Empathy

Last reviewed 5 October 2026

What it is

"Empathy" names a family of abilities that people tend to treat as one. Researchers separate at least two. Affective, or emotional, empathy is feeling something in response to another person's state, such as sharing their distress or being glad for their good news. Cognitive empathy is working out what someone else feels or thinks without necessarily feeling it oneself, which overlaps with what psychologists call theory of mind or mentalizing [1] [2]. A third word, compassion, means caring about someone's suffering and wanting to help, which is feeling for a person rather than feeling with them, and it can be trained separately from empathy [2]. Sharing another person's pain can also tip into empathic distress, a self-focused, aversive reaction that tends to bring a wish to withdraw [2].

The split is real in the data. When the most widely used photo test discussed on this page was introduced, 17 adults with Asperger syndrome scored lower than 18 controls on the cognitive part and no differently on the emotional part, as reported in the paper's abstract [1]. In 178 volunteers, brain imaging found separable networks for sharing an emotion and for inferring a mental state, and activity in each network predicted performance on its own task but not on the other, as reported in the abstract [3]. A drug or a training course can therefore move one kind of empathy and leave the other where it was.

How empathy is measured matters as much as what it is. There are three common approaches.

Questionnaires ask people to rate themselves. The Interpersonal Reactivity Index has four subscales, two cognitive (perspective taking and fantasy) and two affective (empathic concern and personal distress) [6] [17]. The Questionnaire of Cognitive and Affective Empathy was built to keep the two components apart [4]. Self-report has a known weakness. A meta-analysis of 85 studies (14,327 people), known here from its abstract, found that self-rated cognitive empathy accounts for only about one percent of the variance in performance on behavioral tasks [5].

The Multifaceted Empathy Test, or MET, shows 40 photographs of people in emotionally charged situations, half positive and half negative. Each photograph appears three times with a different question. The cognitive measure asks the viewer to pick, from four choices, the word that names what the person pictured is feeling. Explicit emotional empathy is the viewer's rating of how concerned, or how glad, they are for that person. Implicit emotional empathy is the viewer's rating of how aroused the picture makes them feel, included because it is harder to answer in a socially desirable way [6] [7]. Nearly all the psychedelic empathy data on this page come from this one test, and its stimuli are pictures of people who cannot respond.

The Reading the Mind in the Eyes Test shows photographs of the eye region and asks the viewer to choose among four mental-state words [8]. It is a cognitive measure with its own problems. A psychometric analysis in two online samples found that the 36-item test does not fit a single underlying ability, with items agreeing only weakly (a mean correlation of .08) [9]. A scoping review of 1,461 studies that used the test, known here from its abstract, found that 63 percent reported no validity evidence of any of six standard kinds [10].

Metanoia asks about empathy as one of twelve dimensions, and for a research organization the question is narrower than whether psychedelics make people kinder. It is what can be measured in healthy adults, for how long, and against what alternatives. One scope note applies throughout. Metanoia's scope is natural psychedelics. Some of the best-controlled human data on this dimension come from LSD, which is semi-synthetic, and from MDMA, which is fully synthetic and not a classic psychedelic. This page uses them only where they are the main controlled data, labels them each time, and does not assume that a finding transfers to a natural compound.

What is known

The short version. In a handful of small placebo-controlled laboratory studies, psilocybin, LSD, and MDMA raised self-rated emotional empathy on one photo test for a few hours. The psilocybin result was not found in two later laboratory studies. Cognitive empathy was unchanged in most analyses and lower in some, so accuracy at reading other people did not improve anywhere in the controlled literature. No controlled study in healthy adults has shown a lasting change in how people treat each other.

Psilocybin in the laboratory

The founding study gave 32 healthy adults psilocybin and a placebo in separate sessions under double-blind conditions and ran the MET about 160 minutes after dosing. Explicit emotional empathy was higher with psilocybin (F(1,30) = 7.74, p < .01), and so was implicit emotional empathy (F(1,30) = 4.77, p < .05). Cognitive empathy did not differ. A moral-dilemma task given to 24 of the volunteers showed no effect. Three details matter. The implicit result was no longer significant once positive mood was statistically held constant. Psilocybin also raised self-reported arousal. And trait empathy on the questionnaire did not predict who responded. The paper reports no effect sizes in its text [6].

