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Open-Heart Surgery

Photo-Illustration: by The Cut; Photos: Getty Images

After diving into the trippy underground world of psychedelics in part one of Cover Story: Power Trip, the investigative podcast returns to explore its aboveground counterpart — lab research — and see how it compares. In episode six, collaborator Lily Kay Ross and her partner, Dave Nickles, talk with participants from some of the most advanced MDMA-assisted-therapy trials conducted. While on paper the subjects’ experiences proved successful in treating their PTSD, Ross and Nickles uncover that the treatment might have left them with more issues than it fixed.

Cover Story

Mind. Body. Control. Uncover the dark truth in Power Trip, a new investigative series with original reporting from New York Magazine.

To learn more about MDMA-assisted therapy and PTSD, listen and subscribe for free on Apple Podcasts or wherever you listen, and find the full transcript below.

Just a quick note: This series deals with sexual assault and suicide, so please keep that in mind when you decide when and where to listen. Also, to protect their identities, we’ve changed the names of some of the people we’ve interviewed.

LILY KAY ROSS: So I have a new word in my back pocket, which is equipoise. And no, it doesn’t have anything to do with horses. In the context of medical research, the idea with equipoise is that the researchers, and the people that they’re studying, should be poised in a balanced way, where they’re not leaning toward the possibility that it is or isn’t going to work. I’m telling you this because the stories that we’re about to tell you are about scientific research, but they’re also about researching a drug that is already associated with a whole culture and a style of dress and a type of music. A lot of people call it a movement. And it’s a movement that, in some ways, my co-investigator, Dave Nickles, and I have been a part of.

DAVE NICKLES: When I had my first mushroom experience, it was profound existential relief. There was this moment of participating in the mystery of life and death and their intertwining. And in this flash, that existential anxiety was just gone. I got back to my dorm room, and as I was coming down, I remember saying, “This is going to be part of my life.” And from that point on, I just remember devouring any piece of psychedelic information I could get my hands on.

LILY: In the early days, there was this trickle of scientific papers coming out, which meant that people like Dave now had something that they could bring home to their parents.

DAVE: I knew my parents’ position on drugs. They were not hospitable. And I remember, toward the end of my freshman year of college, having a call with my dad where I said something to the effect of, “You know how you and Mom have been commenting about what a good mood I’ve been in for the past months? You know how you’ve been commenting that it seems like something has changed and I’m happier and more contented? I tried mushrooms, and I have a paper from Johns Hopkins that unpacks maybe some of what I’ve experienced. I know this sounds weird, I know this sounds scary, but look — buttoned-up professionals are saying that this stuff has real merit.”

It’s one thing when your son is telling you that he’s eating mushrooms and is feeling happier in day-to-day life. It’s another thing when you turn on the morning news and you see footage of doctors and lab coats and the morning hosts that you’re so familiar with telling you that there might be this promising new treatment that offers levels of healing that have never before been considered to be possible.

LILY: By the time Dave is 25, he is a fully-fledged drug nerd. And he’s one that people are paying attention to because he’s doing things like helping run the DMT-Nexus, which is this online forum for people who want to have rigorous debates and discussions about drug experiences and science.

DAVE: At the point where my parents saw that I was putting together abstracts to present at conferences about drugs. It wasn’t just drug use; it was intellectual endeavors around drug use. I ended up presenting that at a conference in 2013. My mom proofread the abstract that I submitted. And my parents covered the costs for me.

LILY: That’s the power of a lab coat. Dave could write a book called How to Change Your Parents’ Minds. So jumping forward, what started as nerdy conferences are now attended by thousands of people and promoted like music festivals. Universities and venture-capitalist firms are pouring millions of dollars into research to see if psychedelics can be turned into medicine. This means that they have to do a whole series of what are called clinical trials to win the approval of the FDA.

DAVE: Looking across the psychedelic landscape, it’s safe to say that MDMA for post-traumatic stress disorder is the closest to getting approved by the FDA.

