Maybe Your Dead Bedroom Marriage Needs a Hit of Ketamine: Psychedelic Sex Therapy 101

Whether through the iconic Dr. Ruth Westheimer (RIP) or the Netflix hit Sex Education, you’ve probably heard of sex therapy. But have you heard of psychedelic sex therapy? It’s basically traditional sex therapy that integrates the use of psychedelics to address sexual issues. I reached out to Dr. Steven Radowitz, MD, the Chief Medical Officer and Co-Founder of the psychedelic wellness clinic Nushama, to learn more.

Dr. Steven Radowitz, MD, is the Chief Medical Officer and Co-Founder of the psychedelic wellness clinic Nushama. Dr. Radowitz has a wealth of experience seeing the effects trauma can have on our physical health firsthand. He joined Nushama to oversee and develop treatment modalities, believing psychedelics are the future of mental wellness as current solutions treat symptoms, not underlying issues. Dr. Radowitz also runs the primary care program at Goldman Sachs and has practiced internal medicine and primary care since 1998. He completed his MD at Chicago Medical School, worked at St. Vincent’s in general medicine and HIV/AIDS units and was Medical Director of the inpatient alcohol and opiate detox and treatment unit.

In psychedelic couples therapy, both members of a couple, with the help of a sex therapist, work through the emotional blockages that have been getting in the way of healthy intimacy. 

Many relationships get stale over time, thanks to life stressors like work, kids and money, which start to make their way into the bedroom. Sex therapy in a committed relationship can help maintain a deep physical and emotional connection and bond between a couple,. Psychedelic sex therapy takes it to the next level: “Psychedelic experiences can help realign our consciousness and focus away from these mounting worries, help process past difficult life situations and in doing so, regain a greater sense of connection to those that we love,” Dr. Radowitz tells me.

He adds, “Psychedelic sex therapy integrates the use of psychedelics with traditional sex therapy techniques to address sexual issues, intimacy challenges and trauma. This approach combines the psychological healing effects of substances like MDMA, psilocybin or ketamine with therapy aimed at improving sexual well-being, intimacy and relationships.” He adds that currently, on a federal level, ketamine is the only legal psychedelic available to use in a clinical setting in the United States. MDMA and/or psilocybin are legally available for clinical use in a number of other countries such as Australia (MDMA, psilocybin), Jamaica (psilocybin) and the Netherlands (psilocybin truffles).

Per Dr. Radowitz, here’s how it differs from traditional sex therapy:

• Use of Psychedelics: Psychedelic sex therapy involves the controlled use of substances that alter consciousness, with the intention of accessing deeper emotional states, healing trauma and fostering openness in therapy. Dr. Radowitz says, “Traditional sex therapy typically relies on talking, behavioral interventions and psychological techniques without the use of psychoactive substances.”
• Access to the Subconscious: He explains that psychedelics allow access to unconscious emotions and memories that may be difficult to reach in traditional therapy, which can help individuals or couples explore and resolve deep-seated issues related to sexuality (like trauma, repression or body image issues), which might be harder to address in a non-altered state.
• Increased Emotional Openness: “Substances like MDMA can reduce fear and increase feelings of trust, safety and emotional intimacy,” Dr. Radowitz tells me. “This can enhance the therapeutic process by helping people feel more comfortable discussing sensitive issues or facing difficult emotions. Traditional sex therapy may take longer to achieve this level of openness and vulnerability.”
• Somatic Awareness: Psychedelics often heighten body awareness, which can help address physical or sensory aspects of sexuality. “This can facilitate the exploration of body sensations, desires and boundaries, which may be more difficult to achieve through talk-based therapy alone.”
• Enhanced Empathy and Connection: Another benefit of psychedelic experiences: they can foster empathy, which is particularly beneficial in couples therapy. Dr. Radowitz notes that the altered state can help partners connect on a deeper emotional and spiritual level, potentially leading to breakthroughs in communication and intimacy that traditional therapy may struggle to achieve as quickly.
• Therapist’s Role: “In psychedelic sex therapy, the therapist’s role may involve guiding the patient through the psychedelic experience, helping to integrate insights and ensuring a safe and supportive environment,” according to Dr. Radowitz. “In contrast, traditional sex therapy focuses more on facilitating discussion, behavioral change and education within the confines of standard cognitive or somatic therapy techniques.”

Dr. Radowitz stresses that it’s crucial to work with a reputable clinician and therapist who has experience in screening out anyone with a contraindication to the use of psychedelics (including prior history of psychosis/schizophrenia or active mania in someone with bipolar affective disorder). He adds, “Also, it’s critical to make sure they are medically stable for treatment and there are no interactions with any of their current medications. It’s important to work with a therapist who is experienced and comfortable working with psychedelics, who could properly prepare, guide and integrate their experience."