Two later studies did not reproduce the pattern. In a double-blind crossover of 22 healthy, psychedelic-experienced volunteers, the MET about four and a half hours after psilocybin showed no drug effect on either component, and end-of-session trait empathy was unchanged. The authors note that the absence of an effect may reflect the late timing of the test [11]. In a six-condition crossover of 24 healthy volunteers (23 in the psilocybin condition), the MET three hours after dosing showed psilocybin lowering cognitive empathy for positive pictures (p < .001), with only a trend for negative ones (p < .1). Psilocybin did not significantly raise explicit or implicit emotional empathy for either kind of picture. In the supplementary figure the psilocybin bars sit slightly above placebo in all four emotional panels, with no significance marks, so it shows neither a clear rise nor a clear absence of one. The exact values appear only in that graph. MDMA, the comparison drug, raised explicit emotional empathy for positive pictures. The authors also report that psilocybin reduced overall accuracy in a separate face-recognition task [12].

Why do three laboratory studies disagree? Candidates are the timing of the test (about 2.7, 3, and 4.5 hours after dosing), weight-based versus fixed dosing, previous psychedelic experience, and small samples. No study has tested which factor matters.

LSD in the laboratory

LSD is semi-synthetic. Two crossover studies of 24 and 16 healthy adults, analysed together (38 had complete MET data), ran the MET five and a half to seven and a half hours after dosing, when subjective effects had fallen to roughly half their peak. LSD raised both emotional measures, with post hoc significance only in the group given the higher dose. Cognitive empathy fell in both dose groups (F(1,36) = 16.87, p < .001). Recognition of fearful faces was impaired (F(1,36) = 20.71, p < .001), and recognition of sad faces was lower overall. On an economic sharing game with real money, prosocial choices rose in the pooled sample but in neither study alone. The authors note that the higher dose also impaired recognition of neutral faces, which points to nonspecific effects on performance [7].

A later crossover in 16 healthy adults tested four doses. Only the highest raised emotional empathy. The authors report that cognitive empathy was not altered, which differs from the earlier result, but the data are not shown. A pretreatment with ketanserin, a blocker of the receptor that carries most psychedelic effects, prevented the rise in plasma oxytocin and only weakly reduced the rise in emotional empathy. After ketanserin the explicit rise fell short of significance against placebo (p = .09), while the implicit rise stayed significant [13]. The empathy rise therefore does not clearly depend on that receptor, and 16 people cannot settle it.

The nearest thing to an interactive task used scanning and eye tracking in 24 healthy adults, 18 of them men. Participants played a gaze game with a virtual character they believed was a person in another room. In four pre-specified brain regions, LSD reduced activity in areas involved in self-processing and social cognition, and it slowed joint attention by about 0.17 seconds. Errors did not increase, and ketanserin blocked the effects [14]. The task measured joint attention and not empathy.

MDMA as the reference point

MDMA is not a natural product and not a classic psychedelic. It is included because its empathy signal has been tested most often.

In 32 healthy volunteers, half of them women, MDMA raised explicit and implicit emotional empathy and prosocial choices, with the rises significant in men and not in women. It left cognitive empathy alone and impaired recognition of negative faces, especially in women [15]. Against methylphenidate in 30 volunteers, MDMA raised emotional empathy for positive pictures while the stimulant did nothing. The authors call the effects subtle, and the analysis was not corrected for multiple comparisons [16]. Pooling six placebo-controlled studies from two laboratories (118 people), MDMA raised explicit empathy (F(1,112) = 7.23, partial eta squared = .06) and implicit empathy (F(1,112) = 8.68, partial eta squared = .08), mostly for positive pictures, with no change in cognitive empathy and no moderation by sex, though the authors note that women received a higher dose for their body weight, which may have hidden a difference. The authors state that most participants realised which treatment they had received [17]. A 2025 meta-analysis of placebo-controlled studies put the effects at Hedges' g = 0.29 (95% confidence interval 0.09 to 0.48) for explicit empathy across four studies (102 people) and 0.23 (0.02 to 0.44) for implicit empathy across three (82 people). Cognitive empathy was effectively zero (g = 0.09, interval from -0.11 to 0.29), and recognition of fearful faces was lower (g = -0.24, nine studies, 294 people) [18].

On the eyes test, 48 healthy volunteers given MDMA read friendly expressions better and hostile ones worse, in a paper known here from its abstract [19], while a study of 20 people who had taken MDMA three to 40 times before found no effect [20]. Even for the best-replicated compound, the effect is small to moderate, concentrated in positive material, acute, and tied to one picture task.