LILY: These MDMA trials are a really big deal. Not only are they the first psychedelic medicines that might be approved, but the process of approval is being watched by other members of the research community who are trying to figure out how to design their trials. So the main group that is advancing this research into MDMA-assisted therapy for PTSD is a group called MAPS — that stands for the Multidisciplinary Association for Psychedelic Studies. And the executive director of MAPS is a man named Rick Doblin. So Doblin has a TED Talk, and in it, he talks about how in the 1980s, before he even started MAPS, he knew a woman named Marcela. In my years researching sexual violence, one of the things I’ve learned is that it’s the leading cause of PTSD in women. And in his talk, even though he is not a therapist, he tells about how he sat with Marcela as she was able to more fluidly talk about what someone had done to her.

DAVE: To say that Rick Doblin is passionate about MDMA for PTSD is like saying a Dead Head is passionate about the Grateful Dead.

LILY: At the start of 2022, Doblin said, “We are no longer investigating whether psychedelics can help. The evidence is pretty clear.”

DAVE: In late 2018, a colleague of mine from Psymposia, which is our psychedelic watchdog group, published an article about the clinical trials and the future of MDMA as a medicine. And while I was editing it, I was floored to realize that in the phase-two trials, they were only talking about a hundred people at that time. It was almost like a balloon-bursting moment — like, if everybody’s talking about this as a done deal, surely it’s not a done deal based on around a hundred people.

LILY: In the news stories, you’re usually hearing from a certain type of person, like a war veteran talking about how much MDMA-assisted psychotherapy helped and healed them. It’s not like there’s a list of participants that you can call up and ask, “Hey, what was your experience like?” But about two years ago, after Psymposia had published another article, somebody who’d been through the MDMA for PTSD clinical trial wrote to Dave.

MEAGHAN: All right. Hey, guys!

DAVE: Publicly, she’d been a sort of MAPS success story. But in the subsequent months and years, she told Lily and me a lot more about what she’d experienced as a clinical-trial participant.

MEAGHAN: I made notes of things that I wanted to share.

DAVE: We read another public account of a trial participant that raised questions for Lily and me. And eventually, I got in touch with more participants.

LEAH: Oh, you wanted to go just right into that?

DAVE: There’s a very small number of people who have been through those trials.

LILY: We’ve gotten to know a handful of them, and we want you to meet three trial participants.

LEAH: I think I have to talk about the trauma to talk about the rest. I experienced a lot of physical and sexual violence in my life.

MEL: Childhood sexual abuse happened and went on for a while.

DAVE: You have to remember that MAPS was looking to do research into severe PTSD and whether or not MDMA was effective for that. And so they needed people in the study who fit that description.

MEAGHAN: In hindsight, I had such severe PTSD I couldn’t bear to be in the same room as anyone.

DAVE: The participants we spoke to had tried a wide variety of treatments.

LEAH: Exposure therapy.

MEAGHAN: Psychiatric drugs.

MEL: CBT therapy, ACT therapy, people waving giant magnets around my head.

DAVE: They were people who didn’t engage in recreational psychedelic use. And the clinical trials seemed to present an opportunity for a less painful, more manageable existence.

MEAGHAN: Media articles saying 89 percent cure. MDMA is a cure for PTSD.

MEL: First time that I found it, I brought it to my partner. And I said to him, “This is it. This is what’s going to fix me. I’m going to get into this study.”

LEAH: Like, Am I going to just not have PTSD anymore? Like next Monday?

MEAGHAN: I kicked the door down to be in the MDMA clinical trial.

DAVE: Meaghan was the first MAPS clinical-trial participant that I met.

MEAGHAN: Like I fought tooth and nail to get into that.

DAVE: Lily and I got to know her quite well over time.

MEAGHAN: I got into this crazy sport called in-line speed skating.

DAVE: How old were you at the time?

MEAGHAN: 19. Leonardo da Vinci says, “Once you’ve tasted flight, you’ll walk with your eyes, turned skyward, for there you have been, and there you will long to return.” And that, for me, was skating.

DAVE: Meaghan kind of fell into speed skating. She was in Canada and stumbled across some folks speed skating in a park. She borrowed a pair of red skates …

MEAGHAN: It was freedom. It was just being out of the prairies, chasing the wind on my skates.

DAVE: This sport is kind of like NASCAR on skates. And it’s kind of brutal, too — people flying into barricades on the side of the course. It’s intense.

