Should the ‘Love Hormone’ Oxytocin Be Used in Couples Therapy?

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From Arizona comes word that oxytocin — known as the “cuddle chemical” or “love hormone” for its role in bonding parents to children and lovers to one another — is being used on couples in marriage therapy.

KPHO reports:

Dr. Matt French owns the Wellness Solutions Clinic in Glendale. Last September, his office began using a bio-identical form of oxytocin for patients struggling in their marriages.

“If a couple is struggling with bonding issues, with intimacy issues, it could be as a result of inadequate levels of the hormone oxytocin,” French said.

But research suggests that, in fact, oxytocin doesn’t always lead to peace, love or harmony for everyone. Several studies have found a link between high levels of oxytocin and relationship problems in women — not marital bliss. One study published last month found that women who experienced a greater spike in oxytocin following a hurtful experience in a relationship tended to have more anxiety and were less forgiving, compared with women who had lower levels of the hormone.

Similarly, other research in men has found that when they were asked recall their relationships with their mothers — while taking either oxytocin or placebo — those who had had secure relationships with their moms in early childhood tended to recall Mom as being warmer and more loving when taking oxytocin than when taking placebo. Meanwhile, those who had had less nurturing maternal relationships in childhood remembered their mothers as less caring and more distant while taking oxytocin than placebo.

(More on TIME.com: ‘Love Hormone’ Enhances Men’s Memories of Mom — Good or Bad)

In other words, rather than being a “love drug” that indiscriminately increases affection, oxytocin is more like a social memory enhancer — connecting experiences with people not just to pleasure, but to pain if that’s what was primarily experienced in infancy.

Yet another troubling study looked at the effect of oxytocin when administered to patients with borderline personality disorder (BPD). People with BPD have difficulty maintaining relationships, seemingly switching from love to hate or from desperate clinginess to revenge on a dime (think Glenn Close’s character in the film Fatal Attraction).

Although previous studies have found that oxytocin tends to enhance feelings of trust when given to healthy people, researchers found that the impact on people with BPD is altogether different. According to Jennifer Bartz, assistant professor of psychiatry at the Mount Sinai School of Medicine and an author of the study, oxytocin significantly decreased the participants’ feelings of trust toward others, and reduced their perceptions and expectations that other people would behave cooperatively; the hormone also decreased the likelihood that the BPD patients would behave cooperatively themselves.

(More on TIME.com: ‘Love Hormone’ Oxytocin Is Choosy, Not Necessarily Racist)

Co-author Dr. Eric Hollander, a clinical professor of psychiatry at Albert Einstein College of Medicine, notes that oxytocin may rise when relationships are threatened, as a way of signaling the trouble. “The idea [is] that sometimes with a profound rejection or loss, you can get a compensatory increase,” he says. “We thought that perhaps in borderline personality patients, they experience increased oxytocin as if it were a rejection or loss, and the data was consistent with that idea.”

It seems that oxytocin itself can behave like a borderline personality patient. Spikes of the hormone at orgasm promote feelings of romantic love, and high levels in new parents nurture mother-infant bonding. But the hormone also rises when relationships are threatened and perhaps even during feelings of revenge. So it not only wraps you in the warm, fuzzy feeling of being with someone you love, but also triggers the clawing anxiety of withdrawal, if that relationship is threatened or troubled.

(More on TIME.com: Does Men’s ‘Bond’ with Porn Ruin Them for Real Life Sex?)

As for giving oxytocin to troubled couples in therapy, outside of a research setting? That seems premature. Not only is oxytocin not a simple “love drug” — it affects memory and makes connections, good and bad — but when administered artificially, it’s also been shown that people can’t reliably distinguish it from placebo.

“It’s completely untested so we don’t really know what the safety data is,” says Hollander. “And there are important individual differences, not only in terms of [how people with] different diagnoses respond, but also within the general population. I certainly wouldn’t recommend widespread clinical use at this point.”

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