<<

How are affected by MDMA and why can it cause long term change to the personality? Michal Kováč1

Abstract This paper investigates what emotions typically emerge during a 3,4-Methylenedioxymethamphetamine (MDMA) experience, if and how MDMA affects personality and whether and how are the experience and the personality change linked. To answer these questions a focused literature research was conducted, and the findings were used to assemble models of both immediate MDMA effects on emotions and MDMA induced personality change. We have used Parrott's theory as the theory of emotions and Big Five as the theory of personality. We found that out of the primary emotions of Parrott's emotion theory MDMA causes emotions of , and to emerge. An increase in Big Five personality traits of openness and extroversion and decrease in trait of are the typical MDMA induced personality changes. Based on research investigating the therapeutic MDMA potential the emotional experience seems to be one of the key factors in the MDMA induced personality change. We hypothesize that in particular positive emotions, , decreased and increased play a key role in the mood, attitude and personality change.

Keywords: MDMA, emotion, personality, model

1 Introduction Psychedelic renaissance is currently happening in the based on its chemical structure and also some of its scientific world in the fields of psychology, effects it seems to fit into the class of stimulants neuroscience and cognitive science (Bouso, Santos, (Peroutka, 1990, p. 105). However, these effects (e.g., Alcázar-Córcoles, & Hallak, 2018). A substantial part increased energy, decreased appetite, decreased of this renaissance is a drug chemically known as of tiredness) are not what makes MDMA 3,4‑Methylenedioxymethamphetamine (MDMA) or special in the light of therapeutic potential neither in informally (Sessa, 2018). In the last two the eyes of its users (Peroutka, 1990, p. 105). Other decades a lot of research has been conducted mainly traditional class of drugs into which MDMA seems to concerning possible therapeutic uses of MDMA but fit are psychedelics (Peroutka, 1990, p. 105). Indeed, also its effects in general. Combined with research MDMA can cause effects typical for psychedelics conducted before year 1985 when MDMA was like hallucinations, altered sense of time and in banned it creates a large number of fragmented general altered perception of the world (Greer & findings. The purpose of this paper was to analyze the Tolbert, 1986). Because of that some categorize it as current state of the art of MDMA research focused stimulant-psychedelic hybrid (Roseman, Leech, mainly on emotion and personality aspects and to Feilding, Nutt, & Carhart-Harris, 2014). However, provide its overview by assembling corresponding this does not capture the characteristic and unique scientific models. As a part of this effort a hypothesis effects of MDMA that include increased feeling of of how these two subdomains are linked was formed. love, empathy and connectedness to others (i.e. entactogenic effects) (Peroutka, 1990, p. 52). Because Despite being part of the psychedelic renaissance, of these unique effects, clearly distinguishable by the MDMA as a drug is hard to classify. At a first glance

1 Michal Kováč is from the Department of Philosophy, University of Vienna, Vienna, Austria, on a mobility from the Department of Applied Informatics, Comenius University, Bratislava, Slovakia. E-mail: [email protected]

1 user, categorizing MDMA into a new class of drugs spiritual experiences, strong hallucinations, etc.) and called entactogens was proposed (Peroutka, 1990, p. the findings from these publications were only used 105). Despite of that, research of psychedelics can as a supporting evidence. Mainly publications from and has been used for modeling of some of MDMA the domain of behavioral and cognitive psychology effects that seem to be responsible for change in were picked since that is the point of view this paper emotions, mood, attitude and personality (Wagner et set out to map. Neuroscientific publications were al., 2017; Roseman et al., 2014; Bouso et al., 2018; included to the extent necessary for comparing Krediet et al., 2020). mechanism of action of MDMA to mechanism of action of other psychedelic drugs. However, the 2 Materials and methods neuroscientific research is too vast to be completely mapped in the scope of this paper. 2.1 Bibliography research