MEAGHAN: I won 47 national titles and 16 Canadian records and broke a world record. I turned my body into a machine because I was invincible on skates. When I’m asked about my childhood, my first reaction is, I don’t want to talk about it. As a teenager, I shut down and I shut up. That was how I coped. I turned into a ghost.

DAVE: Meaghan told us about some rough experiences growing up, including a predatory coach.

MEAGHAN: I started cutting my arms up and over a math task when I was 15.

DAVE: She tried to kill herself before she was 20.

MEAGHAN: I coped with a lot of things by just driving myself into perfection. I played in six bands and had a 95 average at school and was on five different sports teams and was recruited nationally in three different sports. I moved out and went to vet school and … I was sexually assaulted in my third year of vet school. And that was the straw that broke the camel’s back at that moment.

LILY: And for the next couple of years, she’s seesawing back and forth between excellence and athleticism and crashing.

MEAGHAN: I went from having a 99 percent average in radiology to not being able to function — and during that time being told over and over and over again that I just needed to pull myself together and be fine and just to grow up and get a real job.

LILY: At this point, one thing she does know is that —

MEAGHAN: I couldn’t bear to be in the same room as anyone, and the thought of being vulnerable and touched was terrifying.

I was skating and I was holding on to skating because it was all I had. I subluxated disks in my back and just had crazy injuries, multiple concussions, fractured bones, and kept training on them. I didn’t give a damn. I always just figured I’d die on skates, and I did not care. And so I went from being this world-class athlete to being trapped in a body that was broken, sleeping in my car and sleeping on the street. I found doctors who were willing to let me work for them in exchange for treatment.

DAVE: She finds a psychiatrist —

MEAGHAN: Who changed my life. He’s the one who diagnosed me with PTSD.

DAVE: She had tried multiple psychiatric drugs, and he supported her getting off them. And yet —

MEAGHAN: It was just painstaking progress. I was terrified. I would wear a hoodie and baggy clothes, and I’d flinch when he moved, and he couldn’t stand between me and the door.

DAVE: And at a certain point, he retired.

MEAGHAN: Like, he looked at me, and he just said, “I don’t know where to send you.” And that’s when I got the call for the MDMA clinical trial.

LILY: So let’s back up for a second. When a drug is going through clinical trials, there are usually three phases. The first phase is about determining dosage and getting basic safety data. Then you have phase two, and phase two is continuing to emphasize the safety and the side effects of the drug. They are also getting a picture of, like, is it worthwhile to spend all the money going to phase three, which is a much larger process.

DAVE: Meaghan got referred to a MAPS clinical trial almost ten years ago, so that was the phase-two trials for MDMA-assisted therapy for PTSD. And those trials were a bunch of tiny research studies across numerous sites around the world, which they’ve pooled together, and some of these sites only had a handful of people. So, in reality, we’re talking about unusually small studies, even for phase two.

LILY: Meaghan ends up at the Vancouver site for the phase-two clinical trial, and she’s one of only six participants.

DAVE: There are all sorts of screenings that happen before the trial starts. So you have to show up and do different sorts of tests.

MEAGHAN: You go through a checklist and it’s like, “Have you ever been in a natural disaster?” Well, yes. “Have you ever been sexually assaulted by someone close to you?” Yes. “Have you ever thought that you were going to die? Have you …” I ticked off every single one of them. And at the end of it, they said, “Yeah, you’re in.” And I said, “Okay. Now what?”

DAVE: Meaghan gets to the study site and ends up meeting her therapists, who are a married couple named Richard Yensen and Donna Dryer.

LILY: Meaghan has declined to name her therapists, but MAPS has made their identities public.

DAVE: Yensen has been described as looking like an ewok, a sort of larger, softer, fuzzier character, and Dryer is a serious therapist cut with warm affects. When Meaghan ends up meeting them for the first time, Donna hugs her.

MEAGHAN: “You’re here!” And then she threw her arms around me, and I freaked out because that is not cool in Meaghan’s world — touch is scary and bad, psychiatrist, Ew.

DAVE: So the hug is a huge deal for Meaghan.

LILY: The way these trials are designed is that you have three MDMA sessions over about three months. And in between sessions, there are integration sessions, which give the participant a chance to unpack and process some of what came up for them in their MDMA session. The MDMA sessions are eight hours long and then the participant will often sleep on-site. For Meaghan, the sessions were happening in a therapist’s office.

