PTSDPersonality & Trait FactorsInterpersonal Functioning & Social ConnectednessMDMA

Couple Therapy with MDMA - Proposed Pathways of Action

This theoretical paper synthesises neurobiological, neurochemical and psychobehavioural evidence to propose mechanisms—such as increased empathy, communication, attachment security and social bonding, and reduced avoidance—by which MDMA-assisted couple therapy may facilitate interpersonal and systems-level healing. The authors introduce a clinical model for MDMA-assisted couple therapy and outline implications for intervention development, delivery and future research.

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Authors

Mark Wagner
Anne Wagner

Published

November 11, 2021

Frontiers in Psychology

individual Study

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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.

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Research Summary of 'Couple Therapy with MDMA - Proposed Pathways of Action'

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βBlossom's Take

This theoretical paper is useful because it translates MDMA-assisted couple therapy into a relational mechanism rather than treating the drug effect as only individual symptom relief. It helps formalise a line of work that connects empathy, attachment security, communication and reduced avoidance to systems-level change, which is a sensible framework as couple-based trials begin to appear.