Bibliography studied consists of 6 books, 71 2.2 Emotion theories standalone book sections and 66 scientific papers to When choosing a theory of emotions to use, we have map the state of the art of MDMA research and done an overview of the domain and decided to emotional and personality modeling. Aforementioned primarily focus on theories of categorical and bibliography is a part of the Supplementary Material. dimensional types because they suit the use case of We did not impose a limit on the age of the describing particular emotions without focusing on publications to be able to capture findings from both parameters that are outside of the scope of this project the research era before the MDMA ban when a lot of or not relevant in the context of emotions emerging as general MDMA research was being done and from an immediate result of taking a drug. In the end we the current era when MDMA research is mainly have decided for categorical type because in most focused on the therapeutic potential. Newer findings publications either this type of theory is used, or were by default considered as more relevant since the findings are described in natural language which can state of the art of the domain research is constantly be fitted into a categorical theory easier. Because of improving which usually leads to better methodology. that, increased precision of the dimensional models Although usually if newer findings contradicted older would not be utilized and working with this type of findings, they explicitly stated this fact and discussed theories would add an overhead with little benefits in the cause. Studies done on people with no mental return. As for the particular theory we have chosen health disorders as well as studies done in therapeutic Parrott's emotion theory since it is precise enough for context on people with mental health disorders the data acquisition, we were capable of and easy to (usually post-traumatic stress disorder (PTSD), social work with. and ) were included. This Parrott's emotion theory is a tree structured list of difference in mental processing of participants could emotions. The tree is of depth three. Each level have big impact on the findings since mental health specifies more specific subemotions of the parent disorders can influence both baseline personality and emotion. The first layer has six nodes representing the MDMA experience itself. This taken into primary emotions: love, joy, surprise, , consideration. Differences in findings were analyzed and fear, which have children representing secondary and context specifics findings were clearly marked as emotions like , or cheerfulness, which such. Publications regarding other psychedelic drugs have children representing tertiary emotions for that were extraordinarily relevant because they example , or ecstasy. The complete focused on personality change caused by the tree structured representation of Parrott's emotion experience were also included. They were considered theory is displayed in Table 1. as relevant for MDMA research if the combination of the substance, dosing, setting and other relevant variables resulted into effects comparable to the effects of MDMA (i.e., no strong psychedelic effects which include complete detachment from reality,

2

Primary Secondary Tertiary there we have decided to focus on dimensional and emotion emotion emotion trait theory types since they allow to capture the Love Affection Adoration, Fondness, Liking, personality at the given moment in time and are Attraction, Caring, Tenderness, widespread in research. In the end we have decided , Sentimentality Lust Desire, , for trait theory called Big Five since it is very Longing Longing commonly used, relatively simple and at the same Joy Cheerfulness , Bliss, Gaiety, Glee, time sufficiently precise for the data acquisition, we Jolliness, Joviality, Joy, Delight, were capable of. Enjoyment, Gladness, , Jubilation, Elation, Satisfaction, Big Five consists of five key personality traits that are Ecstasy, Euphoria Zest , Zeal, Excitement, quantifiable and that complexly define the

Thrill, Exhilaration personality. The traits of the Big Five personality theory are openness, conscientiousness, extraversion, Triumph agreeableness and neuroticism. It is hard to compare Eagerness, the quantified change in personality in between Enthrallment Enthrallment, Rapture different studies, but the trend of changes can be Relief Relief evaluated easily. Surprise Surprise Amazement, Astonishment Anger Aggravation, Agitation, , Grouchy, Grumpy, 3 Results Crosspatch Exasperation 3.1 Emotions Anger, , Fury, Wrath, Our findings show that MDMA has wide variety of , Ferocity, Bitterness,