DAVE: The room is tiny and cramped, and it’s in a basement.

MEAGHAN: And because it’s a basement, the window is at the top, and it was this beautiful stained glass. And then underneath the stained glass, they had it so that there’s a bed.

DAVE: There’s like a twin bed in the center of the room. And then there are these armchairs off to either side.

MEAGHAN: And then it’s really weird ’cause you’re facing the foot of the bed and then there’s, like, the MAPS camera straight in front of you and off to the left.

DAVE: The cameras are there so that the sessions can be recorded and people make sure that everything goes according to protocol.

LILY: Remember that the point of these clinical trials is to show the FDA that using MDMA in combination with this specific type of therapy that’s happening in these rooms is helping people.

Can you tell us about that very first session?

MEAGHAN: It was quiet. There’s no one else there, which helped me. If I hear outside noise, I get jumpy in sessions. They had us provide music, and so I gave a bunch of songs that had meaning to me.

DAVE: Her therapists are consulting this clipboard. They’re taking her temperature and her blood pressure. They’re unwrapping the MDMA out and crinkling the packaging.

MEAGHAN: I remember being terrified — like, terrified to the point of not knowing if I could actually take MDMA, knowing that I would be that vulnerable.

DAVE: If you’ve ever seen news coverage of psychedelic therapy, you’ve probably seen the images of somebody lying serenely on a couch or a bed with eyeshades, headphones — perhaps the therapists are holding a hand. It all looks very serene and tranquil. When Meaghan describes her experiences of MDMA therapy —

MEAGHAN: It was a full-body experience. Like just somatically, it hit me. Um. That feeling of losing control is terrifying. And there’s no stopping it once the drug is in your body. I was folded over and shaking and just, What’s going on? What’s going on? Tell me what’s going on. I remember saying over and over again, “You’re safe, you’re safe, you’re safe,” and checking and then just like, WOOSH … I was in the session.

LILY: In those eight hours, Meaghan talks, sometimes she’s nonverbal, sometimes she cries — she’s processing trauma.

DAVE: Richard and Donna made Meaghan feel cared for in that first session.

MEAGHAN: They were really mindful about ensuring food, which really helped.

DAVE: They were bringing her snacks.

MEAGHAN: Cheese from Costco and Pink Lady apples. Sometimes she’d cut up some salami. And I really appreciated that because I forget to do that kind of stuff. It was like this little safe nest.

LILY: At that point, things felt safe.

LILY: It’s not easy to quantify somebody’s trauma. It’s like if you were supposed to answer people with a number when they asked you how you’re doing today. But in these PTSD studies, they have to find a way to measure how bad someone’s PTSD is at the beginning and end of the study so they can figure out if their treatment is working. So they use a tool called CAPS, which stands for the Clinician-Administered PTSD Scale. And the point of it is to figure out how often and how severely the participants are experiencing PTSD symptoms in general and then also concerning specific events.

It would be questions like “How often are you experiencing intrusive thoughts or flashbacks or nightmares?” “When it does happen, how severe is it?” Each of these answers is a number answer. So by the time you get to the end of the assessment, they’re able to add those numbers together, and the final number is what gives you your CAPS score. In the phase-three trial, the two participants that we’ve spoken to were asked to focus on one traumatic experience.

MEL: I know, for me, the abuse happened and went on for a while. I was a mess. I was a shitshow, you know?

LEAH: Scientists were, like, poking at my trauma and, like, waking things up.

LILY: Mel and Leah were at study sites in different parts of the world, and they both found their first experiences to be exactly the kinds of experiences that participants hope to have.

MEL: The first session was amazing.

LEAH: There was just this profound feeling of safety.

LILY: And they were able to confront and process and work through some challenging, traumatic memories.

MEL: It was so beautiful because everything was revealed.

LEAH: I think I just chronologically went backward through time and unloaded all of the traumatic experiences. It just came out. And it was the first time I’d ever been able to talk about it. I felt like I had been choking on it for years. And I finally got it out.

MEL: It was literally like peeling back a curtain and being able to see everything. And I had this sense of, It’s going to be okay. You’re going to be okay. You’re going to make it.