Retreat and ceremony studies

The uncontrolled studies are more numerous and more positive in direction. One field study has a placebo arm. At six ayahuasca retreats in Europe, 30 experienced participants (on average about 24 earlier ayahuasca experiences) were randomly assigned by the host organisation to ayahuasca (14) or placebo capsules (16). On the MET the morning after, arousal to negative pictures rose in the ayahuasca group and not in the placebo group (interaction p = .038), while mood and anxiety improved equally in both arms. Participants guessed their treatment correctly 57 percent of the time on ayahuasca and 69 percent on placebo. The authors call the design single-blind, and note strong expectations, no control over how the capsules were prepared or stored, and a possibly too low amount [40].

Dutch ayahuasca ceremonies were studied in 43 attendees at baseline, with 20 morning-after and 19 one-week assessments. Only 41, 25, and 12 people completed the MET at the three time points. Cognitive empathy rose (effect size d = 0.93 the next morning and 0.79 at one week), implicit emotional empathy rose at one week (d = 0.62), and explicit emotional empathy did not change. The authors list the weaknesses: no control group, self-selected volunteers, heavy dropout, and the same test repeated three times, which can inflate scores [21]. The starting cognitive score (16.7 of 40) was also lower than the roughly 22 to 26 of 40 seen at baseline or on placebo in other MET studies [17] [22]. This is this page's own observation and not the authors', but part of the rise may reflect a low starting point. The direction differs from the laboratory work, where cognitive empathy went down with LSD and, in one study, with psilocybin.

A psilocybin retreat in the Netherlands tested 55 people before, 50 the morning after, and 22 seven days later. Both explicit and implicit emotional empathy were higher the next morning, though the explicit rise was confined to negative pictures, and cognitive empathy did not change significantly. At seven days one result remained, implicit empathy for negative pictures, right at the edge of significance (p = .05, 22 people). Explicit empathy had returned to its starting level. There was no control group [22]. A 2026 systematic review of 16 ayahuasca studies (11 observational, 5 experimental), known here from its abstract, concluded that observational work reports more empathy while experimental work shows only faster reaction times, citing small samples and learning effects [24]. In a 2026 pharmacoimaging study of 12 healthy, experienced ayahuasca users, the MET showed no difference in cognitive or emotional empathy against placebo. A self-rated social scale rose a week later after the higher dose, which was not blinded, and the authors note a possible ceiling effect in people whose empathy is already high [41].

A laboratory study of an ayahuasca-inspired formulation, which combines DMT and harmine and is not the plant brew, gave 31 healthy men placebo, harmine alone, and the combination. A day later, compassion for others on a validated scale was higher after the combination than after placebo by 2.28 points on a 20 to 100 scale (p = 0.04), and it did not differ from harmine alone. The authors found the effect in the half of the sample who rated the drug effects as stronger, but that split was made after the fact and by response to the treatment itself, and the interaction was not significant (p = .20). Two of the authors co-founded a company developing psychedelic drugs, and the study measured compassion, not empathy [23].

A pooled estimate and its limits

A 2024 meta-analysis of the MET across LSD, psilocybin, and ayahuasca pooled five studies in six comparisons (158 people, with one LSD study entered once for each dose group) and found higher explicit emotional empathy (g = 0.79, 95% confidence interval 0.18 to 1.41), a borderline rise in implicit emotional empathy (g = 0.76, interval from -0.02 to 1.55), and no overall change in cognitive empathy (g = -0.12, interval from -2.03 to 1.80, heterogeneity of 87 percent), a range too wide to rule out a large effect in either direction [25]. It is not a usable estimate. The analysis combines laboratory trials with before-and-after retreat studies that have no control group. Three subgroup results (p = 0.04, p = 0.008, and p = 0.04, for explicit empathy with positive and negative pictures and implicit empathy with positive pictures) are printed as significant although their confidence intervals include zero. Its table of included data sets omits both the 2021 LSD dose study and the 2023 psilocybin study that found nothing, although both were published before its November 2023 search cut-off, and it predates the 2026 psilocybin comparison. The authors searched PsycINFO as well as PubMed and Scopus.

Does anything last?

