 1-55. Shor. R. & Orne, E. 1962. HarvardGroupScale of Hypnoric Susceptibrlity. Palo Alto. CA: Consulting Psychologists Press. Shulgin. A. & Shulgin. A. 1998 [1991]. Pihkal: A Chemical Love Story. Berkeley, CA: Transform Press. Stolaroff.,M. J. 2004. The Secrer Chief Revealed. Sarasota, FL: Multidisciplinary Association for Psychedelic Studies. Stolaroff, M. J. 1994. Thanaros ro Eros: Thirty Five Years of Psychedelic Explorarion. Berlin: VWB. Tart, C.T. 1975. Stares of Consciousness. New York: E.P. Dutton. Tellegen. A. 1981. Practicing the two disciplines for relaxation and enlightenment: Comment on Qualls and Sheehan. Journal of Experimenral Psychology 110: 2 17-26. Tellegen, A. & Atkinson, G. 1974. Openness to absorbing and self-altering experiences ("absorption"), a trait related to hypnotic susceptibility. Journal o Abnonnal Psychology 83: 268-77. f

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