Relational and Growth Outcomes Following Couples Therapy With MDMA for PTSD

Abstract

Healing from trauma occurs in a relational context, and the impacts of traumatic experiences that result in post-traumatic stress disorder (PTSD) go beyond the diagnosis itself. To fully understand a treatment for PTSD, understanding its impact on interpersonal, relational, and growth outcomes yields a more fulsome picture of the effects of the treatment. The current paper examines these secondary outcomes of a pilot trial of Cognitive Behavioral Conjoint Therapy (CBCT) for PTSD with MDMA. Six romantic dyads, where one partner had PTSD, undertook a course of treatment combining CBCT for PTSD with two MDMA psychotherapy sessions. Outcomes were assessed at mid-treatment, post-treatment, and 3- and 6-month follow-up. Both partners reported improvements in post-traumatic growth, relational support, and social intimacy. Partners reported reduced behavioral accommodation and conflict in the relationship, and patients with PTSD reported improved psychosocial functioning and empathic concern. These improvements were maintained throughout the follow-up period. These findings suggest that CBCT for PTSD with MDMA has significant effect on relational and growth outcomes in this pilot sample. Improvements in these domains is central to a holistic recovery from traumatic experiences, and lends support to the utility of treating PTSD dyadically.

Psychedelic-Assisted Psychotherapy—A Systematic Review of Associated Psychological Interventions

“…Depression, emotion regulation, trauma-related beliefs along with patient and partner satisfaction also improved. Subsequent analyses revealed improvements in post-traumatic growth measures, relational support, social intimacy as well as greater wellbeing within the couple, improved psychosocial functioning and empathic concern (Wagner et al, 2021).…”

“…Our search identified 3 papers on an observational study testing the efficacy of psychedelic-assisted CBCT in the treatment of couples in which one member suffered from PTSD (Wagner et al, , 2021. CBCT (Monson and Fredman, 2012) is a treatment model for PTSD which, instead of focusing on patients alone, recruits their intimate partners in an attempt to improve treatment outcomes.…”

Couple Therapy With MDMA—Proposed Pathways of Action

“…MDMA helps increase cooperation and feelings of trustworthiness (Stewart et al, 2014;Gabay et al, 2019). Increased experience of social intimacy following MDMA-assisted couple therapy (Wagner et al, 2021) Couple engaging in the whole process together…”

“…Improved relationship satisfaction, decreased distress in MDMA-assisted couple therapy (Monson et al, 2020;Wagner et al, 2021) Encouraging shared experiences, engagement together in the therapeutic process having clarity of thought without becoming overwhelmed by the emotions that the thoughts may typically elicit (Wagner et al, 2019). Neuroimaging results demonstrate that negative memories may be perceived as more tolerable following MDMA (Carhart-Harris et al, 2014).…”

“…One pilot trial has been conducted for MDMA-assisted Cognitive Behavioral Conjoint Therapy (CBCT) for PTSD, wherein both partners participated in the entire protocol, including MDMA-assisted sessions. Findings from the study include improved PTSD scores, relationship satisfaction, posttraumatic growth, and improved social intimacy for the partner with PTSD (Monson et al, 2020 ; Wagner et al, 2021 ). These pilot trial results are promising, and suggest the potential for non-diagnostic specific MDMA-assisted couple therapy, given the significant improvements in relationally oriented outcome measures.…”