Autism is a condition marked primarily by difficulty socialising, communicating, and understanding other people.
MDMA is a drug known primarily for making people feel connected, understanding, and above all extremely social.
What happens when the two are combined? If the experience of myself and others on the spectrum are anything to go by - something quite wonderful.
The first thing to understand is that, while what I’m saying may sound like a radical idea to most, it really isn’t all too strange. MAPS is a non-profit organisation in the US set to have MDMA approved by the FDA as early as 2023 for use in MDMA assisted psychotherapy. The initial research is focusing on the treatment of PTSD, but research into its use in other conditions is already being researched and autism is among them.
Even way before MAPS, when Alexander Shulgin - the so-called “godfather of ecstasy” - first synthesised MDMA decades after it was patented by German pharmaceutical company Merck but never researched, he began conducting his own research by first trying the drug himself, and later providing samples to others, before he promoted it for use within psychology. It was for a time used by a group of “underground” psychologists believed to be in the hundreds before later becoming popularised in the club scene and subsequently being made illegal.
Once it was made a schedule I controlled drug, this halted virtually all further research into the therapeutic potential of the substance until MAPS took on the task of bringing it into the world of legitimate medicine by raising enough funding to run clinical trials and being granted special permission from the FDA to run said trials on a schedule I drug - a group of drugs which, officially, has no medical value. It is currently in stage III clinical trials in the US and stage II clinical trials in Europe with promising results.
Of course while the boffins are hard at work gathering data to prove the therapeutic benefits of MDMA to the powers that be, these are something users have known about for a long time, ever since Shulgin unleashed the substance onto the world.
I was diagnosed with what was then known as Asperger’s - a diagnosis no longer used in the DSM-V, instead replaced with high functioning ASD - as a young child. Since then I have had to develop many coping strategies mostly for the sake of appearing “normal” and blending in for the purposes of having a career and social life.
This is something known as “masking” within the autism community because, as the name suggests, it is effectively the practice of covering up your natural behaviours and replacing them instead with behaviours considered more socially acceptable. As we do this our entire lives, beginning in childhood, we consciously have to develop and maintain invented personas. In other words we have the “mask on.” It requires constant work, constant learning, trying our hardest to understand and mirror those around us, whose behaviours appears just as strange to us as our behaviours likely appear strange to you.
We do this for the sake of fitting into society, because for us it’s normal to socialise and express ourselves in ways considered strange or rude by NTs (“neurotypicals”, a term for people without autism or other neurological conditions), such as speaking obsessively about our interests, finding eye contact uncomfortable or even painful, missing social cues, and to engage in comforting behaviours others look down on such as “stimming” - stimulating behaviour to release energy, such as during a feeling of excitement, most commonly in the form of hand flapping.
Despite often being a sign of happiness, most parents discourage behaviour such as hand flapping, even at home, simply because it is percieved as abnormal. To use an analogy, it is like being told you are not allowed to smile because others find it weird.
This, I feel, creates a barrier between myself and others. I am not having genuine conversations or creating genuine connections. Instead I am constantly ensuring that my mask doesn’t slip, that I don’t act too weird and alienate people, and dealing with the constant stress and anxiety arising from this. Some of the required masking is understandable - for instance learning the subtleties of social nuances so as to make friends, get a job, and not accidentally insult people during conversation is a good thing - but it goes way beyond social nicities and ultimately all of it adds up in little bits and pieces to a rejection of our natural behaviours and a push to create this mask we must hide behind in order to simply be accepted.
In adulthood, all of this compounded leads to many of us feeling ashamed of our natural behaviours. And by this point, the constructed false persona becomes difficult to distinguish from who we really are. Because it begins from childhood and is consistent throughout adulthood, it all becomes entangled.
Sure, we usually still flap our hands in private, but only in private as we’ve been brought up to see it as shameful behaviour. We wouldn’t dare do so in front of even our closest loved ones.
On the outside we must hide any indication of who we are. And not to wax too philosophical here but I think Nietzsche said it best: “If someone obstinately and for a long time wants to appear something it is in the end hard for him to be anything else.”
The question then comes, how do we take the mask off? Unfortunately this is not so easy. When you grow up having to fake every aspect of your persona your entire life - even in front of your own family - it’s not something you can just switch off at will. As we begin doing this out of necessity at such a young age, it’s often difficult to tell where the mask ends.
