Can Psychedelics Help Heal a Broken Relationship?

This article explores the potential of using psilocybin and MDMA in a therapeutic setting to help couples navigate the complex challenges of substance use disorders and codependency, and repair their relationship dynamic.

Synopsis

A 2025 narrative review in Contemporary Family Therapy proposes a novel approach to couples therapy where psilocybin is used to treat a partner’s substance use disorder, while MDMA is used to address codependency in the other partner. This dual approach, grounded in family systems theory, recognizes that addiction is a relational problem and aims to heal both individuals and the partnership itself.

When Addiction Enters a Relationship

When one partner in a relationship struggles with a substance use disorder (SUD), the effects ripple outward, profoundly impacting the other partner and the health of the relationship itself. The non-using partner often develops codependent behaviors, taking on the consequences of the addiction and losing their own sense of self in an effort to control the situation. This creates a painful, self-reinforcing cycle where the addiction and the codependency feed off each other, making true recovery for either individual—let alone the couple—feel impossible.

Traditional therapy often treats these as separate issues, focusing on the individual with the SUD in one context and the partner with codependency in another. But what if there was a way to treat both partners simultaneously, addressing the dysfunctional dynamic that holds them captive? Emerging research into psychedelic-assisted therapy suggests a powerful new path forward for couples in crisis.

A Dual Approach to Healing

A groundbreaking 2025 paper in the journal Contemporary Family Therapy outlines a theoretical model for using two different psychedelic compounds to heal the two sides of a dysfunctional relationship dynamic (1). The authors propose a form of couples therapy where psilocybin-assisted therapy is used to help the partner with the SUD, while MDMA-assisted therapy is used to help the partner struggling with codependency. This innovative approach is rooted in family systems theory, which views the couple as an interconnected system where the health of one person directly affects the other.

By treating both the addiction and the codependency at the same time, this model aims to break the cycle and create a new, healthier dynamic. It acknowledges that you can’t fix one part of the system without addressing the other. The goal is to accelerate recovery by healing the systemic issues that keep the couple stuck.

How Psilocybin and MDMA Could Work Together

The proposed therapy leverages the unique properties of each substance to target different aspects of the relational problem. Psilocybin has shown significant promise in treating SUDs, including addiction to alcohol and nicotine. It is believed to work by disrupting rigid patterns of thought and behavior, increasing motivation to change, and provoking profound insights that can lead to long-term recovery.

MDMA, on the other hand, is known for its ability to increase feelings of empathy, connection, and emotional openness while reducing fear. This makes it a potentially ideal tool for addressing the trauma and emotional inhibition often associated with codependency. An anecdotal account from psychiatrist Dr. Julie Holland describes a woman with codependent traits who, after MDMA-assisted therapy, was better able to understand her husband’s psychological issues and transform their relationship (2). The MDMA appeared to ease her emotional restraints, allowing for a new level of insight and connection.

The Science of a Broken System

Family systems theory helps us understand why this dual approach is so compelling. It posits that a family or a couple is an emotional unit, and that the behavior of one member cannot be fully understood in isolation. When one person has an SUD, the other often adapts by developing codependent traits. The codependent partner might enable the substance use, make excuses, or sacrifice their own needs to maintain a sense of stability, however dysfunctional.

This creates what researchers call a state of "pathological homeostasis," where the couple is stuck in a painful but stable pattern. The 2025 review notes that in these dynamics, the codependent individual can develop an "addiction to the partner," becoming just as trapped as the person with the SUD (1). Psychedelic-assisted couples therapy aims to disrupt this unhealthy equilibrium and help the couple find a new, healthier way of relating to one another.

A New Hope for Couples

For couples caught in the devastating cycle of addiction and codependency, this emerging therapeutic model offers a new sense of hope. It validates the experience of both partners and provides a path toward healing that honors the complexity of their situation. By addressing the root causes of both the addiction and the codependency, it creates the possibility for not just individual recovery, but for the relationship itself to be reborn.

It is crucial to remember that this research is still in its early stages, and there is not yet clinical data on using MDMA specifically for codependency. Psilocybin and MDMA remain Schedule I substances and should only be used in a legal, therapeutic context with trained professionals. However, this pioneering work is paving the way for a future where couples have access to more effective tools for healing the deep wounds of addiction.

If you and your partner are struggling with these issues, know that you are not alone and that healing is possible. We invite you to contact our practice to learn more about evidence-based approaches to couples therapy and to begin the journey of rebuilding your connection. Schedule a consultation with us today.

References

(1) Hosford, S., & Austin-Robillard, H. (2025). Psilocybin and MDMA in Couples Therapy: Investigating Treatment for Substance Use Disorders and Codependency. Contemporary Family Therapy. https://doi.org/10.1007/s10591-025-09766-8

(2) Holland, J. (2020). Good Chemistry: The Science of Connection, From Soul to Psychedelics. Harper Wave.

Disclaimer: Psychedelic Assisted Psychotherapy has not been approved by any regulatory agencies in the United States, and the safety and efficacy are still not formally established at the time of this writing.