Could MDMA save your marriage?
The feeling washed over her. Light, pink and sparkly, it was a longed-for contrast with a year cloaked in darkness.
Caught up in the emotional maelstrom of losing a child, Lucie* had drifted from the man she loved. But now she gazed at her partner of five years, sitting wide-eyed on a pile of cushions in their home, and all she could feel was gratitude. ‘I had a profound sense that we were going to be okay,’ says the 36-year-old copywriter from Bristol. ‘It forced me to surrender all the heavy feelings I’d held.’
The mind-altering intervention lightening Lucie’s mental load wasn’t a new mindfulness app or biohacking regime, but MDMA – the illegal drug linked to dance music culture now getting rave reviews in therapeutic settings.
Alongside psychedelics such as ketamine and psilocybin (the active ingredient in magic mushrooms), MDMA research has shown promising results for treating addictions, eating disorders and PTSD.
The American Food and Drug Administration granted MDMA ‘breakthrough therapy’ status for PTSD in 2017 – a classification only awarded when evidence supports a substantial advantage over existing drugs. And since Australia legalised medical-use psychedelics last year (psychiatrists can prescribe MDMA for PTSD and psilocybin for treatment-resistant depression), the UK’s former chief scientific adviser and current government minister for science, Sir Patrick Vallance, has thrown his support behind studying MDMA as a treatment for depression.
Now, the same neurobiological processes that have seen psychedelics show promise in
the treatment of mental health conditions are seeing dance-floor drugs such as MDMA make moves in couples therapy. By boosting feel-good neurotransmitters and quelling brain regions that react to threats, it’s thought that the drugs could bolster the health of the very thing that gives daily lives meaning: relationships. It’s an intriguing idea in a time when long-term love feels harder than extricating yourself from a joint mortgage.
Research published by Experian back in March found that financial pressures were to blame for one in five 18- to 35-year-olds ending a relationship, while a third admitted they were only staying together out of fear of being unable to afford living alone. That more than half of therapists accredited with the British Association for Counselling and Psychotherapy have reported an increase in clients presenting with relationship issues speaks to a need for alternative ways to make monogamy feel good. But is psychedelic-assisted therapy’s relational pivot the connective salve practitioners posit it to be? Or is MDMA a relational red flag?
Hit the high road
If drug-assisted couples therapy sounds like the stuff of dystopian reality TV, it’s already happening. At Beautiful Space – a psychedelic-assisted wellness clinic in Amsterdam, where psilocybin truffles are legal – the three-month online therapy programme features an in-person experience on the drug. The day before, a therapist conducts a preparatory breathwork ceremony, followed by a psilocybin trip lasting four to six hours. Couples maintain physical contact (nothing sexual) while a therapist guides their conversation, along with any adverse reactions. The following day, a two-hour counselling session provides an opportunity to integrate what came up, followed by three more talking sessions online. And deep work requires deep pockets; packages are priced from £5,990.
‘Our programme starts with the individual, looking at family and traumas, then we work on what’s acting out in the relationship,’ says therapist Sarah Tilley, the British founder of Beautiful Space, who’s worked with plant medicine and altered states for two decades. Tilley likens psychedelic therapy to a snow globe. ‘First, through talking therapy, we’re shaking it up. Then you take the medicine and everything we’ve shaken up begins to settle and you see things with a new eye.’ While mainstream couples therapy is typically ongoing and cyclical, notes Tilley, psychedelics manipulate brain chemistry to swerve the defensiveness or self-consciousness that precedes clamming up.
Tilley’s ingestibles may be left field, but her clientele isn’t. Couples are typically struggling with intimacy after the exhaustion of early years parenting, adjusting to perimenopause or menopause or embracing career changes or empty nests – and their goals tick the hard-relate box: ‘Learning how to transform into that next phase rather than separating,’ Tilley summarises, adding that almost 80% of the couples she’s worked with have successfully done so. But perhaps what’s most promising is that Tilley’s clinic, which sounds about as experimental, out-there and controversial as it gets, has a legitimate academic partner: Imperial College London.
Make a song and trance about it
While the university isn’t sponsoring Beautiful Space’s psychedelic programme – nor
is it responsible for it – over the next two years, it will collect observational data on the couples who enrol, with the aim of understanding exactly how the combination of psilocybin and psychological support could improve relationship wellbeing.
It’s the latest line of investigation from Imperial College’s Centre for Psychedelic Research that, alongside operating clinical studies on psychedelics’ role in alleviating conditions such as chronic pain and anorexia, is branching into the health of human relationships.
In February, it published research showing that psilocybin could improve sexual function. Participants who’d taken the drug self-reported finding it easier to talk to their partner during sex, enjoying more frequent pleasure and feeling more confident about their appearance. ‘Psilocybin reduces ruminative thinking, making people less distracted, and we know that one of the best treatments for sexual dysfunction is mindfulness training,’ says study lead Tommaso Barba. Now, the team wants to know how psychedelics affect intimacy and attachment styles beyond the bedroom.
Its Psychedelic Couples Study, open to participation at the time of writing, asks couples who are planning to take psychedelics to record the impact on their relationship before, during and after. ‘The idea is that MDMA, which decreases the fear response and increases trustworthiness and connection, could create an environment in which couples discuss relationship problems without having the normal fight-or-flight response,’ Barba explains, optimistically. It’s a field where lab data is sparse, albeit encouraging. A 2021 trial that guided six couples through MDMA-assisted therapy (in each couple, one partner had PTSD) found improvements in support, intimacy and conflict reduction.