Hatred, Scorn, , emotion related effects, but not all of them are fully Vengefulness, Dislike, understood yet. Quoting one of the fairly recent Revulsion, , Loathing papers "we have only limited understanding of the basic emotional processes involved in its prosocial Torment Torment effects" (Wardle & de Wit, 2014, p. 1). We have Sadness Agony, , Hurt discovered that this statement also applies to other Sadness Depression, Despair, Gloom, Glumness, Unhappiness, , MDMA effects which is further discussed below. , Woe, Misery, Melancholy However, the understanding of the basic effects is Dismay, Displeasure solid and is supported by many independent research , , projects. Neglect Alienation, , Dejection, , , One of the better understood MDMA effects is what , Insecurity, , , , Rejection immediate emotions it causes. This data was mostly , , Sympathy obtained using questionnaires filled out by Fear Horror Alarm, Shock, Fear, Fright, Horror, participating subjects either during or after the Terror, , , MDMA experience. Following primary emotions of Mortification Nervousness Anxiety, Suspense, Uneasiness, Parrott's emotion theory were reported to appear the Apprehension, , Distress, most: love, joy and surprise (Peroutka, 1990, p. 53; Dread Love Affection Adoration, Fondness, Liking, Baggott et al., 2016; Greer & Tolbert, 1986; Hysek et Attraction, Caring, Tenderness, al., 2014). Increasing the granularity to secondary Compassion, Sentimentality emotions of love, MDMA causes affection and longing with sexual desire surprisingly lacking Table 1: Parrott's emotion theory (Baggott et al., 2016; Hysek et al., 2014; Peroutka, 2.3 Personality theories 1990, p. 53). Most notable secondary emotions of joy When choosing a theory of personality to use we have were cheerfulness, zest, contentment and, specific for started with an overview of the domain as well. From therapeutic setting, relief (which will be further discussed later on in the context of emotional

3 breakthroughs) (Baggott et al., 2016; Hysek et al., (Baggott et al., 2016; Wardle & de Wit, 2014). 2014). The emotion of surprise - amazement and MDMA decreases ability to identify emotionally astonishment - was reported in the context of altered negative expressions and creates a bias to identify sensory perception (enhanced visual and haptic expressions as emotionally positive (Baggott et al., sensations) (Greer & Tolbert, 1986; Peroutka, 1990, 2016; Kirkpatrick, Lee, Wardle, Jacob, & de Wit, p. 53). The same emotions but weaker reappeared in 2014). Emotional processing overall is increased some cases even on the next day after the MDMA (Peroutka, 1990). In a therapeutic setting this can lead experience, especially in first time users (Greer & to an emotional breakthrough experience which is a Tolbert, 1986; Peroutka, 1990, p. 53). This suggests release of strong emotions that results into a relief that MDMA also has semi-long-term effects on from past trauma (Krediet et al., 2020). This is emotions. Most users reported that strength of the believed to play a significant role in the possibility of effects deteriorates with subsequent sessions therapeutic use of MDMA (Krediet et al., 2020). (Peroutka, 1990, p. 53). The complete model of our Interestingly ~24% of participants in non-therapeutic findings is captured in both tabular form ( study with no involvement of a therapist still reported Table 2) and diagram form (Figure 1). "undergoing a therapeutic emotional process" (Greer & Tolbert, 1986). Primary Secondary Tertiary emotion emotion emotion 3.2 Mood and attitude Love Affection Fondness Phenomena that were occasionally brought up in the Liking publications in the light of being affected by MDMA Attraction as well were mood and attitude. They are mostly out Caring of scope of this project, but it is worth mentioning Tenderness them. Mood seems to lie in between emotions (which Compassion are short lived) and personality (which is very stable) Longing Longing and therefore might play a role in the personality Joy Cheerfulness Bliss change caused by MDMA. An increase in positive Gaiety mood states was observed (Kirkpatrick et al., 2014). Joy Reported attitude changes included "more Delight self‑understanding, more tolerance of others, less Enjoyment egocentricity, a less materialistic and aggressive Gladness orientation, and more appreciation of music, art, and Happiness nature" (Studerus, Kometer, Hasler, & Vollenweider, Elation 2011, p. 15). Ecstasy Euphoria 3.3 Personality Zest Excitement Personality in adulthood is considered to be very Thrill stable (Erritzoe et al., 2018; Wagner et al., 2017). Exhilaration However, there seem to be exceptions. For example, Contentment Pleasure both PTSD and depression seem to personality Relief Relief traits (Wagner et al., 2017). These are than affected Surprise Surprise Amazement again by therapy - be it a conventional one or a Astonishment psychedelic/entactogen based one (Erritzoe et al., 2018). MDMA or psychedelic drug experiences can Table 2: List of emotions commonly caused to emerge by taking be another cause of a personality change (Krediet et MDMA categorized using Parrott's emotion theory al., 2020; Bouso et al., 2018). Other findings include increased empathy with heightened sensitivity to noticing empathy of others

