MDMA: A Love Potion Re-emerged?
Associated with illegal rave culture and heavy D&B, MDMA, also known streetwise as "ecstasy" and "molly", may seem an unlikely suspect for aiding couples counselling. However, being capable of inducing intense feelings of connection and the comfortability to talk openly about deep issues in its users, this so-called "party drug" makes a perfect candidate.
MDMA is often associated with rave culture and electronic dance music
The research shining a light on the therapeutic applications of various psychedelics is ever-growing. As with classical psychedelics, like LSD and psilocybin, MDMA has been a key contributing molecule to psychedelic research, both pre-criminalisation, and in today's ongoing psychedelic renaissance. Use in couples-based psychotherapy is by no means a modern utilisation of the drug. However, it is one of the less well-known applications in MDMA-research today. With increasing advocacy for MDMA-therapy to treat trauma and addiction, may we predict a re-emergence of MDMA in relationship counselling?
History of MDMA use in couples therapy
In the late 1970s, Sasha Shulgin, also known as "the godfather of ecstasy" synthesised various compounds, based on the structure of mescaline, which included MDMA. Shulgin introduced MDMA to psychedelic researcher Leo Zeff, who saw MDMA as a perfect contender for psychotherapy, which could aid patients with personal and spiritual development. For twelve-years, Zeff administered MDMA to about 4000 people and trained over 150 therapists including Shulgin's wife, Anne.
Leo Zeff, also known as the “secret chief” for his underground work in psychedelic therapy
MDMA was introduced as a couples counselling aid in 1980 by psychedelic-therapist Rick Ingrasci, who was searching for new compounds to use in therapy since President Nixon banned LSD and psilocybin research in 1971. From 1980 to 1985 he conducted over 150 therapy sessions with MDMA, a third of which were with couples. Ingrasci saw MDMA as a tool to help partners better communicate with one another, quoting:
"I have seen MDMA help many couples break through long-standing communication blocks because of the safety that emerges in the session as a result of the drug".
As well as being a catalyst for open and honest communication, Ingrasci hypothesised that, because patients stay highly cognitive-functioning whilst on the drug, their insights during the session would be incorporated into everyday life.
In 1985, MDMA was made illegal. But underground therapists continued to use the drug. Friederike Meckel Fischer was one of these therapists, who led well-crafted LSD and MDMA group therapy sessions, which included couples. Her unfortunate arrest in 2009 discontinued her practical therapeutic work. Yet, since her release, she has continued to inform and educate others about psychedelic substances' healing potentials, notably MDMA for couples therapy. In a recent interview she quoted:
"The MDMA is, as I used to say, the gold for the relationship."
Underground therapist and educational advocate of psychedelic therapy, Friederike Meckel Fischer
Why MDMA?
So what is it about MDMA that makes it so great for aiding couples therapy? MDMA decreases activity in the amygdala, an area of the brain responsible for fear, allowing couples to feel more at ease, and confident to talk about different issues. This also explains why MDMA has been found to be a promising treatment for post-traumatic stress disorder (PTSD), as PTSD patients often have a hyperactive amygdala, meaning anything which reminds them of the traumatic event causes an over-arousal of the fear response. However, by dampening this area down with MDMA, patients can talk about their traumatic experience with a psychotherapist, without the extreme fear and anxiety attached.
Brain scan from imperial study showing how MDMA decreases activity in the brain area containing the amygdala
Kate Anderson, who researched MDMA-based couples therapy for her PhD at London South University, describes that the dampening of amygdala activity means couples who MDMA together experience being “sheltered in a bubble.” Feeling sheltered and safe, this allows counterparts to be vulnerable, and open up about deep and personal issues affecting the relationship.
On a neurochemical level, MDMA has been shown to increase levels of oxytocin, also known as “the love molecule and released during the initial bonding between mother and baby post-labour. Oxytocin is linked to various psychological functions which are crucial for relationships, including empathy, trust, and processing bonding cues. One study suggested oxytocin was vital for relationship attachment, showing that couples in the first stages of a romantic relationship had significantly higher oxytocin levels than non-couples.
