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MDMA and virtual reality as trauma treatment

Military veterans with posttraumatic stress disorder often have symptoms that are both chronic and complex. Professor by Special Appointment Eric Vermetten is looking for new ways to help them deal with these. One possible medicine: party drug MDMA.

Eric Vermetten still remembers the veteran who came to see him in the mid-1990s. Suffering from anxiety and constantly on the alert, paranoid and exhausted, he couldn’t stop thinking about Srebrenica: about the humiliations, the fear, the young children at the gate whom he had got to know by name as time passed... Did they survive the fall of the enclave and the ensuing massacre at the hands of the Serbs? 

Under the skin

‘These are typical symptoms of PTSD,’ says Vermetten. He is a psychiatrist at the mental health service for the armed forces and Professor by Special Appointment in Medical-Biological and Psychiatric Aspects of Psychotrauma at the LUMC. In both roles, he has been working with traumatised military personnel for many years already. ‘With some people, such a traumatic event gets under their skin. They may suffer from feelings of guilt and nightmares that take a great deal of energy to suppress, but suddenly rear up again when least expected. And they often feel as though the frightening situation could return, as though it never really ended.’

Patients often feel as though the frightening situation could return

Vermetten recently received a large donation for ‘his’ chair. Retired Major General Rob Nypels (88) donated a sizeable sum to the Nypels-Tans PTSD Fund that he himself established – one of the ‘named funds’ at the Leiden University Fund – to promote interdisciplinary research into psychotraumatology. The main aim is to research the effect of new treatments and thus improve the care for veterans and members of the armed forces.

Party drug as a medicine

One thing Vermetten wants to test is whether MDMA – the active substance in the party drug XTC – can help people process trauma. ‘This was used in the past to treat people with war trauma – the survivors of concentration camps, for instance. And more recently, the therapy has achieved good results with American veterans. If you combine MDMA with psychotherapy, the patient is able to view emotions such as anxiety, shame and guilt differently. As a limited dose increases empathy, these emotions won’t hinder patients as much when they relive the traumatic experience.’ Vermetten and his colleagues at Arq/Centrum ’45 have now received training in administering the therapy and have begun preparations.

‘The patient can communicate perfectly well with MDMA. This is in contrast to other drugs such as magic mushrooms or truffles’ 

An additional advantage of the therapy, says Vermetten, is the unique nature of ‘inward-looking recovery’. MDMA is a psycholytic, which means it enables people to come closer to their inner world without negatively affecting their consciousness, concentration or speech. The patient can communicate perfectly well, and can thus tell the practitioner about the ‘back-end’ of the trauma. This is in contrast to other drugs such as magic mushrooms or truffles, which take people away from their environment and therefore make communication during the treatment process that bit harder. ‘The magic words, therefore, are reliving the experience,’ says Vermetten. ‘Patients can only process the trauma if they are brought back to the situation, the traumatic experience that closed them down.’

Virtual reality

This idea of reliving the experience also crops up in various other therapies that Vermetten is developing. He is researching the use of virtual reality, for instance. This too is a form of ‘immersive therapy’: here VR headsets return veterans to the scene of the traumatic attack or combat with the aid of their own photos. He is also working in an international context on a therapy in which the patient walks on a treadmill and literally into his own photo. Furthermore, Vermetten and various colleagues are researching whether revisiting the place where the veteran was deployed can help.

‘The solder has come to terms with his past. It is heartwarming to see’

That is exactly what the soldier who came to see Vermetten in the 1990s did: he recently returned to Bosnia-Herzegovina – accompanied by Vermetten. He took to Facebook and found tracked down more and more of the Bosnians he had known in Srebrenica. The children at the gate too, who were now young women, often with children of their own. Vermetten: ‘He spoke to the survivors, with the aid of the photos that were taken when he was deployed there. He has come to terms with his past. He has achieved a new sense of equilibrium. It is heartwarming to see.

This article was previously published in Leidraad (in Dutch), the alumni magazine of Leiden University. The full magazine can be viewed online.

Text: Merijn van Nuland
Photo: Vincent Boon Photography
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