Psychedelic Medicine


MDMA-Assisted Couples Therapy with Kayla Knopp, PhD


In this episode of the Psychedelic Medicine Podcast Kayla Knopp joins to explore the topic of MDMA-Assisted Couples Therapy. Dr. Kayla Knopp is a clinical psychologist and researcher specializing in non-traditional couples and relationships. She specializes in making couple therapies more inclusive, accessible, and effective, including MDMA- and ketamine-assisted couple therapy.

In this conversation, Dr. Knopp introduces MDMA-assisted couples therapy, discussing why this entactogen is a good fit for couples therapy. She discusses how MDMA helps couples explore issues by dissolving typical defensive boundaries and encouraging empathy. She emphasizes that not all couples may be a good fit for this therapy, however, and especially cautions against couples therapy in contexts of abuse where connecting with resources for safety and pursuing individual courses of therapy is more appropriate. In closing, Dr. Knopp discusses the importance of screening and the responsibility the psychedelic community has to ensure these substances are being used in safe and effective therapeutic contexts overseen by qualified and caring facilitators.

In This Episode

• The history of MDMA-assisted couples therapy
• When couple therapy is and is not appropriate
• Integrating MDMA-assisted therapy with cognitive-behavioral conjoint therapy for PTSD
• Therapeutic modalities which may be well-suited to MDMA-assisted couples therapy


“[MDMA] does so many things that are facilitative of the primary goals of couples therapy, which are to reduce defensiveness, to increase the flexibility that we have in taking our partner’s perspective, increase the empathy and intimacy we feel with other people, increase the reward that we get from positive interpersonal interactions.” [4:33]

“When we treat relationship dysfunction, we know mental health often improves as a result of that and conversely, we also know that sometimes when we do mental health treatments, if we ignore the relational context that somebody is living in, we only give them part of what they need in order to fully heal psychiatrically. So, couple-based interventions for mental health disorders, including PTSD, are up-and-coming as a really effective way to address mental health concerns.” [8:14]

“MDMA tends to increase our window of tolerance for emotional experiences—it makes it safer and easier for us to remain in contact with feelings that might otherwise feel pretty overwhelming.” [23:48]


* The Psychedelic Medicine Podcast has allowed the Psychedelic Medicine Association to post episodes as an educational resource, and in return the PMA is hosting the podcast show notes.