Additive Effects of 3,4-Methylenedioxymethamphetamine (MDMA) and Compassionate Imagery on Self-Compassion in Recreational Users of Ecstasy

In a naturalistic setting, recreational users who consumed chemically verified MDMA performed a self-focused compassionate imagery exercise on two separate occasions: once after taking MDMA and once without. The exercise and MDMA each independently increased emotional empathy toward critical facial expressions and self-compassion, and their effects on self-compassion appeared to add together. The findings suggest that combining MDMA with compassionate imagery may enhance self-directed affiliative feelings, though controlled studies are needed to confirm the combined utility for therapeutic contexts.

Study at a glance

Abstract

3,4-Methylenedioxymethylamphetamine (MDMA;'ecstasy') produces prosocial subjective effects that may extend to affiliative feelings towards the self. Behavioural techniques can produce similar self-directed affiliation. For example, compassionate imagery (CI) and ecstasy reduce self-criticism and increase self-compassion to a similar extent, with the effects of CI enhanced in the presence of ecstasy. Here, we examine self-compassion and self-criticism in recreational users who consumed chemically verified MDMA in a within-subjects crossover study. In a naturalistic setting, polydrug-using participants performed a self-focused CI exercise on two occasions separated by ≥6 days: once having consumed self-sourced MDMA and once not. Effects on state self-criticism, self-compassion and emotional empathy were assessed before and after MDMA use (or over an extended baseline period on the occasion that MDMA was not consumed) and reassessed after CI. In participants (n = 20; 8 women) whose ecstasy contained MDMA and no other drug, CI and MDMA appeared to separately increase emotional empathy (to critical facial expressions) and self-compassion. The effects of CI and MDMA on self-compassion also appeared to be additive. Establishing the observed effects in controlled studies will be critical for determining the combined utility of these approaches in fostering adaptive self-attitudes in a therapeutic context.