Exploring Psychoanalytic Themes and Therapeutic Alliance in MDMA-Assisted Psychotherapy
Emily Williams, M.D.
In two related retrospective analyses, we are evaluating the effect of MDMA on therapeutic alliance and emerging psychoanalytic themes in an already completed Phase 2 trial of 3,4- methelyenedioxymethamphetamine (MDMA)–assisted psychotherapy for the treatment of posttraumatic stress disorder (PTSD).
We are performing both quantitative and qualitative analyses of video and transcripts of psychotherapy sessions from a clinical trial of 22 individuals with PTSD. Emily William’s study will quantify language-based indicators of therapeutic alliance in these psychotherapy sessions using a text analysis application called Linguistic Inquiry and Word Count (LIWC2015). We will also quantify behavioral coordination between the patient and therapist, such as posture, gestures, and mannerisms, during each session using an automated computer-based approach. This novel approach will allow for fine-grained analysis of verbal and non-verbal behaviors in patients and therapists. These behavioral markers will be correlated with more traditional, well-validated, questionnaire measures of therapeutic alliance (e.g., Working Alliance Inventory- Self Report, WAI-SR) as well as with the primary clinical outcomes of the parent study (e.g., decreases in PTSD symptoms, Clinician-Administered PTSD Scale, CAPS). Evan Sola’s study focuses on identifying psychoanalytic and Jungian themes present in therapy sessions via a manually coded technique and correlated with improvement in CAPS scores.
Our overarching goal is to better understand the psychological mechanisms of action of MDMA-assisted therapy by determining the effects of MDMA on therapeutic alliance in the psychotherapeutic relationship and by further exploring the processes of therapeutic action through a psychoanalytic and Jungian lens. Results from these analyses will provide high-impact data on the mechanisms of MDMA-psychotherapy, a critical next step in developing a behavioral biomarker for efficacious MDMA-assisted psychotherapy.
Emily Williams, M.D., is a psychiatry resident at UCSF where she is currently conducting an analysis of the effects of MDMA on therapeutic alliance as well as serving as co-PI on a MDMA-assisted psychotherapy for PTSD Phase 3 clinical trial site. She also works as the independent clinical rater for the MAPS-funded study on MDMA for end of life anxiety in Marin, CA. In addition to her clinical and research work, she has a passion for harm reduction and serves as a supervisor for the Zendo Project which provides psychedelic harm reduction for events and festivals.