The theory goes that by stimulating mood-regulating serotonin – which in turn releases oxytocin, the key neuromodulator for closeness – MDMA allows the amygdala (the almond-shaped brain region responsible for your fear response) to process fearful memories without either partner withdrawing from the conversation. In other words, imagine having a deep-and-meaningful without your partner putting their walls up.
Take a chill pill
Part of the new wave of couples DIY-ing the tactic, Lucie was uneasy before taking MDMA. She’d only ever dabbled with drugs at parties in her twenties, but her partner, Gray*, had taken psychedelics with friends and described those experiences as some of the most enlightening of his life. Ultimately, it was the doula who’d supported the couple through pregnancy and pregnancy loss – herself a therapist who’d used psychedelics with clients, in countries where it’s legal – who gifted the pair a small pouch containing MDMA.
Lucie recalls feeling an overwhelming closeness to Gray and their absent child during the drug trip. ‘I felt connected to my baby and had such gratitude for our lovely relationship. It reminded me who we were before our grief.’ In the weeks that followed, Gray says Lucie was the most content he’d ever seen her, and they both cite the experience (which they haven’t yet repeated) as the most magical thing they’ve ever done for their relationship.
Emma can relate. The 34-year-old from Leeds, who’s in her final year of training to be a sex and relationship therapist, was curious professionally and personally. She’d taken psychedelics before (always in a country where it was legal), and a few years ago decided to use them with her partner of five and a half years to discuss potential crossroads in their relationship, such as opening it up to new partners. ‘I have an anxious attachment style and a tendency to ruminate, but psilocybin brings me into my body,’ she says, adding that it also helped her dismantle entrenched beliefs.
‘My partner and I have been trying to work through the narrative that we both deserve sexual pleasure,’ she explains. The couple now hire a cottage every year in a country where psychedelics are legal, often joined by therapist friends, to do a relationship audit. Even off the drugs, Emma says they’re more compassionate broaching difficult subjects. Above all, psychedelic sessions have helped the couple unpick the ways they’d been told they ‘should’ live and figure out their own path.
A woman of substances
The rave reviews for the drug’s effectiveness as a relational intervention are largely anecdotal, but a few mental health professionals are tentatively on board, too. ‘If psychedelics can help reduce someone’s defensiveness, enable them to be more introspective and reduce the fear that they might get emotionally hurt, that could prove really helpful,’ offers Miranda Christophers, accredited psychosexual and relationship therapist and founder and clinical director of The Therapy Yard. But her tentative endorsement comes with a caveat. ‘So much more research is needed.’
For one, the lack of regulation is a bitter pill to swallow. Research in clinical settings uses the pure substance in meticulously measured doses, whereas illegal drugs are a lottery. MDMA can trigger panic attacks, seizures and a loss of consciousness; the dangers with magic mushrooms include accidentally eating a poisonous variety, along with nausea, stomach cramps and a loss of control. That psychedelics are also more likely to trigger a psychotic episode if you have a personal or family history of schizophrenia or bipolar disorder is the reason academics exclude people with such medical histories from psilocybin trials.
Consider, too, that everyone’s mental journey is unpredictable. Psilocybin amplifies emotions; go into a trip angry or sad, warns Tilley, and those emotions will loom large. That’s why it’s vital to have a professional to guide you: not just through a bad trip, but what emerges in the aftermath. Imagine, for example, that one of you confesses to an affair. In Tilly’s clinic, sudden confessions are unlikely, thanks to a confidential session with each person prior to the experience with the goal of flagging any potentially damaging information. Without this kind of professional support, the stress of hiding a secret can turn a trip into hours of paranoia. Even as a therapist in training, one of Emma’s early experiences on psilocybin brought up so much grief that she didn’t think she was going to pull through it.
Even returning from a good trip could lumber you with unexpected baggage. Tilley tells WH that she’s guided couples who’ve gone on to break up, while Barba recalls one man who realised during an MDMA trip that he wasn’t in love with his girlfriend. That it’s hard to identify what constitutes a good outcome in matters of relationship restoration is one reason quantifying study results proves so difficult; if a trip reveals a couple to be incompatible, it could be considered a good thing for both parties in the long run, but that doesn’t make the break-up any less painful.
‘You’d need to screen for domestic abuse and make sure you don’t end up chaining together dysfunctional relationships with drugs,’ adds Barba, of one of the many ethical implications, should psychedelic-assisted couples therapy become a legal possibility. Such fears aren’t hypothetical, either; the case of a tech millionaire who was alleged to have exploited his ex-partner’s MDMA-induced vulnerability in order to get her to sign a separation agreement, earlier this year, highlighted the issue of coercive control under psychedelics.
Open your mind
That MDMA remains a class A drug in the UK – illegal under the Misuse of Drugs Act – means a scenario in which you’re offered it in a therapist’s office alongside a box
of tissues is unlikely. At least for now. Anna Machin, an evolutionary anthropologist at the University of Oxford, speculates that an oxytocin nose spray to engineer closeness between couples could become available within a decade, with MDMA featuring in some forms of therapy if ethical concerns can be ironed out. In the meantime, the risks of self-medicating monogamy with illicit substances – both for your health and your liberty – make for a strong case for watching this space.
None of the women WH spoke to for this piece found psychedelics to be a silver bullet for their relationship, nor did they speak of a single trip that made everything feel rosier; their experiences, much like their relationships, were complicated. But if their stories share a common thread, it’s a desire to work on a concept that’s central to any well-functioning relationship; one that’s cited in divorce proceedings more than any other: communication.
Read next: How to boost your sense of self-worth
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