LEAH: It’s nice to remember the good parts.

LILY: Both Mel and Leah were hopeful going into their second session. But the sessions themselves were a lot more intense.

DAVE: Both of them were given the option to take a higher dose and did.

MEL: “You do have an option if you want to go higher or stay lower.” More is always better, right?

LEAH: I remember kind of questioning the logic of that. I was like, Do I need to? And then like, Okay, you’re the bosses. I don’t know anything about this.

MEL: I have found now that more is not better, especially with MDMA.

LEAH: My second session was brutal. It had a lot of visuals right at the beginning, but they were terrifying. And I had this sensation of falling backward into the gears of a gigantic clock. And I was getting crushed by the gears.

MEL: That second session, I just felt every ounce of shame that there was. I fought the whole time. My body just wouldn’t stop. It was awful. And I didn’t come out of it. Like, I didn’t get to the other side of it. I just went home. More firm in my belief that it was my fault, that I had this evil thing living inside of me that was going to come out if I didn’t watch it. So then it was just head down and plow forward to get to the next medicine session that was going to fix that.

LEAH: It felt like someone took my fucking trauma history and beat me over the head with it for, like, seven straight hours.

DAVE: When Meaghan describes her second MDMA-assisted-therapy session, which was years earlier, it’s also incredibly intense. She ends up reliving a sexual assault from her past.

MEAGHAN: I had an incident when I was racing in, on the World Cup circuit in Italy, where I’d been sexually assaulted. And so that was what was reenacted in my second session. It was discussed before session two that they wanted to break through. I remember fighting. I just remember fighting, and “Get off me,” and just fighting and trying to get them off me.

DAVE: At one point, she ends up kicking a therapist off of the bed.

MEAGHAN: I remember her body flying and “Wah” as she fell off the bed. And then I remember my male therapist locking me in a bear hug from behind — I can’t stress how weird it was. Like, beyond weird. I can’t stress what it is like to be close to someone. I physically cringed from everyone, and yet it was his arms around me, and it was feeling his chest, and, like, feeling the weight of his body. And I said to him at some point, like — he’s just, he’s a short, stocky, solid guy. And I thought that was safe. It’s a really big relief to have so much pressure in the world. And just be trying to survive and then to be in a space where I could just close the office door and for a day and a half in my life, I’m in this tiny little incubator — and that’s what we called it. It’s like being wrapped in a blanket and not being afraid.

LILY: All of the participants told us that moving toward their final session, they felt more and more cracked open. So at the start of the trial, they had measured their PTSD around specific traumatic events. But now there was more coming up than they had anticipated and more coming up than they felt they could control or process in the time they had in the trial. There was just no way to get through all of this before the trial was going to be over. So, like, what were they going to do with all of this when they’re no longer sitting in these nests with the therapist that they’ve bonded to so intensely on MDMA?

LEAH: As I was coming down off the medicine, there was just this, like, deep knowledge that something had been left wide open and completely unresolved. It was like hell was inside of me, and it was only halfway out, and it got stuck. I don’t think they assessed the dangerousness of the territory that they were leading me in. I had this strong and terrifying feeling that I was hopelessly dependent on them and an impending fear that this was not getting resolved and I wouldn’t be able to survive it.

MEL: I remember at my termination session saying to them, “I seriously contemplated gluing myself to this chair and refusing to leave until you continue to see me.” I said it jokingly, but I was serious.

LEAH: From the moment I came down from my third MDMA session, I kept saying, “We can’t finish. We can’t leave at this, like this. I cannot end the study.” And I was fucking sobbing. And I was begging them to find a way to not kick me to the curb.

MEL: You know I’ve equated it to, like, if someone did open-heart surgery, and they tore open my chest, and they repaired the little damage in the heart there but then everyone just walked away from the table and my chest was still wide open. No one’s going to survive that.

DAVE: Here’s the confounding thing: A few weeks after their final integration sessions, both Leah and Mel were asked to take the CAPS test again — the one that asks you to focus on one specific event. And when they took this test, their answers indicated that their PTSD diagnoses were gone.

