The Boost Psychedelics add to Couples Therapy

Research proves that psychedelics have mental health benefits. As such, scientists are exploring their potential to help couples. For example, studies suggest that the substances promote more organic conversations and openness around trauma. 

In fact, psychedelic-assisted therapy sessions were once common. According to New Atlas, the idea of couples counseling with MDMA first took off in the 1970s and 1980s. 

As a study in Sage Journal further explains, many psychotherapists took to finding the therapeutic uses of MDMA around this time, like psychotherapists Leo Zeff, Ann Shulgin, Claudio Naranjo, and many more. Various researchers were interested in its therapeutic effect, especially its impacts on couples, effects on the psyche and subconscious, expressing feelings and more.

MDMA was used in psychotherapy because of its empathogenic qualities, which help increase feelings of empathy and connectedness, the Alcohol and Drug Foundation explains. However, U.S. officials added MDMA to the list of schedule I controlled substances. Schedule I substances have no recognized medical value, and are illegal. 

As such, psychedelic therapy is not currently legal with substances like MDMA — but is available using ketamine. Ketamine is a federally-approved anesthetic. 

Since the 1960s, ketamine has been legal for registered practitioners for surgical and therapeutic use, according to Mind Bloom. While ketamine is illegal in non-clinical settings, it has been an FDA-approved anesthetic since 1970. It has vast antianxiety and antidepressant capabilities, especially for those who have developed a resistance to other drugs.

Ketamine-assisted therapy “can benefit patients with a wide variety of diagnoses when administered with psychotherapy and using its psychedelic properties without need for intravenous (IV) access,” according to the Journal of Psychoactive Drugs. The study found that this form of therapy decreases anxiety and depression, even for those with extreme symptoms.

According to a Frontiers in Psychology review, two-thirds of participants reported improved relationships with their loved ones after using psychedelics.

In that same review, researchers found that MDMA-assisted couples therapy fosters empathy, communication, social connection, non-avoidance, openness, social intimacy and relationship satisfaction. 

In the brain, psychedelics align with the same neural pathways associated with qualities like interpersonal trust, attachment, bonding and forming affection, according to Frontiers in Psychology. The psychedelics reactivate the neurochemical routes and create emotional, cognitive, behavioral and somatic improvements.

The review also explains how psychedelics in couples counseling have benefits like increasing attention to positive emotional cues, decreasing defensiveness and reducing anxiety. They also enhance feelings of closeness, reduce fear, and increase both introspection and cooperation.

It’s also important, however, to engage in this kind of counseling with a professional and focus on the Setting, Structure and Safety, Exploration and Experience, Template and Trust model (The SET Model). This means that couples must establish a sound setting and structure to ensure safety, and work with a professional. They must also set boundaries to work on exploration, curiosity and openness. It’s also essential to create a template for trust and effective communication. Experts believe this model is essential to the safety and comfort of participants.

Jayne Gumpel, who works with New York’s Woodstock Therapy Center in ketamine-assisted psychotherapy, emphasized the importance of a safe environment.

“If you are interested, make sure it’s with a licensed provider,” she told Emerald. “Ketamine is the only legal way to do this.” 

For her process, she meets with couples for a few sessions before engaging with ketamine. She gets consent; tells people how everything works; talks through their expectations; answers questions, and more. This background work ensures couples can communicate in a healthy way with intentional dialogue.

After the preparatory sessions, she will prescribe a dose of ketamine. From there, they will take it under Gumpel’s supervision. Sessions last around 1.5 hours.

“For couples that are stuck, it loosens things up and helps them get out of long time patterns that they’re attached to,” Gumpel said. It’s another way to see into the relationship.

These couples drop their defenses and see each other deeply in a safe way. 

“There’s no such thing as a bad trip,” Humpel explained. “If you understand beforehand what the medicine is about, what to expect, what your intention is and you feel safe — when you get to a place that feels kind of scary, you’ll be encouraged to breathe into it, take a look at it and learn from it.” 

Any anxiety during the experience could be visiting past trauma, she added. “The medicine is the gift of the experience without the muck getting in the way.” 

Afterward, couples can reflect during a non-dosing session and learn more about the experience through integration. Integration is the chance to sit down with what happened and unpack it in an ordinary state of consciousness with someone like a therapist. Then, people can take what they’ve learned into their lives. 

Research shows that psychedelics are effective in couples therapy because their effects mimic those of neurotransmitters and other hormones in the body. They give people a chance to talk about their trauma in a more open way and encourage strengthening and healing interpersonal relationships, according to the Frontiers in Psychology review.

The Multidisciplinary Association for Psychedelic Studies (MAPS) conducted a study combining cognitive-behavioral conjoint therapy (CBCT) and MDMA to evaluate post traumatic stress disorder (PTSD) symptoms. CBCT alone helps treat PTSD; it’s done with a family member or partner to improve relationships, according to the U.S. Department of Veteran Affairs.

The MAPS study showed that using MDMA with CBCT improved depression, sleep, emotional regulation and trauma, promoting overall happiness. It was able to facilitate trauma recovery and help partners have more empathy, strengthen their connection, remember why they came together, and talk about painful experiences without directly feeling the pain.

Looking ahead, according to New Atlas, groups like MAPS will conduct more studies with a larger set of diverse participants who have varying levels of relationship distress. Because MDMA therapy is not yet legal, the opportunity is not immediately available.

In the meantime, psychedelic-assisted couples counseling may improve qualities of life and help cope with mental health issues. It may just be a future tool to help people overcome relationship obstacles.