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Cited by 1Personality Disorders and PsychopathologyPsychedelics and Drug StudiesPsychotherapy Techniques and Applications

MDMA-assisted therapy for borderline personality disorder

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Inouye, Ann M., Wolfgang, Aaron S., Philhower, Lianne T.·2023·Journal of Psychedelic Studies
DOI 10.1556/2054.2023.00196
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Abstract

Abstract Associated with high-risk behavior, borderline personality disorder (BPD) remains one of the field's most misunderstood, misdiagnosed, and stigmatized conditions. Individuals with BPD are frequently labeled as treatment-resistant patients. Furthermore, 25–58% of BPD individuals have a comorbid diagnosis of post-traumatic stress disorder (PTSD), and BPD may be conceptualized as a trauma-spectrum disorder. In Phase 3 clinical trials for 3,4-methylenedioxymethamphetamine (MDMA) full-dose participants for treatment-resistant PTSD found that up to 71.2% no longer met the criteria for PTSD. While PTSD is quite different from BPD, a qualitative exploration on the overlap in etiology and conceptualization provided new perspectives by interviewing two clinicians who focus their treatment with BPD diagnosed individuals and two MDMA-assisted therapy clinicians. This research examines the etiological, conceptualization, and therapeutic mechanisms of MDMA-assisted therapists and dialectical behavioral therapists. Through eight qualitative interviews, perspectives of the four participants revealed the similarities and limitations of both treatments.

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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 [37]

    The Conclusion (page unavailable) calls for further research into MDMA-assisted therapy for borderline personality disorder, which supports considering its potential. But the Limitations section says the findings are four clinicians’ hypotheses, not treatment results in patients; the paper does not establish potential use across psychedelics or personality disorders generally. (LLM, conf=0.86)

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1 retracted

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1 of the 75 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. Burge, B. (2017). FDA grants breakthrough therapy designation for MDMA-assisted psychotherapy for PTSD, agrees on special protocol assessment for phase 3 trials. Multidisciplinary Asso- ciation for Psychedelic Studies. https://maps.org/news/media/ 6786-press-release-fda-grants-breakthrough-therapy- designation-for-mdma-assisted-psychotherapy-for-ptsd-agrees- on-special-protocol-assessment-for-phase-3-trials.
  2. Gasser, P. (1994). Psycholytic therapy with MDMA and LSD in Switzerland. MAPS Newsletter, 5, 3-7. https://maps.org/news- letters/v05n3/05303psy.html.
  3. Linehan, M. (2016). DBT skills training manual for treating border- line personality disorder (2nd ed.). New York: Guilford Press.

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Authors
Inouye, A. M., Wolfgang, A. S., & Philhower, L. T.
Affiliations
  • Brown University (US)
  • Uniformed Services University of the Health Sciences (US)
  • Chaminade University of Honolulu (US)
Corresponding author
Inouye, Ann M.
ORCID
Venue
Journal of Psychedelic Studies
Publisher
Akademiai Kiado Zrt.
Published
2023-12-14
Volume
7
Issue
3
Pages
227-237
ISSN
2559-9283 (ISSN-L)
DOI
10.1556/2054.2023.00196
OpenAlex
W4389616335
Cited by
1
References
75
Citations by year
2025: 1
FWCI
0.29
Type
journal article
Language
en
Open access
Licence
Locations
Journal of Psychedelic Studies (publishedVersion, cc-by-nc)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
MDMA-assisted psychotherapy, borderline personality disorder, post-traumatic stress disorder, treatment-resistant disorders, dialectical behavior therapy, therapeutic mechanisms, psychedelic-assisted psychotherapy, clinician perspectives

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