A new systematic review suggests that psychedelic drugs may facilitate feelings of intimacy and social connection, particularly when administered in controlled clinical settings. While the analysis provides evidence for positive outcomes like increased empathy and relationship satisfaction, it also indicates that recreational use carries significant risks of social disconnection and negative interpersonal experiences. The findings were published in the Journal of Psychoactive Drugs.
The research was conducted by Anna Bradford, a master’s candidate in psychological counseling at Columbia University; Ethan Freedman, a master of social work candidate at Columbia University; and Rachel E. Dinero, an associate professor of psychology at Le Moyne College and head of the Applied Social Health Lab.
This team sought to investigate the potential of pharmaceutical interventions to improve relationship functioning. Recent years have seen a resurgence of interest in psychedelic substances within the medical community. Clinical trials have explored the efficacy of drugs like psilocybin and MDMA for treating conditions such as depression and post-traumatic stress disorder.
However, fewer studies have focused specifically on how these substances affect intimacy. Intimacy is generally defined as the experience of emotional closeness and interdependence between individuals. It is a fundamental component of human well-being.
The rationale for the study stems from the profound impact of social relationships on physical and mental health. Previous data indicates that a lack of positive social bonds can increase mortality rates. The health risks associated with loneliness are comparable to those of smoking or obesity. Given this context, the researchers wanted to determine if psychedelics could serve as a tool to foster connection.
“Our research team is somewhat unique in its interdisciplinary perspective on relationship functioning. Our backgrounds collectively include counseling, human sexuality, attachment, public health, and pharmaceutical intervention effectiveness,” the researchers told PsyPost.
“Our frameworks intersected in a common interest in understanding what types of interventions are effective in improving relationship functioning. We were collectively intrigued with the possible role that pharmaceutical intervention, specifically psychedelic drugs, might have in improving relationships outcomes.”
“There has been increasing interest across the last two decades in the use of psychedelic and psychedelic-related drugs on psychological disorders like depression and PTSD. Early research is promising but the use of these drugs as a pharmaceutical intervention remains controversial.”
“From our perspective, the first step in understanding what impact psychedelic drugs might have on relationship functioning was to see what research already existed and what we can learn from looking a the findings of this body of research as a whole.”
The team searched through seven major academic databases. They used search terms related to a wide range of psychedelic substances, including psilocybin, MDMA, LSD, ayahuasca, and ketamine. They paired these terms with keywords related to intimacy, sexuality, and close relationships.
The initial search yielded 5,902 potential articles. The researchers then went through a multi-step screening process. They removed duplicate entries and screened abstracts for relevance.
Ultimately, they identified 19 studies that met all inclusion criteria. To be included, a study had to be peer-reviewed and published in English. It also had to measure outcomes related to intimacy specifically.
The final selection of studies encompassed a variety of research designs. Nine of the studies were conducted in laboratory settings. These involved researchers administering specific dosages in a controlled environment.
Six of the laboratory studies utilized placebo-controlled experimental designs. This is the gold standard for pharmacological research. It helps distinguish the drug’s pharmacological effects from the participant’s expectations.
The remaining ten studies relied on retrospective self-reports. These involved participants describing their past experiences with drug use in non-clinical, naturalistic settings. This included recreational use or participation in guided retreats.
The review revealed a distinct pattern of results based on the setting of the drug use. The findings from the controlled laboratory studies were overwhelmingly positive regarding intimacy outcomes. In all nine laboratory studies, participants reported improvements in social functioning.
One notable study included in the review examined the effects of MDMA on communication. Participants who received MDMA used more social and emotional words during a standardized talking task compared to those who received a placebo. This suggests that the drug may facilitate emotional disclosure.
Another reviewed study compared psilocybin therapy to a standard antidepressant regimen for major depression. The results indicated that psilocybin was more effective at increasing feelings of connectedness to others. This effect appeared to persist for months after the treatment.
Research involving couples was also highlighted in the review. One study utilized MDMA-assisted therapy for couples where one partner suffered from post-traumatic stress disorder. Both partners reported higher relationship satisfaction following the intervention.