4

Emotions

Love Joy Surprise

Affection Longing Cheerfulness Zest Contentment Relief Surprise

Fondness Bliss Excitement Pleasure Amazement

Liking Gaiety Thrill Astonishment

Attraction Joy Exhilaration

Caring Delight

Tenderness Enjoyment

Compassion Gladness

Happiness

Elation

Ecstasy

Euphoria

Figure 1: List of emotions commonly caused to emerge by taking MDMA categorized using Parrott's emotion theory

In particular the following personality traits were et al., 2018). Conscientiousness seems to increase just found to be most commonly influenced by the at the trend level and agreeableness does not seem to MDMA experience. Openness seems to increase in be affected at all (Erritzoe et al., 2018). A model all users (Bouso et al., 2018; Erritzoe et al., 2018; visually representing the personality change caused Wagner et al., 2017). Neuroticism decreases more by MDMA is in Figure 2. Not only these changes last substantially than openness increases however it longer than the pharmacological presence of the drug seems to be mostly limited to people with in the body but they seem to be permanent or at least extraordinarily high neuroticism to begin with (i.e., very long-lasting (Krediet et al., 2020; Bouso et al., people with mental health disorders) (Wagner et al., 2018; Wagner et al., 2017; Greer & Tolbert, 1986; 2017; Erritzoe et al., 2018). Extroversion seems to Studerus et al., 2011; Erritzoe et al., 2018). statistically significantly increase as well although this change is mentioned in less publications (Erritzoe

5

Openness 4 Discussion ⇧ In this paper we have summarized the current state of the art of MDMA research. We have used it to create a model of emerging emotions during the MDMA Conscientious Neuroticism ness experience and a model of a personality change after ⇩* ⬦ taking MDMA. Based on these models and research conducted in general we came up with a hypothesis about how these two phenomena are linked. The research of how emotions are affected during the MDMA experience has shown that this domain still is Agreeableness Extraversion not understood in detail. What emergent emotions are ⬦ ⇧ caused is more or less clear but more complex phenomena like increased empathy or emotional break throughs still need to be studied more. Figure 2: Model of personality change caused by MDMA using Big Five theory Available research of personality changes has its own limitations. A lot of the experiments are from 3.4 Link between emotional experience and therapeutic setting which allows generalization to personality change some extent but can be misleading. However, We hypothesize that the personality change is caused personality change seems to be better understood by the following combination of factors. Decreased overall especially because of the recent in fear and enhanced self- enable the user to therapeutic use of MDMA. The resulting hypothesis face and overcome inner issues that can be a cause for about the link of these two phenomena emerged increased neuroticism. The user experiences naturally which is a good sign. Following are two increased empathy in conjunction with increased major limitations of this hypothesis. It is not very sensitivity to positive emotions and decreased precise and therefore its potential use is limited. It is sensitivity to negative ones in others. This results into very theoretical which makes testing it rather hard. seeing everyone as a more positive person than usual and leads to an increase in openness. The prosocial Acknowledgment effects of the drug make the user want to I would like to thank my supervisor Paolo Petta for communicate the positive he or she is his support, my discussant Lisa Herde for her inputs experiencing towards others with them which leads to and my peers Anja Terglav and Kevin Purkhauser for an increase in extroversion. All of this is accompanied discussing the project with me. This project was made by a strong euphoria and very strong positive possible by European Union through its Erasmus+ emotions which naturally do not happen in this extent. programme. Therefore, after the experience the user remembers this state of mind and is more relaxed which reduces Supplementary Material neuroticism and he or she sees the world around more positively than before which causes increase of Bibliography of publications collected as a part of this openness and extroversion. On top of that based on project can be accessed on the following url: the reinforcement theory the person remembers his or http://davinci.fmph.uniba.sk/~kovac254/cogsci/mob her state of mind, mood and attitude from the proj/MoPE2020-KovacM-Finalpaper.bib experience and how good he or she felt during this time and therefore tries to repeat the behavior to References achieve a similar reward. Baggott, M. J., Coyle, J. R., Siegrist, J. D., Garrison, K. J., Galloway, G. P., & Mendelson, J. E. (2016). Effects of 3,4-