LILY: So for Meaghan, she’d come into the trial with extremely high PTSD scores, and by the end of the trial, her scores had improved a lot — so much so that she believed she was making real progress. And yet she still had this feeling of having been cracked open. So we spoke to MAPS about this, and they said they understand that ending the therapy is difficult. They’ve adapted their latest consent documents to warn participants that “Your PTSD symptoms may get worse during the study.”

They also agree with other researchers — that the CAPS isn’t a perfect tool for measuring PTSD. But the FDA requires that they pick one, and CAPS is the accepted standard. The question is when there’s a mismatch between CAPS scores and what participants say they’re experiencing, what do you do? Other researchers that we spoke to said that it’s on MAPS to find ways to track that information and to get it out there — into the scientific discussion and into the public. We’re going to talk more with MAPS researchers about this in the next episode. Meaghan told us that her therapist used to say something she thought was pretty smart. He would say, “Trauma’s not a zit.”

MEAGHAN: “Trauma’s not a zit, and you can’t just squeeze it and get the pus out,” and that resonated. You can’t just pretend that you can cut it out and be like, Everything is fine now.

LILY: By the end of their treatment sessions, neither Meaghan, Leah, nor Mel felt like they were ready to stop their therapy. MAPS told us that the research therapists are technically allowed to continue therapy with participants without MDMA once the trial is completely over, but it’s at the therapist’s discretion. So Meaghan, Mel, and Leah all asked for more therapy, and they all got different messages. Mel’s therapist told her “no” — that it would be a conflict of interest to treat her after the trial. Leah’s therapist told her “no” and then later told her “yes,” which she found confusing. We’re going to come back to that. When Meaghan ended her treatment sessions, she was completely broke and desperate for help. She says even though she was still involved in the trial because they hadn’t completed the yearlong follow-up yet, her therapists told her that they would keep seeing her for free.

DAVE: They live on Cortes Island, which is a small island off the coast of British Columbia.

MEAGHAN: I started looking for places where I could go.

DAVE: It’s incredibly remote. You can only get there by essentially island-hopping, using small ferries.

MEAGHAN: I couldn’t afford rent, but I have a background in agriculture. So I started looking to see if I could just be on a farm somewhere.

DAVE: She winds up working out, like, a barter agreement with a guy who owns a farm relatively close to where her therapists live. And she figures that this will allow her to have a place to live, but also she’s seeing Richard and Donna for therapy, biking to their house. Eventually, she starts seeing them for dinner.

MEAGHAN: They’d been my therapist, and all of a sudden, I’m seeing them socially. And so we talked about that, and we talked about boundaries, and the only boundary was, “Can you just give us a call before you come? Just so we know.”

DAVE: At that point, the lines blur even more. Meaghan starts helping Richard and Donna out with elements of the clinical trial. She has a science background; she wrote an honors thesis in college critiquing pharmaceutical clinical trials for psychiatry. So being Meaghan, she says, “I think I might be able to lend a hand.”

MEAGHAN: Like, emails from MAPS to my therapists — I was answering them. At one point, they needed medical information about me, and so I typed it up and just sent them back the email. And like, “Here you go!” So, yeah, I was my own research assistant.

DAVE: Meaghan should not have been doing any work at all on a clinical trial she was the subject of.

MEAGHAN: They were grateful. There were expressions — like, they couldn’t do it without me.

DAVE: Meaghan doesn’t do half-measures. She wanted to, like, not just to experience her healing but to be able to do well for these people who were putting this novel, revolutionary therapy under the microscope in the hopes of bringing healing to the masses.

MEAGHAN: They spoke often about how what they’re doing is so far beyond psychiatry. Like, it’s this new experience and “This is beyond what anyone can understand, and it’s so wonderful and so amazing.”

DAVE: Her own healing and her own improvements were, in some senses, bound up with the world-changing research that she was a part of.

MEAGHAN: I became a part of their lives.

DAVE: And a year later, she finds herself on the stage at a psychedelic conference, giving accounts of her own healing journey. She approached it seriously as a representative of what MDMA-assisted therapy had to offer the world at large.

MEAGHAN: I did this little talk and then had, like, the big hug with Rick Doblin at the end. And “Look at me — I’m the woman who was afraid of touch, and now I can hug the founder of MAPS.”

