MDMA-assisted psychotherapy for borderline personality disorder
Open accessAbstract
Borderline personality disorder is a complex psychiatric disorder with limited treatment options that are associated with large heterogeneity in treatment response and high rates of dropout. New or complementary treatments for borderline personality disorder are needed that may be able to bolster treatment outcomes. In this review, the authors comment on the plausibility for research on 3,4-methylenedioxymethamphetamine (MDMA) used in conjunction with psychotherapy for borderline personality disorder (i.e., MDMA-assisted psychotherapy [MDMA-AP]). On the basis of the promise of MDMA-AP in treating disorders overlapping with borderline personality disorder (e.g., posttraumatic stress disorder), the authors speculate on initial treatment targets and hypothesized mechanisms of change that are grounded in prior literature and theory. Initial considerations for designing MDMA-AP clinical trials to investigate the safety, feasibility, and preliminary effects of MDMA-AP for borderline personality disorder are also presented.
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Preliminary findings support the potential use of psychedelics in personality disorder treatment.
“While the exact mechanisms of action remain unclear, and despite study limitations including small sample sizes and challenges in maintaining blindness in placebo-controlled trials (36), these preliminary findings support the potential use of psychedelics in personality disorder treatment (18, 25, 37, 38).”
From Psychoanalytically informed MDMA-assisted therapy for pathological narcissism: a novel theoretical approach (2025) · cites this paper as [38]
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Wrege, J. S., Ruocco, A. C., Euler, S., Preller, K. H., Busmann, M., Meya, L., Schmidt, A., Lang, U. E., Borgwardt, S., & Walter, M. (2019) · Cognitive Affective & Behavioral Neuroscience · doi:10.3758/s13415-019-00716-0 · Cited by 39 · see citing works
Relational and Growth Outcomes Following Couples Therapy With MDMA for PTSD
Wagner, A. C., Liebman, R. E., Mithoefer, A. T., Mithoefer, M. C., & Monson, C. M. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.702838 · Cited by 38 · see citing works
Borderline Personality Disorder and Posttraumatic Stress Disorder: Time for Integration?
Hodges, S. J. (2003) · Journal of Counseling & Development · doi:10.1002/j.1556-6678.2003.tb00267.x · Cited by 37 · see citing works
Fitzpatrick, S., Liebman, R. E., & Monson, C. (2021) · Clinical Psychology Review · doi:10.1016/j.cpr.2021.101983 · Cited by 32 · see citing works
Zeifman, R. J., Landy, M. S. H., Liebman, R. E., Fitzpatrick, S., & Monson, C. M. (2021) · Clinical Psychology Review · doi:10.1016/j.cpr.2021.102030 · Cited by 32 · see citing works
Barnicot, K., & Crawford, M. J. (2018) · Journal of Traumatic Stress · doi:10.1002/jts.22340 · Cited by 30 · see citing works
Amad, A., Raduà, J., Vaïva, G., Williams, S., & Fovet, T. (2019) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2019.07.018 · Cited by 30 · see citing works
Lischke, A., Herpertz, S. C., Berger, C., Domes, G., & Gamer, M. (2017) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsx134 · Cited by 29 · see citing works
Risk Factors for Borderline Personality Disorder in Adolescents
Zanarini, M. C., Temes, C. M., Magni, L. R., Aguirre, B. A., Hein, K. E., & Goodman, M. (2020) · Journal of Personality Disorders · doi:10.1521/pedi_2019_33_425 · Cited by 27 · see citing works
FKBP5 gene variants and borderline personality disorder
Amad, A., Ramoz, N., Peyre, H., Thomas, P., & Gorwood, P. A. P. M. (2019) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.01.025 · Cited by 25 · see citing works
Murphy, A., Bourke, J., Flynn, D., Kells, M., & Joyce, M. (2019) · Irish Journal of Medical Science (1971 -) · doi:10.1007/s11845-019-02091-8 · Cited by 25 · see citing works
Streit, F., Witt, S. H., Awasthi, S., Foo, J. C., Jungkunz, M., Frank, J., Colodro‐Conde, L., Hindley, G., Smeland, O. B., Maslahati, T., et al. (2022) · Translational Psychiatry · doi:10.1038/s41398-022-01912-2 · Cited by 24 · see citing works
Barnicot, K., Redknap, C., Coath, F., Hommel, J., Couldrey, L., & Crawford, M. (2021) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12362 · Cited by 22 · see citing works
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The impact of posttraumatic stress disorder on the symptomatology of borderline personality disorder
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Kwon, D. (2024) · Scientific American · doi:10.1038/scientificamerican0122-48 · Cited by 15 · see citing works
Challenges with benchmarking of MDMA-assisted psychotherapy
Halvorsen, J. Ø., Naudet, F., & Cristea, I. A. (2021) · Nature Medicine · doi:10.1038/s41591-021-01525-0 · Cited by 12 · see citing works
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Flagged first, then by citations
Cited by
Sorted by citations
Zeifman, R. J., Kettner, H., Ross, S., Weiss, B., Mithoefer, M. C., Mithoefer, A. T., & Wagner, A. C. (2024) · European Journal of Psychotraumatology · doi:10.1080/20008066.2023.2297536 · Cited by 37 · see citing works
“…alliance plays an especially important role (e.g. individuals with borderline personality disorder [BPD]; Boritz et al., 2018; Zeifman et al., 2021), further attention may be needed to ensure that a strong therapeutic alliance is established (Traynor et al., 2022; Zeifman & Wagner, 2020).”