The review also touched on specific populations that might benefit from these interventions. For instance, one study involved autistic adults who experienced social challenges. After MDMA-assisted therapy, these participants reported reduced social anxiety.
Similarly, a study involving long-term AIDS survivors found that psilocybin-assisted group therapy helped reduce attachment anxiety. Attachment anxiety is characterized by a fear of abandonment and a desire for extreme closeness. However, this study also noted that those with high attachment avoidance faced more challenges during the psychedelic experience.
The findings from the naturalistic and recreational studies presented a more complex picture. Of the ten studies relying on retrospective reports, six identified positive intimacy-related experiences. Participants described feelings of deep interconnection, empathy, and love.
One survey of people who attended psychedelic ceremonies found that a sense of “communitas” was a key factor. Communitas refers to an intense spirit of community and equality. Those who experienced this during the ceremony reported enduring increases in social connectedness weeks later.
However, the naturalistic studies also provided evidence of significant negative outcomes. Four of the self-report studies documented adverse effects on intimacy. Some users reported feeling socially disconnected or isolated following their experience.
Specific negative outcomes included increased social anxiety and feelings of distrust. In a study examining “chemsex,” which involves using drugs to facilitate sexual encounters, a portion of participants reported that the practice negatively impacted their intimate relationships. This highlights the potential for harm when these substances are used without therapeutic guidance.
Another study interviewed individuals who had experienced difficulties after psychedelic use. These participants reported communication breakdowns and a sense of being judged by others. Some described a state of social withdrawal or “shutdown” after the drug experience.
The researchers also noted that mixing substances could alter outcomes. One cross-sectional survey found that co-using low doses of MDMA with psilocybin or LSD was associated with higher reports of love. However, this did not necessarily reduce feelings of isolation compared to using the substances alone.
Based on these mixed results, the authors suggest that the setting is a major determinant of the outcome. The presence of a trained professional appears to be a protective factor. Therapists can help integrate the experience and manage difficult emotions that arise.
“There is preliminary evidence that psychedelic drugs can have a short-term positive impact on the experience of emotional intimacy, specifically when these drugs are used in a controlled context with a therapist or other trained professional’s support,” the researchers explained. “There are significant risks and negative outcomes associated with recreational psychedelic use.”
“Additionally, more controlled clinical trials are needed to understand what individuals might benefit from this treatment and the specific therapeutic environments that would support positive outcomes.”
As with all research, there are some caveats to consider. The review only included peer-reviewed, published studies. This introduces the possibility of publication bias, where studies with null or negative results are less likely to be published.
Additionally, the reliance on self-report measures in many of the studies is a limitation. Retrospective accounts are subject to memory errors. Participants may remember their experiences as more positive or negative than they were at the time.
The review also notes that “intimacy” was measured in many different ways across the studies. Some used validated psychological scales, while others relied on interviews or behavioral tasks. This makes it difficult to directly compare the magnitude of the effects across all studies.
The authors also raise a safety concern regarding the therapeutic relationship. Psychedelics can induce a state of heightened suggestibility and emotional openness. This can blur boundaries and potentially lead to stronger transference toward the facilitator.
This vulnerability underscores the need for strict ethical guidelines and professional training. The potential for manipulation or emotional harm exists if the facilitator is not properly trained. The authors caution that safety protocols are essential.
“Psychedelic drugs, especially MDMA, are often used recreationally because of the perceived benefits on emotional and sexuality intimacy,” the researchers said. “Unfortunately, recreational use of these drugs often results in the opposite effect. Additionally, psychedelic drugs have significant short and long-term negative effects on users that are more likely in recreational settings. Due to these risks, there is a stigma toward the use of psychedelic drugs, even in clinical settings.”
“There are, of course, significant risks to using these drugs. However, many pharmaceutical interventions have significant risks if not used as directed by medical professionals. We hope this study can help build understanding that there is real potential for these drugs to have clinical benefits. Ideally, this understanding could translate into more research that would provide the information needed to whether and how these drugs can be used to improve relationship functioning.”
The study, “Psychedelic Use and Intimacy: A Systematic Review of Experimental and Naturalistic Research,” was authored by Anna Bradford, Ethan Freedman, and Rachel E. Dinero.