Beyond acting as a love-catalyst, re-igniting lost sparks, oxytocin could also contribute to successful talk therapy. For example, one piece of research found that giving couples intranasal oxytocin, before having a conversation about a conflict, increased the ratio of positive to negative communication behaviours.
Dr Ben Sessa, who is leading the ongoing MDMA for alcoholism studies, shared with us this quote:
“Two of the major neurophysiological effects of MDMA are its capacity to turn off the brain’s fear centre, the amygdala, and its effect of releasing oxytocin - the hormone secreted from the brains of breast-feeding mothers - from the hypothalamus.
In combination, these effects foster an intense experience of attachment and bonding. MDMA, when taken together with an intimate partner, provides a wonderful platform for connectivity and shared empathy.
Couples who have found themselves stuck in rigid narratives of point-counter-point stubborn misunderstanding after years of stolid relationship stagnation, can, on MDMA, come together and reflect upon, challenge and resolve old patterns of relationship dynamics.
This medicine has incredible potential for healing oneself and one’s connectivity with loved ones.”
Footage from our documentary visiting the MDMA research clinic in Bristol
Looking to the future of MDMA-therapy
Psychiatrists and therapists are re-evaluating MDMA as an essential therapeutic aid. However, being a schedule 1 drug, there are still many barriers bringing MDMA into mainstream healthcare and therapy. Since being moved to schedule 1, the Multidisciplinary Association for Psychedelic Studies (MAPS) have been working towards MDMA approval as a licensed treatment. With success, Rick Doblin, the founder of MAPS, announced in December 2020 MAPS obtained FDA-approval for phase 3 MDMA-psychotherapy studies in PTSD, a considerable advancement towards legalising the drug for medical purposes.
However, before medical rescheduling, more research needs to be conducted, and policymakers must carefully decipher which models MDMA could be legal and regulated. It is likely MDMA will emerge first as a treatment for PTSD, as most MDMA research has focused on this area. However, once approved and shown to be both safe and effective, MDMA may serve as a fully legal licensed medicine for a large sphere of conditions. Following the current trajectories, Doblin predicts we could expect to see licensed legalisation of MDMA, and other classical psychedelics, by 2035.
An aid and not a solution
The research showing that MDMA is useful for couples is in the context of therapy. Like with all psychedelic medicines, the drugs themselves are not the solution. Instead, they are tools which assist talking therapy. Regardless of the setting, MDMA may still elicit open, and honest conversations between couples. However, integrating the experience and working under a well-established framework is likely to lead to longer-lasting and more significant outcomes.
Meckel-Fischer recognised the importance of integration and putting in work towards relationship improvement, outside of the drug experience:
"…if we can really first find this true, deeply rooted love, and then talk together and learn to interact, first in the session, and then practicing in everyday life, to install the understanding of each other, and taking the other as he is, without wanting to change him anymore. That's a very good outcome."
Couples support has been tried and tested with success. And for those looking for help with their relationship, finding a therapist should certainly be a first-line option.
Being aware of the risks
MDMA is NOT ecstasy. MDMA sold in ecstasy pills contains various harmful impurities, including amphetamines and caffeine, great for all-night raving, but not so much counselling support.
Even in its "pure" form, any drug bought illegally can never be guaranteed to be pure. And the pure substance itself still has it's dangers. It is crucial that couples looking to experiment together with illegal drugs, such as MDMA, know the risks. And with a body of harm-reduction information available on the internet, learning how to avoid such risks is also imperative.
Born and clinically tested in the open laboratories, MDMA journeyed to party-goers in the 80s acid house scene. After the criminal law feat, the drug has mostly remained underground in the hands of "street drug" black market and illegal raves. However, MDMA is making a full circle as it returns openly to the clinic. And perhaps in the not too distant future, inside the wooden drawer under the couples-therapists desk.
MDMA holds the potential to decrease communication barriers between romantic partners. In talk therapy, it catalyses oneself to return to an emotive, uninhibited state of love, free from blockages. In light of such capacity, a rather fitting quote from Rumi to close with a little inspiration goes:
"Your task is not to seek for love, but merely to seek and find all the barriers within yourself that you have built against it."