JH: Do you think that MDMA has any place in alternative medicine?

AW: I don't know that I would put it in alternative medicine. I think it has a place in medicine. I wouldn't make a distinction there. For me, the interesting thing is that if the set and setting are properly attended to, MDMA can produce a state of great relaxation and lack of defensiveness in which the body behaves differently. You see that chronic pain can disappear and that habits can disappear. It can show people that there is a possibility that they're not obliged to have certain symptoms. The experience can motivate them to figure out other ways to maintain that symptom-free state.

JH: What is your opinion about the use of MDMA in palliative care?

AW: I have less experience with that. I know of some cases of people with advanced cancer who felt it was very positive for them. It helped them come to a sort of resolution with their lives and complete emotional work that they had to do with other people.

JH: I was hoping to touch on the potential for MDMA to be used as an analgesic [painkiller].

AW: A major component of pain is the subjective experience of it. MDMA changes your perspective about what is going on in your body, so it can help people develop a new relationship with chronic pain in which it is less of a discomfort.

JH: And what about the impact of fear and anxiety on pain perception?

AW: That's a huge component of pain. If the experience is structured properly, MDMA induces an extremely low anxiety state, which can dramatically lessen that aspect of pain. Often, there is a great deal of carryover after that experience.

JH: Do you see insight as a tool to assist in physical healing? For instance, if MDMA is used in a psychotherapeutic setting, and a person comes away with a better understanding of self-defeating or selfdamaging behavior in terms of lifestyle, do you think that could help someone with his or her health issues?

AW: Yes. I think that gaining insight is the easy part; the harder part is applying it.

JH: The integration?

AW: Yes. Integration may require some work and help, so that the experience doesn't just get boxed up and put into the past. But I definitely think that during the experience, one can gain insights into the nature of one's problems.

JH: What about the recreational or pleasurable component of MDMA? Most people want to separate the recreational and the therapeutic aspects of MDMA.

AW: I don't make much of a distinction. I think recreational experiences can be therapeutic.

JH: The quality of acceptance or forgiveness that people experience with MDMA can be valuable. Would you say that in some medical conditions, there is an element of anger or fear or guilt?

AW: Definitely. I think all of those kinds of states translate into body states.

JH: So it would probably be therapeutic to have an experience where those emotions are markedly lessened. What is your take on "psycho-neuro-immunology"?

AW: It is a field that's very well established. It's been around for three decades, and there is a vast body of research on it. The problem is that it's made very little impact on thinking and practice in conventional medicine. It's had all sorts of resonance with the general public as a result of books and TV shows. At the University of Arizona in the immunology course, for instance, the word "psycho-neuro-immunology" isn't even mentioned. There is a lack of connection between this body of research and the public's enthusiasm for it, as opposed to the actual day-to-day application in medicine.

JH: Do you have any opinion about the issue of MDMA being synthetic, as opposed to natural, in terms of its use in alternative medicine?

AW: If there were a totally natural substance that had the effect of MDMA, I would use it, but there isn't one. MDMA is semisynthetic; it's pretty close to a natural substance, but it's got a slight twist.

JH: I have heard you speak of optimism as a healing tool. For most people, the MDMA-induced state is chock full of optimism.

AW: Right. ... Optimism is a behavior and an attitude that can be learned, and I think that it has many consequences in terms of how our bodies function and how our minds work. I think that just having the experience of it, seeing that there is a mental perspective from which things can look positive, is very useful--especially if you haven't had that perspective in a long time. The basic point is that mental states translate into physical states. And one of the great values of the MDMA experience is that it can show you very concretely how a shift in your mental state can produce dramatic responses in your body. Often, this has significant carrryover into daily life.