Sophia* was wandering through the LGBTQ Pride Celebration in San Francisco when she ran into Simon and Mia, a pair of twins who she knew from childhood, though they had grown apart over the years. “We love you so much!” they exclaimed, hugging her repeatedly. Sophia was surprised, but she embraced the situation. The twins expressed interest in rekindling the friendship and exchanged phone numbers with her. After they parted ways, Sophia felt grateful for the interaction. However, neither Simon nor Mia ever contacted her, and never returned her messages; this was disappointing, confusing, and hurtful for Sophia. When she spoke to a friend who had been present at the original encounter, they said that the twins had been quite obviously under the influence of MDMA.
Jeff had taken MDMA with his roommates and was still very much feeling the effects when his partner Anna, who was sober, came over that evening. Jeff had been having some doubts about their relationship, but when they cuddled in bed together he was overcome with intense feelings of intimacy and tenderness. After having passionate sex, he told Anna that he loved her for the first time and she took his words seriously. However, he realized the next day, with tremendous guilt and regret, that the feeling was gone, and decided that it hadn’t been genuine love to start with. His words that night created a great deal of emotional pain for Anna and himself; their relationship ended messily several weeks later.
These true stories, which are taken from interviews I conducted over the past year, illustrate how interpersonal harm can arise when people who are under the influence of MDMA tell others that they love them. In both cases, the harm came from the recipient interpreting the words of love in a certain way, then discovering later that the words did not mean what they initially thought. Sophia and Anna understood these words as expressing real, authentic love that would persist into the future. When the feelings disappeared afterwards, both women doubted that love was ever present in the first place.
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This potential for interpersonal harm might seem at odds with MDMA’s reputation as a “love drug” that consistently produces overflowing, genuine warmth and facilitates deep, compassionate communion between people. Users often report that taking the empathogen “opens their hearts,” facilitating powerful, transformative intimacy in their MDMA-influenced encounters. Users also frequently report that their relationships with friends, family members, and partners became significantly closer and healthier after taking MDMA together. For example, Dr. George Greer, one of the psychiatrists who practiced MDMA-assisted psychotherapy before the drug became illegal, told an interviewer that taking the drug with his wife in 1980 “was very profound for us in terms of talking about issues in our relationship—forgiving each other for things we had done—and sped up our decision to get married.”
MDMA clearly has the potential for promoting beneficial, loving connections between people; in fact, there has been a resurgence of interest in this possibility, and researchers are beginning to more rigorously investigate it in different contexts—including and especially as a treatment for PTSD. However, as we can see from Sophia and Jeff’s stories, the drug also has the potential to produce an impulse to say “I love you”—sometimes in circumstances where acting on these impulses might ultimately lead to interpersonal harm.
“I love you” is a powerful statement expressing a powerful sentiment, and it should not be thrown around carelessly, especially under the influence of MDMA. How, then, can MDMA users make sure that they are being careful with their expressions of love, in order to avoid causing harm to other people or themselves? How can MDMA users know when they should or should not say “I love you” to other people?
If you have the impulse to say “I love you” while you’re rolling on MDMA, the first question to ask is “how will the other person most likely interpret and experience my expression of love in this context?”
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There are many ways that the words can be interpreted and experienced, some more emotionally consequential than others. If there is uncertainty in this regard, the MDMA user should explicitly and mindfully communicate with the other person, so as to prevent misunderstanding and harm.
For example, if an MDMA user is interacting with a friend whom she suspects may have some unrequited romantic feelings for her, then she should contextualize her words of love, if she chooses to say them (e.g. “I feel very close to you as a friend, like we are family. I trust and appreciate you, and I want to tell you something that I don’t say very often. Is that ok?”).
Even if this communication does happen, there are other questions to ask in order to be safe. The first is, “what is this feeling that I am having for this other person, and is it real, authentic love, or something else?” The second is, “can I reasonably expect this feeling to persist after the MDMA wears off?”
Without clarification, it is reasonable to expect that other people will often interpret the words “I love you” in the way that Sophia and Anna did: as expressing real, authentic love that will endure after the interaction. If the MDMA user is not confident that her present feelings satisfy these conditions then she should consider refraining from saying “I love you” until other expectations have been established.
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I would argue that “real, authentic love” involves truly caring for another person, rather than, say, merely enjoying her presence. The MDMA user must mindfully examine her emotions, trying to distinguish between true care and other powerful feelings that might be mistaken for love.
