MDMA-assisted cognitive-behavioral therapy may help couples overcome PTSD

Post-traumatic stress disorder (PTSD) affects roughly 7 million people in the United States alone. It is associated with a variety of comorbid conditions, including depression, anxiety, and increased risk of heart attack. Developing effective new therapies to combat it is thus an essential activity.

In a study published in the European Journal of Psychotraumatology, six couples participated in accelerated Cognitive-Behavioral Conjoint Therapy (CBCT), two session of which occurred while under the influence of 3,4-methyl​enedioxy​methamphetamine, more commonly known as MDMA. In each of the six couples, one partner had been diagnosed with PTSD.

Conjoint CBT has been shown to be particularly effective in the treatment of PTSD, focusing on “the relationship between the participants as the treatment target,” such that couples develop their skills “as a dyad, both in terms of communication as well as reduction of avoidance and challenging of beliefs.”

MDMA was selected for the study for its empathogenic qualities, that is, the fact that it enhances feelings of emotional connectedness and togetherness. The administration of MDMA was timed to coincide with certain related aspects of the CBCT interventions (like the development of communication skills).

The study’s results revealed “significant and sustained improvements” in PTSD, as assessed by clinicians and according to self- and partner-rated symptoms. Overall depression, emotion regulation, and trauma-related beliefs improved markedly.

While the study is the first of its kind, both its power and generalizability are quite low, given it involved only 12 participants, all of whom were Caucasian and in heterosexual couples. Additionally, there were no control groups, which makes it impossible to ascertain whether MDMA-assisted CBCT out- or underperforms relative to traditional CBCT.

At the very most, we can only say that facilitating CBCT with MDMA does not hinder its efficacy, so additional research will be needed to better understand its impact and, of course, exactly how it interacts with therapy and outcomes.

The paper, “MDMA-facilitated cognitive-behavioural conjoint therapy for posttraumatic stress disorder: an uncontrolled trial”, was published by Candice M. Monson et al in December, 2020.