MDMA Can Help Couples Struggling With PTSD in Therapy, Says Study

Researchers added MDMA to PTSD procedure for couples' therapy, and saw promising results.
Brad Bergan

After years of critical work with incredible results, MDMA-assisted psychotherapy for PTSD is edging toward approval in the United States — and some researchers are having success investigating the benefits of MDMA use for couples therapy, according to a recent study published in the European Journal of Psychotraumatology.


MDMA can help couples therapy suffering from PTSD, study says

The recent study is the first to explore how MDMA affects therapy for couples where one member suffers from PTSD. The study's corresponding author Candice Monson said the proof-of-concept trial came about organically from earlier MDMA for PTSD research.

"PTSD in one partner can cause distress in the relationship and barriers to understanding each other," said Monson. "It seems that MDMA-assisted psychotherapy can engender empathy and connection, opening a pathway to remembering why [the couple] came together in the first place and a desire to understand the other."

The initial study researched the viability of integrating two MDMA sessions into one previously established PTSD regime of therapy called CBCT — short for cognitive-behavioral conjoint therapy. In contrast to traditional PTSD therapies — which emphasize the individual — CBCT aims to improve relationship functioning for couples, while still improving PTSD symptoms in the afflicted patient, New Atlas reports.

MDMA can help 'guide couples' to 'openness, empathy'

The study describes a trial involving six recruited couples — one member of each having a pre-existing PTSD diagnosis — and investigated the possibility of integrating MDMA sessions into CBCT procedure, which typically includes roughly 15 therapy sessions carried out through several months.

"The literature that inspired this study suggests that MDMA may allow people to talk about painful experiences without experiencing the pain again," said Monson. "The therapist can guide couples to talk about very difficult things that they've either experienced themselves or experienced together — against the other or with the other — with a greater sense of understanding, openness, connection, and empathy."

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Feasibility study established safety for MDMA in PTSD treatments

The recent study shows how the integration of MDMA in couples therapy procedure brought about effects "on par with, or greater than, those achieved with CBCT alone," said Monson in the study. Noted improvements in both the outcomes of the relationships and individual PTSD symptoms were made. The most significant effects were seen at the six-month follow-up, which suggests MDMA therapy enables crucial long-term improvements.

Notably, the study was uncontrolled — which means comparisons in efficacy to CBCT alone will only come about via an examination of earlier CBCT studies. But this viability study establishes the safety of MDMA to pre-existing therapeutic procedures without negatively interfering with other PTSD treatments.

Combining MDMA with CBCT helped couple confront trauma

An earlier case study — published in the Journal of Psychoactive Drugs examined the experiences of one couple during this preliminary trial. The relevant couple — called Stuart and Josie — suffered from relationship issues after Stuart's trauma-related PTSD symptoms happened.

"For Josie, the CBCT + MDMA experience allowed her the opportunity to no longer feel she had to 'walk on eggshells,' and to experience relief from anxiety and tension," said the case study. "Together, Stuart and Josie were able to share the experience of Stuart's traumatic memories, and face them in a united and accepting manner."

Next step to study MDMA with PTSD across diverse issues

This pilot study saw improvements in PTSD symptoms greater than those observed in numerous individually-delivered MDMA-assisted psychotherapy for PTSD trials. Naturally, this pilot study was very small, so it isn't exceedingly tenable to compare its efficacy to those studies involving larger and ongoing trials. But the interpersonal nature of PTSD — in addition to how it affects close relationships — implies a significant potential for therapeutic protocol to enhance treatment outcomes.

At present, the research team is developing a larger and randomized controlled trial, called Phase 2. After this is completed, the team aims to explore the efficacy and safety of MDMA-facilitated CBCT for PTSD in participants showing a more diverse spectrum of relationship issues.

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