... Second, the majority of studies on the socioemotional effects of MDMA provide converging evidence that MDMA specifically increases social reward processing (e.g., increased emotional disclosure, increased recognition of positive facial cues; Baggott et al., 2016;Bedi, Hyman, & de Wit, 2010;Bedi, Phan, Angstadt, & de Wit, 2009;Carlyle et al., 2019;Gabay et al., 2018;Hysek, Domes, & Liechti, 2012;Hysek et al., 2014). As a result, MDMA has been discussed as increasing feelings of positive emotional empathy, as well as associated feelings of trust, both within the self and with others, all of which have been posited to improve the therapeutic alliance and treatment outcomes (Bershad, Miller, Baggott, & de Wit, 2016;Jungaberle et al., 2018). Importantly, the experience of emotional empathy implicates awareness and recognition of a variety of emotions both in the self and others, the opposite of which is, arguably, alexithymia, or difficulties in identifying and labeling emotional feelings (Taylor, Bagby, & Parker, 1997). ...