6

methylenedioxymethamphetamine on Roseman, L., Leech, R., Feilding, A., Nutt, D. J., & socioemotional feelings, authenticity, and Carhart-Harris, R. L. (2014). The effects of autobiographical disclosure in healthy psilocybin and MDMA on between-network volunteers in a controlled setting. Journal of resting state functional connectivity in Psychopharmacology, 30(4), 378–387. doi: healthy volunteers. Frontiers in Human 10.1177/0269881115626348 Neuroscience, 8. doi: Bouso, J. C., Santos, R. G. dos, Alcázar-Córcoles, M. 10.3389/fnhum.2014.00204 Á., & Hallak, J. E. C. (2018). Serotonergic Sessa, B. (2018). The 21st century psychedelic psychedelics and personality: A systematic renaissance: Heroic steps forward on the review of contemporary research. back of an elephant. Psychopharmacology, Neuroscience & Biobehavioral Reviews, 87, 235(2), 551–560. doi: 10.1007/s00213-017- 118–132. doi: 4713-7 10.1016/j.neubiorev.2018.02.004 Studerus, E., Kometer, M., Hasler, F., & Erritzoe, D., Roseman, L., Nour, M. M., MacLean, Vollenweider, F. X. (2011). Acute, subacute K., Kaelen, M., Nutt, D. J., & Carhart-Harris, and long-term subjective effects of R. L. (2018). Effects of psilocybin therapy on psilocybin in healthy humans: A pooled personality structure. Acta Psychiatrica analysis of experimental studies. Journal of Scandinavica, 138(5), 368–378. doi: Psychopharmacology, 25(11), 1434–1452. 10.1111/acps.12904 doi: 10.1177/0269881110382466 Greer, G., & Tolbert, R. (1986). Subjective Reports Wagner, M. T., Mithoefer, M. C., Mithoefer, A. T., of the Effects of MDMA in a Clinical Setting. MacAulay, R. K., Jerome, L., Yazar- Journal of Psychoactive Drugs, 18(4), 319– Klosinski, B., & Doblin, R. (2017). 327. doi: 10.1080/02791072.1986.10472364 Therapeutic effect of increased openness: Hysek, C. M., Schmid, Y., Simmler, L. D., Domes, Investigating mechanism of action in G., Heinrichs, M., Eisenegger, C., … Liechti, MDMA-assisted psychotherapy. Journal of M. E. (2014). MDMA enhances emotional Psychopharmacology, 31(8), 967–974. doi: empathy and prosocial behavior. Social 10.1177/0269881117711712 Cognitive and , 9(11), Wardle, M. C., & de Wit, H. (2014). MDMA alters 1645–1652. doi: 10.1093/scan/nst161 emotional processing and facilitates positive Kirkpatrick, M. G., Lee, R., Wardle, M. C., Jacob, S., social interaction. Psychopharmacology, & de Wit, H. (2014). Effects of MDMA and 231(21), 4219–4229. doi: 10.1007/s00213- intranasal oxytocin on social and emotional 014-3570-x processing. Neuropsychopharmacology, 39(7), 1654–1663. doi: 10.1038/npp.2014.12

Krediet, E., Bostoen, T., Breeksema, J., van Schagen, A., Passie, T., & Vermetten, E. (2020). Reviewing the potential of psychedelics for the treatment of PTSD. International Journal of Neuropsychopharmacology, 23(6), 385– 400. doi: 10.1093/ijnp/pyaa018 Peroutka, S. J. (Ed.). (1990). Ecstasy: The clinical, pharmacological and neurotoxicological effects of the drug MDMA. Buying options. In Ecstasy: The clinical, pharmacological and neurotoxicological effects of the drug MDMA. Boston, MA: Springer. doi: 10.1007/978-1-4613-1485-1

7