LILY: As far as the audience in the room was concerned, Meaghan was a quintessential MAPS success story. She was like Marcela 2.0: a new person to point to and say, “Look at how this medicine works.” But there was a lot that had been happening back on Cortes Island that the audience did not know about.

DAVE: Going back to when Meaghan first moved to Cortes, it seemed like things were moving in a positive direction. But there’s also this one evening where there’s, like, a group of people that come to Richard and Donna’s house, and they’re discussing some of their lineage and the people that they learned from. And they all start talking about this maverick Mexican psychotherapist named Salvador Roquet.

MEAGHAN: “How amazing Salvador was,” and “what a gifted healer he was,” and “how he broke people down and reconstructed them,” and that “There’s no such thing as a bad trip, only a difficult trip.”

DAVE: You might remember Salvador Roquet — he’s hailed by his fans as able to achieve rates of healing that have never been replicated?

MEAGHAN: He was this guru that was posited on — he’s on par with, like, Freud and Ferenczi and Jung and then there’s Salvador Roquet.

DAVE: You might also remember that he tortured people on behalf of the Mexican government.  

MEAGHAN: The more the patient suffers, the better the job the therapist is doing.

DAVE: Richard Yensen was Salvador Roquet’s interpreter. Richard Yensen has written a fair bit about Roquet. He presents himself as Roquet’s son and father and sort of plays around with all of these familial relationships. And those ideas come to bear on the way that he’s engaging with Meaghan.

MEAGHAN: I mean, they called themselves Mommy and Daddy. “This is reparenting, and this is good. Just keep doing this; this is appropriate and acceptable,” and they openly called me their experiment.

DAVE: Boundary violations were in service to grow.

MEAGHAN: They’re breaking me down and building me up again. He started touching me. This is September of 2015. He started rubbing my neck and started rubbing my shoulders, and I froze. I responded to it by taking my car, and I bolted off the island. I have all these emails begging me to come back, and “It’s all a misunderstanding, and please come back, and we love you, and we care about you, and we can sort this out.”

It’s hard to say it, but there were a lot of positives in my relationship with my therapists. There were moments of laughter, and there were moments of support, and there were moments of healing. And that is part of the mindfuck. So I went back. And that was a shift for me — like, when I drove to their property in September, and I knocked on the door, and it was just like the prodigal son has returned. And then they fed me, and I stayed there, and it felt like I’d chosen to go back to them. And I suppose I did.

It progressed from there. He wanted to walk, and so it was a couple of times a week, and I offered to walk with him ’cause I was like, That’s something I can do. That’s something I can give back to them. And we’d walk, and we’d talk, and he wanted to hold hands. And so we’d hold hands, and we’d walk, and he started losing weight, and he started getting more energy. He takes just handfuls of pills every day — like vitamins. And so they asked me to sort his vitamins for him and bag his vitamins for him once a month. And then I was doing all the writing with him and then I started cleaning for them.

DAVE: She was recovering from another head injury at the time. Meaghan’s prone to concussions from her days as a speed skater.

MEAGHAN: The dependency just kept on building. It became extremely normalized to curl up for hours on the sofa and cuddle together.

DAVE: We reached out to Yensen and Dryer for comment. Dryer declined to speak with us, and Yensen never responded. Meaghan’s memories of that time are very specific.

MEAGHAN: When I talk about it being like a frog boiled alive. By December, he was touching me. By January, the first time he kissed me, it was like tongue and mouth. March, digital penetration. He laid his futon out into a bed in front of the fireplace, and he reached his hand to my vagina. I had a massive trigger and was on the bed in a fetal position, shaking, totally dissociated, totally out of it. And I was like, Maybe if I can just push through this … He openly called it exposure therapy.

The first time we had physical intercourse was in March of 2016. He was insatiable. In May of 2016, he called me selfish and seductive and a manipulative bitch — because I said “no.”

LILY: I’ve looked at a bunch of emails between Richard Yensen and Meaghan from a time when she had left the island for a little while. And it’s really clear to me that he is a master manipulator. He’s very good at making it seem like every issue that she’s raising is all in her head and she’s hurting herself, not that he’s hurting her.

