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I've watched DVD footage of a few underground MDMA sessions, such as the ones that Beth leads. Somewhat like Edna Foa, I felt befuddled, uncomfortable. Patients seem dazed; they murmur slowly and slurrily about love, love, loovvve. These blissed-out voyagers may be reveling in newly discovered gifts of mental clarity, but those powers aren't visible to the naked eye. Foa is right: Even if, like me, you've spent countless hours reading about MDMA therapy and speaking with patients and therapists, it's impossible to grasp what MDMA feels like from the outside. So with some trepidation, I decide to try it from the inside.

On a rainy October day, I'm in a borrowed apartment in downtown Manhattan, chatting quietly with an underground therapist I'll call Eli. (When I ask Eli where he gets his product, he replies, "My friend has a friend with a lab," with a firm smile that says, End of discussion.) It's been 20 minutes since I swallowed about 125 milligrams of pharmaceutical-grade MDMA, and I'm detecting an anticipatory rumbling in my cortex: electrical signals are popping and whirring, neurotransmitters are choo-chooing into place. "Something is happening to me," I tell Eli, who murmurs, You're okay, everything is okay, all you need to do is breathe. "I'm going to go over here for a bit," I tell him—by which I mean I'm going to sit exactly where I am on the sofa, drop my chin to my chest, and bury my face in my hands.

For a while my five senses cohere in a synesthesia of inhale, exhale, inhale, exhale, like the surge and fallback of the ocean lapping the shore. A flash flood of dopamine, serotonin, and oxytocin is pouring through me, setting my teeth chattering. I'm overwhelmed yet not anxious; my mind's fear center has been put to a peaceful, dreamless sleep, like Dorothy in the poppy field. Imagine the instant right before orgasm or before a roller coaster tips over its peak height, then stretch that instant to the length of a pop song—or maybe two songs, or three. Imagine every pore and molecule in your body yawning open, vibrating with the effort, an exhilarating stretch that reaches almost far enough to touch pain.

A religious person might say that her circuit boards were jamming with the light of God. A transcendentalist might feel the boundaries between himself and Creation joyously dissolving. As for me, I'm aware as never before of my mind and body as an astounding machine: the sponges and honeycombs of my pumping lungs, the dendrites tickling toward my glowing cell bodies.

At some point I lift my face from my hands and turn toward Eli. It's deeply strange, yet pleasant and not at all startling, to see him still sitting there on the opposite side of the couch. The vaguely pulsating room is like a David Lynch movie stripped of dread—as if I'd closed my eyes and woken up in a parallel world where everything looks and sounds almost the same, but isn't. Eli appears crisper, more distinct, yet there's a delicate gauze hung between us. As I begin to speak, the lower range of my voice purrs and buzzes—my words are velvety physical things, trilling against my throat. I feel like I've just emerged from anesthesia, only there's no lingering grogginess. I'm clear, lucid, on point.

I rub and stretch my legs and walk about, and wonder why I don't pay more attention to these ingenious contraptions that move me around all day. I sit on a futon, pushing and pulling my hands against the duvet and squeezing the pillows, delighting in a sensation that has been available to me forever. I talk about my childhood and my amazing husband and how much I love swimming and cycling and coral reefs. I talk about the ways I squander my time and my talents—but my attitude toward these shortcomings is kindly and curious, not judgmental or self-deprecating per usual. I am ready to be at my own service. I say, "Everything seems possible right now." For three hours, I am swept up in a proactive, scientific empathy toward myself—a place where safety is euphoric, and euphoria feels safe.

Precisely at the start of the fourth hour, I tell Eli, "It's changing." The trip turns itself inside out. Hour Four is possibly the worst hour of my life. Waves of shame and humiliation shudder through me. I sit on the floor, knees to chest, sobbing with my whole body. I'm consumed with remorse for everything I've ever said or done, for the obscene calamity that is me. Old heartbreaks and embarrassments take on the jagged contours of monsters I can't quite see, screaming in my head. My mind is a slaughterhouse. If the first three hours of MDMA were a dream made real, Hour Four reveals them to be a fiendish practical joke.

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