BackgroundZeifman, R. J., Kettner, H., Pagni, B. A., Mallard, A. J., Roberts, D. E., Erritzøe, D., Ross, S., & Carhart-Harris, R. L. (2023) · Scientific Reports · doi:10.1038/s41598-023-40856-5 · Cited by 33 · see citing works
ACTUAL PROBLEMS OF MODERN SCIENCE
International Science Group, & Vladlenov, D. (2023) · doi:10.46299/isg.p.2023.1.4 · Cited by 21 · see citing works
Yang, J., Wang, N., Luo, W., & Gao, J. (2024) · Psychiatry Research · doi:10.1016/j.psychres.2024.116043 · Cited by 19 · see citing works
Kaur, H., Karabulut, S., Gauld, J. W., Fagot, S. A., Holloway, K. N., Shaw, H. E., & Fantegrossi, W. E. (2023) · Psychedelic Medicine · doi:10.1089/psymed.2023.0023 · Cited by 10 · see citing works
“Unsurprisingly, psychedelics are being evaluated in treating mental health disorders, 169–171 including, and not limited to, social anxiety in ASD.”
Albert, A. E., & Back, A. L. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1529427 · Cited by 6 · see citing works
“…exact mechanisms of action remain unclear, and despite study limitations including small sample sizes and challenges in maintaining blindness in placebo-controlled trials (36), these preliminary fi ndings support the potential use of psychedelics in personality disorder treatment (18, 25, 37, 38).”
ЄВРОІНТЕГРАЦІЙНІ ПРОЦЕСИ В УКРАЇНІ: ІСТОРИЧНІ, КУЛЬТУРНІ, ПОЛІТИКО-ПРАВОВІ ТА ПСИХОЛОГІЧНІ АСПЕКТИ
Бойко, Н. С., Дойко, Н. М., Гандовська, Л. В., Буран, В. В., Чисніков, В. М., Глодний, Я. С., Доценко, В. О., Kaszowska, M. U., Czarnecki, D., TSYHANOVSKA, N., et al. (2023) · doi:10.36059/978-966-397-311-1 · Cited by 4 · see citing works
Proceedings of the IV International Scientific and Practical Conference
Пундєв, В. В., & Pundev, V. (2023) · doi:10.46299/isg.2023.1.4 · Cited by 3 · see citing works
Foe, A. D. (2023) · Psychoactives · doi:10.3390/psychoactives2020011 · Cited by 2 · see citing works
“Exemplified trends in literature show specific therapeutic benefits in the treatment of suicidal ideation with ketamine [24], improvement in interpersonal problems (and potentially intrapersonal/personality disorder spectra) after the administration of empathogens [25], and treatment of anxiety with atypical depressan…”
BackgroundСоціальна адаптація особи з межовим розладом особистості
Пундєв, В. В. (2023) · Социально-гуманитарные исследования: векторы развития науки и образования · doi:10.36059/978-966-397-311-1-59
Open MDMA: An Open Source Framework and Practical Guide for the Therapeutic use of MDMAPreprint
Groeneveld, M., & Harper, T. (2024) · doi:10.31234/osf.io/aps5g
Recreational MDMA use in Norway: results from an internet convenience sample
Grønnerød, C., Rønningen, T., Haugsjå, I. R., Andersen, K. A. A., Dahlgren, C. L., & Kvam, T.-M. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1619676 · Cited by 1 · see citing works
Cassidy, E. K., Davis, A. K., & Rao, S. (2025) · Psychedelics · doi:10.1016/j.psyche.2025.100007
Gerrans, P., McGovern, H. T., Hohwy, J., & Oestreich, L. (2026) · European Journal of Psychotraumatology · doi:10.1080/20008066.2026.2631358 · Cited by 1 · see citing works
“This prediction is consistent with learning-based accounts of trauma recovery and memory reconsolidation, which emphasize the necessity of repeated, contextually embedded corrective experiences for durable change (Ehlers et al., 2004; Feduccia & Mithoefer, 2018; Traynor et al., 2022).”
Hwang, C. S., Cameron, D. C., O’Neill, A. C., Morasco, B. J., Dobscha, S. K., Korthuis, P. T., & Stauffer, C. S. (2026) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2026.2710059
- Authors
- Traynor, J. M., Roberts, D. E., Ross, S., Zeifman, R., & Choi-Kain, L.
- Affiliations
- Harvard University (US)
- Venue
- Focus
- Published
- 2022-10
- Volume
- 20
- Issue
- 4
- Pages
- 358-367
- ISSN
- 1541-4094 (ISSN-L)
- 1541-4108
- PMC
- PMC10187385
- OpenAlex
- W4307380201
- Cited by
- 15
- References
- 121
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 7
- FWCI
- 0.54
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- FOCUS The Journal of Lifelong Learning in Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- MDMA-assisted psychotherapy, borderline personality disorder, MDMA, 3,4-methylenedioxymethamphetamine, treatment-resistant depression, post-traumatic stress disorder, mechanisms of change, treatment goals, clinical trial design, treatment discontinuation, treatment response heterogeneity
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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