Couple Therapy With MDMA—Proposed Pathways of Action
Summary & key facts
This theoretical paper reviews past and recent work on using MDMA in couple therapy. It explains how MDMA might change the brain and feelings in ways that could help partners connect, communicate, and feel safer with each other. The authors describe a model for MDMA-assisted couples therapy, note the first pilot trial for couples with PTSD has been completed, and outline directions for future research and clinical development.
- MDMA was first explored as a therapy helper for couples in the 1970s and 1980s.
- The paper notes that the first pilot trial of MDMA-assisted psychotherapy with couples for PTSD has been completed.
- This is a theoretical paper that reviews neurobiological and neurochemical effects of MDMA in a relational (dyadic) context rather than reporting a large new clinical trial.
- The authors describe emotional, behavioral, cognitive, and bodily (somatic) effects of MDMA that could matter during couple therapy.
- The paper lists specific interpersonal processes that MDMA may affect: empathy, communication, perception of social connection/support, non-avoidance, openness, attachment/safety, bonding/social intimacy, and relationship satisfaction.
- The authors introduce a model to support MDMA-assisted couples therapy and state future directions, including implications for developing and delivering such interventions.
Abstract
MDMA's first identified potential as a therapeutic catalyst was for couple therapy. Early work in the 1970s and 1980s explored its potential amongst seasoned psychotherapists and their clients. With the completion of the first pilot trial of MDMA-assisted psychotherapy with couples for PTSD, and as the possibility of conducting MDMA-assisted psychotherapy trials expands due to new regulatory frameworks, we have an opportunity to explore and investigate how and why MDMA-assisted couples therapy works. This theoretical paper will explore the neurobiological and neurochemical effects of MDMA in a relational context, the emotional, behavioral, cognitive and somatic effects within a dyadic frame, and how empathy, communication, perception of social connection/support, non-avoidance, openness, attachment/safety, bonding/social intimacy and relationship satisfaction, are all impacted by MDMA, and can be harnessed to facilitate systems-level and interpersonal healing and growth. A model to support MDMA-assisted couple therapy is introduced, and future directions, including implications for intervention development and delivery, will be elucidated.