It does seem quite possible for real, authentic, caring love to arise within a momentary MDMA-influenced interaction (even one with a friendly stranger at a festival), only to disappear later on. Perhaps most people have an inherent, hidden potential for loving almost anyone, and MDMA can briefly actualize this potential for the duration of the drug’s effects. A great deal of research is necessary for further investigating this possibility.
The current body of MDMA research, however, does shed light on how the drug’s effects might give rise to feelings that are misidentified as real, authentic love. One of MDMA’s unique and consequential effects, repeatedly demonstrated in experiments yet little known outside the research community, is that it enhances one’s ability to recognize and respond to expressions of positive emotion and diminishes one’s ability to recognize and respond to expressions of negative emotion. I call this the “positive emotion recognition bias.”
Someone who has taken MDMA is disposed to encounter positive emotional signals as amplified or exaggerated, while paying much less attention to negative ones. Thus, a user might fall into a distorted, positively-skewed, and deceptive impression of someone else’s feelings, reactions, intentions, or even personality during an MDMA influenced interaction.
Especially if both people have taken MDMA and are feeding off each other, the action of the positive emotion recognition bias could make the interaction seem extraordinarily harmonious, flowing, warm, close, and rewarding (qualities which may actually be present, if exaggerated). An MDMA user may discover extraordinary joy in this interpersonal encounter, experiencing an intoxicating and intensely pleasurable social euphoria, with a natural desire to dive further into the interaction and the other person’s presence. These feelings may sometimes be primarily selfish and hedonistic, in the sense that the MDMA user may unknowingly be experiencing other people as instruments for her own happiness, rather than truly caring for them as other human beings. The user might mistake these feelings for real, authentic love, and feel compelled to say “I love you.” The impulse to say those words may also emerge from the motivation to enter more deeply into the rewarding encounter, intensifying the social euphoria.
Especially if both people have taken MDMA and are feeding off each other, the action of the positive emotion recognition bias could make the interaction seem extraordinarily harmonious, flowing, warm, close, and rewarding.
Being mindful of these distinctions in one’s own experience is a subtle art, a skill that must be cultivated. So far, I have only presented suggestions for how MDMA users can bring interpersonal harm reduction practices to their MDMA-influenced interactions, but I have not discussed any methods for making expressions of love more beneficial (i.e. healing, intimate, transformative, etc.) for everyone involved. How can MDMA users take the drug in ways that promote long-term well-being and strengthen interpersonal relationships?
Most people remember special moments when friends, family members, or partners have said “I love you” at precisely the right time or precisely the right way. MDMA users, as well as psychologists who have practiced MDMA assisted couples’ therapy, often report that the drug appears to demonstrate a tremendous potential for promoting healthy, enduring intimacy between people. In order to harness the potential benefits of an MDMA experience, it’s important to create an optimal “container” for that experience. One general blueprint that can be used to create such a container is the well-known “preparation session,” “dosing session,” and “integration session” model.
In the preparation session, MDMA users can establish intentions, expectations, and guidelines for the MDMA experience, discussing any emotions, hopes, or fears that they may have going into it, and then initiate the dosing session when they are ready. As a result, the people involved are more likely to be on the same page during the experience, allowing them to engage with each other in mutually beneficial ways with fewer opportunities for confusion and miscommunication. Afterwards, in the integration session, they can discuss what happened during the dosing session, working together to process it all. The integration session allows the users to revisit and mindfully communicate about the experience, addressing any lingering issues or questions, and gathering everything up so that it can be brought back and woven into their lives and relationships.
By engaging in skillful, conscious preparation before taking MDMA, users should find it much easier to understand the interpersonal context within which they might say “I love you.” Perhaps what was once a roaring bonfire of love is still present as burning coals; perhaps the fire appears to have completely died out, leaving a degree of confusion in its ashes. In the first case, the integration session could serve as a way of fanning the fire that remains, keeping it burning onwards into the future. In the second case, the integration session could serve as a way of working through the confusion together, rather than leaving it tangled up inside. In both cases, the integration session is important for promoting the health of the interpersonal relationship.
When people are mindful of saying “I love you” during an MDMA-influenced interaction, these powerful words can promote, rather than diminish, the well-being of everyone involved.
*All names have been changed to protect the identities of the sources.
Joseph Holcomb Adams is a bioethicist and educator. He received his BAs in philosophy and religious studies from UC Davis, and his MA in bioethics from New York University. He has served as a science teacher in the Oakland Unified School District for two years (high school biology, then middle school special education science). For the moment, his bioethics work is primarily focused on analyzing issues related to Oregon’s Psilocybin Services Act.
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