Combining Cognitive-Behavioral Conjoint Therapy for PTSD with 3,4-Methylenedioxymethamphetamine (MDMA): A Case Example
Mithoefer, A. T., Mithoefer, M. C., Monson, C. M., Wagner, A. C.
This case study (n=2) describes the treatment methodology of MDMA (112.5mg) -assisted Cognitive-Behavioral Conjoint Therapy administered to a PTSD patient in conjunction with his romantic partner. Through the therapeutic context, set, and setting that entailed multiple days of participant engagement and the empathy-inducing effects of the MDMA, the procedure created strong therapeutic bonds between the couple and the therapists and facilitated the resolution of PTSD symptoms and improvement in relationship satisfaction.
Abstract
Introduction: Treatments for posttraumatic stress disorder (PTSD) have evolved significantly in the past 35 years. From what was historically viewed as a pervasive, intractable condition have emerged multiple evidence-based intervention options. These treatments, predominantly cognitive behavioral in orientation, provide significant symptom improvement in 50-60% of recipients. The treatment of PTSD with MDMA-assisted psychotherapy using a supportive, non-directive approach has yielded promising results. It is unknown, however, how different therapeutic modalities could impact or improve outcomes.Methods: Therefore, to capitalize on the strengths of both approaches, Cognitive Behavioral Conjoint Therapy for PTSD (CBCT) was combined with MDMA in a small pilot trial.Results: The current article provides a case study of one couple involved in the trial, chosen to provide a demographically representative example of the study participants and a case with a severe trauma history, to offer a detailed account of the methodology and choices made to integrate CBCT and MDMA, as well as an account of their experience through the treatment and their treatment gains.Discussion: This article offers a description of the combination of CBCT for PTSD and MDMA, and demonstrates that it can produce reductions in PTSD symptoms and improvements in relationship satisfaction.