MDMA-assisted therapy for borderline personality disorder

Borderline personality disorder (BPD) is often misunderstood, misdiagnosed, and stigmatized, with 25–58% of individuals also having post-traumatic stress disorder (PTSD). In Phase 3 clinical trials, up to 71.2% of full-dose MDMA participants for treatment-resistant PTSD no longer met PTSD criteria. This qualitative study interviewed two clinicians treating BPD and two MDMA-assisted therapy clinicians, exploring overlaps in etiology and conceptualization. Through eight interviews, perspectives revealed similarities and limitations of both dialectical behavioral therapy and MDMA-assisted therapy.

Study at a glance

Abstract

AbstractAssociated 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.