There’s one where Richard just writes to her saying, “Sorry to say, I have lost my patience with you. I will be in touch when and if it is regained.” And Meaghan writes back this very thoughtful, very clear attempt to assert boundaries about how she wants to be treated. And she says, quote, “Until my ‘no’ matters as much as your ‘yes’ and vice versa with both being expressed, understood, and heard clearly … neither is respected. This isn’t respectful to any of us, and all of us are being hurt.”

Richard’s response begins, “Dear Meaghan, you are a powerful storyteller. Your stories are full of strife and abuse. You have been telling them for a long time. I’ve sought to comfort and assist you in dealing with the consequences of telling those stories. Now you’re telling them about me. I do not experience them as related to reality.” The way that he denies her sense of reality as though that’s the thing that’s hurting her, rather than the way that he’s treating her. He says in the same email, quote, “Frankly, I feel enticed, rejected, and condemned. Nothing has ever happened between us that wasn’t fully consensual,” which, like, Richard Yensen has admitted to having a — “sexual relationship” is how he frames it. And, as her therapist, there is no such thing as a consensual sexual relationship. That doesn’t exist. That’s not a thing.

When Meaghan forwarded these emails to Dave and me, she put a note at the top. She says, quote, “It’s really hard for me to read these, by the way, both just seeing how messed up I was, tore into, the clarity of saying no. And then the fear/trying to assuage. Please keep in mind how utterly dependent I was at the time.”

Meaghan’s response at the end of all of this is to write back to Richard saying, “You are right, and I am sorry. I am horrible and can’t even see what’s true anymore.”

DAVE: So you remember that talk that Meaghan gave about her experiences as a clinical-trial participant? Well, she gave that talk after a whole year on Cortes Island.

MEAGHAN: There I was onstage, and it was one of the moments where the split between what was going on and my speaking of that event hit home.

DAVE: When Meaghan finishes, a MAPS researcher who she’s familiar with sees that something isn’t quite right.

MEAGHAN: And she just got me out of there. And she just said, “Would you like to come meet my malamute?”

DAVE: Meaghan loves dogs.

MEAGHAN: I just wrapped my arms around a malamute. It’s like hugging a polar bear that happens to be a dog. I came close to telling her what was going on. I didn’t because how could I, in that venue? How could I have just done that presentation? I know in myself that that kind of ability to present is very much protective — like, that’s how I have coped and survived — but outwardly, I can appreciate how that would raise a lot of questions. It was such a façade, and I did it knowing it was a façade, and I did it wanting it to be true.

LILY: What happened to Meaghan was singular — but also not. The other participants also ended the trial feeling utterly dependent on the therapists who had given them MDMA, and they each suffered in their ways.

MEL: Before I started the trials. I thought that, really, I was just a part of an alien experiment, and I lived inside a fishbowl, and the aliens would reach down and be like, “Let’s see what happens if we fuck with this.” And then they would move something. And that was my life. Now, all of a sudden, everything is real. I know that everything that happened to me is real. I know that what I think is real, what I feel is real, everything is real — and that is overwhelming.

LEAH: For months after the trial ended, I would have these fucking visceral nightmares every fucking night, way worse than I had ever had before. And I couldn’t fucking wake up out of them. I’d stay stuck in these nightmares.

MEL: I was just a mess. Suicide became a moment option again. And now it was coupled with the fact that I had been given a miracle cure and wasted it, that I had tasted what life is supposed to be like. And somehow I managed to blow it.

LEAH: And so, like, the whole fucking end of the study was me, like, insisting that they see what was happening to me. After the trial, I emailed them in crisis probably three or four times. I was extremely suicidal by then.

MEL: I didn’t tell them that I was having a hard time. I didn’t share any of that. Um, I just reached out to them. I just needed contact with someone who knew my story. I just needed to touch base. Crickets.

DAVE: What did that feel like?

MEL: It was devastating.

DAVE: I think the biggest overall takeaway from these three experiences is that the way that MDMA therapy is being discussed does not match the experiences of these participants.

LEAH: I was one of the people who looked cured on paper.

DAVE: All of them had really bad and difficult experiences in the trials. And none of them could find those experiences represented in the published papers.

LEAH: I guess that’s, like, a problem with research in general — is, like, you can only capture the things you measure when it comes to data. And the things they measured made me look pretty good on paper.

LILY: It raises the question, What else wasn’t captured on paper?

Open-Heart Surgery