I have used MDMA multiple times over the years and have always marvelled at its ability to completely remove the barriers usually standing between myself and not only others, but also my own emotions. I often have a hard time processing and understanding my own emotional state before other people even come into it. Yet on MDMA this all becomes effortlessly easy. I can not only process and understand my own emotional state, but I feel deeply empathetic towards those of others, as well as gaining a deep introspective insight into my own mind.
My most memorable “roll” was the first time I took the drug along with a fellow aspie. Dosing at the same time in a sunny park, it enabled us both to effortlessly swing from discussing difficult subjects and providing genuine reassurance and practical advice, to happily laughing with each other end, of course, enjoying music.
I was able to open up about some difficult things such as personal insecurities and events from my past, I discussed various issues on my mind and came to realisations, saw things from others’ point of view, and my aspie friend was able to do the same - it was truly a mutually therapeutic experience. We were already friends, but we got to know each other on a much deeper level during this time, and we felt comfortable being who we are around each other.
I seriously cannot overstate how special this experience was for me. I felt in touch with myself, my thoughts, my feelings. My feeling of shame at who I am disappeared. My usual psychological barriers and defence mechanisms disappeared. My trouble processing and communicating emotions disappeared. Not only my own but others too. I could truly feel what my friend felt, and it felt so natural, so human. It felt like… genuine affective empathy.
Not only that but despite getting into some pretty heavy stuff in these conversations, there were no difficult feelings or even so much as a fleeting sense of awkwardness. I normally feel awkward just saying hello to someone. And yet here we could literally be discussing something dark from the past one minute, give the other advice on it and hug it out, then be listening to music and singing along all happy the next.
While rolling I feel no pressure to be someone else, or to fake my behaviours, or to hide who I am. All the barriers are gone here too. I felt, for the first time in my entire life, at peace with myself. My friend later remarked that they saw a totally different side of me they’d never seen before and felt closer to me despite us already knowing each other for years. I felt the same.
On a separate occasion while rolling I even flapped my hands in front of the woman I love without feeling ashamed. It was the first time I’d ever stimmed in front of anyone as an adult. It’s difficult to state just how special this is to me.
In this state I felt like I was effortlessly “myself.” I did not care about putting on an act and pretending I was anything but who I was, and as a result I was able to feel genuinely closer to people important to me. I’m sure this feeling of openness is a common effect of MDMA in NTs too, but this was such a profound experience because it gave me emotional abilities I simply do not possess otherwise, and of course most NTs don’t feel the need to mask to the extent autistic people do, nor experience such difficulty processing and expressing emotion under normal circumstances.
And that right there is the truly remarkable benefit of MDMA in the treatment of autism - perhaps the most vital one. It allows you to finally take your mask off, even if just for a day. And the effects of that stick with you for months afterwards.
While it is generally considered under the umbrella of “psychedelic medicine”, MDMA is not a full blown psychedelic, but rather acts primarily as an empathogen. Despite not providing a true trip, it can still enable powerful introspection and a unique perspective on both how your own mind ticks and past events and people that may be weighing on it.
Unlike traditional pharmaceuticals such as SSRIs, antipsychotics, or benzodiazepines - none of which are licensed to treat autism, but are sometimes prescribed for it or associated conditions such as social anxiety - MDMA is not something you are stuck taking daily in the hope that it covers up your symptoms.
Likewise, many on the spectrum turn to drinking in order to make socialising feel easier. After all, booze is a legal, socially acceptable, readily and cheaply available GABA agonist - in other words it has anti-anxiety properties. Unfortunately, relying on alcohol is also objectively much more dangerous and addictive than therapeutic MDMA usage despite the current legal status of each substance.
Additionally, alcohol, much like traditional psychtriatric meds, merely covers up your emotional state. It’s a method of running from yourself and it cannot last forever. The moment the substance leaves your body, your issues come flooding back. In the medical world this is known as “rebound symptoms.”
MDMA is very different. It is instead something that briefly changes how you think and feel, your entire state of mind, and rather than numbing your emotions, it allows you the power to feel, connect, introspect, gain new perspectives, and genuinely accept yourself for who you are - and the benefits can persist for months after your last dose.
I’m writing this report in retrospect, and I still feel as if that experience has changed me for the better. I understand myself better, I am more at peace with who I am, I feel better about myself, I know I can actually connect with and care for people after all, and honestly I have begun masking a bit less in my daily life ever since. More than that, I’ve begun to feel pride at the person I am, the person I’ve become, and the person I know I will be.
What other pill can do that?