MDMA-assisted therapy was first used as an aid to couples therapy in the 1970s. The results were astonishing right off the bat — therapists reported significant improvements in communication, empathy, and emotional healing among their patients.
Despite clear progress, all of this came to a halt in 1985 when the DEA officially banned the drug. Similar bans were imposed over the following years in Canada and across Europe.
While it was illegal to conduct any further research on the drug after this time, it remained active in underground therapy circles, and research has since come back with a vengeance over the past ten years or so.
Dr. Friederike Meckel Fisher — a therapist who was imprisoned for using psychedelics in her practice and now advocates for their use in couple’s counseling, has been quoted stating:
“MDMA alleviates fear, which allows individuals to access parts of their minds they might normally suppress. When you feel safe being vulnerable with your partner, the potential for healing and growth becomes possible.”
Study participants in multiple therapeutic studies involving MDMA have reported a reduction in fear and emotional hurt, as well as improvement in PTSD symptoms that ultimately lead to better relational dynamics.
The effects of MDMA closely resemble neurological processes that occur when one experiences love. A few examples include:
- Elevated serotonin & dopamine activity — By blocking serotonin & dopamine reuptake, MDMA increases synaptic levels of these two neurotransmitters, resulting in feelings of pleasure and euphoria.
- Elevate oxytocin levels — Oxytocin is associate with attachment, interpersonal trust, and bonding.
- Reduced sense of fear — MDMA shows to result in reduce blood flow (lower activity) to the amygdala. The amygdala is responsible for regulating feelings of threat, fear, and emotional pain.
Navigating complex trauma responses in a partnership brings its own unique challenges. PTSD (post-traumatic stress disorder) has been shown to cause stronger relational stress through behaviors like withdrawal and avoidance, emotional volatility, hyperarousal or hypervigilance, depression, and numbing behaviors.
In addition to its benefits to the partnership as a whole, MDMA has shown strong promise in supporting individuals struggling with PTSD.
MDMA is, by far, the most widely studied psychedelic when it comes to relationship therapy, and current pathways are opening up for its mainstream use in the future.
MAPS completed a phase 1/2 study on the effects of MDMA-assisted cognitive-behavioral conjoint therapy (CBCT) for couples with one partner with PTSD in 2018 and found significant improvements in PTSD symptoms as well as relationship adjustment and happiness.
Other similar studies are currently recruiting participants:
- Sunstone Medical is seeking to evaluate the safety and usefulness of MDMA-assisted therapy for couples with a cancer diagnosis.
- Remedy seeks to further research the effectiveness of MDMA-assisted CBCT vs CBCT alone for patients with PTSD and their partners.
These studies are estimate to be complete in late 2024 and 2026, respectively.
Ketamine has far less research in the couples therapy field, but given its rising popularity, interest is beginning to spark.
A recent study by Cornfield and colleagues was the first of its kind to explore the benefits of ketamine-assisted couples therapy through an Imago relationship therapy approach. Researchers found that participants experienced a reduction in anxiety, enhanced empathy and vulnerability, lower emotional defensiveness, and the ability to see alternative perspectives — all of which supported relationship processes.
Similar to LSD and MDMA, ketamine has the potential to aid in PTSD treatment and, like the other substances, may offer indirect support for couples navigating trauma responses.
Though not nearly as popular for relationship therapy as MDMA, LSD (lysergic acid diethylamide) has also shown promise in enhancing interpersonal relationships.
Although acid lacks some of the mechanisms that make MDMA so ideal for conjoint work (such as the powerful empathogenic qualities), individual LSD therapy can be useful for breaking down deep-seated psychological and emotional defensive barriers.
While MDMA directly enhances the couple’s experience, LSD offers support on a more individual level.
Stanislav Grof states in his book Realms of the Human Unconscious: Observations from LSD Research that LSD experiences can give insight into interpersonal relationship issues and that the mystical experience and its themes of unity can enhance feelings of interconnectedness, which inherently help support healthier relationships with other humans.
LSD has also shown promise in helping with PTSD and may, therefore, support partners in dealing with the challenges and strains that complex trauma can create in their relationship.
Magic mushrooms (and the active, isolated ingredient, psilocybin), although hardly ever talked about in a couples therapy context, have shown potential in enhancing both sexual function and intimacy issues.
Study participants reported feeling greater attraction to their partners, along with more confidence, satisfaction, and enhanced ability to connect after taking psilocybin mushrooms. Similar findings are in the LSD group in this study.
Couples who use mushroom microdoses as an intimacy ritual reported that the practice enhanced sexual connection and satisfaction with their partner.
Intimate partner violence (IPV) is a major concern in couples therapy and an issue that counselors take extremely seriously.
While some approaches are designed to address IPV, other methods, like the Gottman Method, recommend that patients seek individual therapy. Intimate partner violence, especially ongoing violence rather than situational violence, is often seen as a strong reason not to pursue couples therapy together.
Psychedelics have shown some promise when it comes to the prevention of intimate partner violence. For example, a 2018 study found that men who have consumed LSD or psilocybin are less prone to perpetrating violence than non-users.
Because most cases of domestic violence have a history of traumatic stress that helps explain explosive responses, addressing PTSD effects and supporting clients in navigating previous emotional stress may help alleviate violent behavior.
All four of the psychedelics we’ve covered so far have shown significant promise in addressing the implications of PTSD.
Although psychedelics can be a wonderful tool to treat trauma, patients need to have basic emotional regulation skills before attempting a psychedelic experience either independently or as a part of a therapeutic process.
Psychedelics have the potential to re-traumatize users by accessing repressed experiences or reliving traumatic episodes.
Having strong coping strategies, safety plans, and equipped support from a practitioner is crucial in this case in order to harness the potential benefit of psychedelics while reducing the risk of harm to the client.
Of all the substances out there, MDMA has been the one with the most eyes on it for couples and relationship therapeutic processes. It’s the most directly related to feelings of connection, love, intimacy, and openness — elements that facilitate relationship work and enhance the ability to communicate openly and effectively.
Other substances seem to hold promise as well — even if used in an individual therapeutic process rather than in conjoint experiences.
Because individual well-being and growth are such key components to healthy relationships. The healing potential of substances like LSD, psilocybin, and ketamine could be supportive to couples that affect by individual issues.
Relationships bearing the strain of mental health conditions like depression, anxiety, PTSD, and the like could indirectly benefit from individual psychedelic therapy.
All of these psychological conditions interfere with our ability to connect and empathize with others — especially on an intimate level.