We found no controlled study in healthy adults that measured empathy beyond the morning after the session. Two controlled studies come close. One measured a self-rated social scale a week later in 12 experienced ayahuasca users, with the higher dose not blinded [41]. The other, in 31 men given an ayahuasca-inspired formulation, measured compassion rather than empathy and found no lasting effects at one and four months [23]. The retreat studies reach seven days without a control group. An independent 2026 systematic review of placebo-controlled LSD, DMT, and psilocybin studies, which also searched PsycINFO, found six studies that measured empathy, all with the MET, and only four studies of any cognitive or psychological outcome beyond 24 hours [42].

The one controlled follow-up of empathy itself is in patients. Among 51 adults with a mild to moderate depressive episode, those given psilocybin within a psychological support programme rated higher explicit emotional empathy than the placebo group at two days, eight days, and fourteen days, driven by positive pictures. The largest difference came at day eight (1.12 points on a nine-point scale, 95% confidence interval of the difference 0.13 to 2.11, d = 0.66), and reporting the largest of three differences tends to overstate the typical one. For negative pictures the interaction was not significant (p = .084). Implicit and cognitive empathy did not change. This was a secondary outcome of a trial built for another purpose, the support programme means the drug and the support cannot be separated, blinding and expectation were not assessed. Several authors report ties to a psychedelic-drug company or to the study's funder [26]. It is a clinical population, and its result should not be carried over to healthy adults.

The nearest thing to an answer for healthy adults is a University of Zurich trial of 122 healthy people aged 18 to 40, comparing psilocybin, MDMA, and methylphenidate. Its primary outcomes include the MET and prosocial tasks about four weeks after the session. The registry, last updated on 19 November 2025, lists it as completed on 22 September 2025, with no results posted, and PubMed searches on 1 and 4 October 2026 found no report from it [27].

What the acute effect might mean

Three cautions apply, and the third is this page's own reading.

The MET responds to many things. In 60 healthy social drinkers, alcoholic beer produced a small rise in emotional concern for positive pictures, but the overall effect on explicit empathy was not significant (p = .14), and the authors say the positive-picture result did not survive correction for multiple comparisons [28]. In a between-groups experiment with 24 healthy men per group, nasal oxytocin raised emotional but not cognitive empathy [29]. A later study found no effect of nasal oxytocin on the MET or on behavioral tasks in 20 MDMA users, although it raised their self-rated personal distress [20]. A rise in MET scores therefore does not show a specific effect on empathy.

The gains cluster in positive pictures. Feeling pleased for a smiling stranger is a different thing from staying with someone's pain, and compassion mostly concerns the second.

Finally, feeling more while reading others no better, or worse, is a strange meaning of "more empathic". Recognition of fearful or sad faces fell in the LSD and MDMA studies, and cognitive accuracy fell in one psilocybin study. A person who feels warmly toward everyone and misjudges what they feel has not clearly gained a social skill.

What is not known

Whether any effect lasts in healthy adults. We found no controlled measurement of empathy beyond the next morning, apart from patients. The Zurich four-week data are the first likely test.

Whether the effect shows up with real people. The pictures on the MET do not respond, and the one task with a simulated partner did not measure empathy. A Maastricht trial registered in healthy couples plans to measure empathy, brain synchrony, and conflict resolution between partners after LSD. Its registry status is "unknown", it has no results posted, and its participants were required to have taken a psychedelic before [30].

Which psilocybin result is right. Timing, dosing method, prior experience, and chance all remain open.

Whether anything here is specific to psychedelics. No study has compared a psychedelic with alcohol, oxytocin, or a trained empathy skill on the same measures in the same people. The closest are the stimulant comparison for MDMA [16] and the six-condition crossover [12].

What natural sources do. The controlled laboratory studies use isolated or synthetic compounds given by researchers. We found no controlled MET data on whole mushroom in healthy adults. For ayahuasca, the only controlled MET data come from one small field study in which the researchers did not control how the capsules were prepared or stored [40], and the ceremony data are uncontrolled. For an organization whose scope is natural psychedelics, that is the largest gap.

Individual differences. The LSD analysis found no moderation by sex or by previous use. The psilocybin founding study found no difference between experienced and naive volunteers and reported no test by sex. With 40 and 32 people, neither could detect a modest moderator. The MDMA studies give a mixed answer on sex, as described above.

How much of the literature exists. A count of interventional psilocybin studies on ClinicalTrials.gov on 1 October 2026 found 296 registered, of which 79 are flagged by their sponsors as accepting healthy volunteers [31]. A search of MEDLINE for microdosing and empathy in titles or abstracts, run through Europe PMC on the same date, returned three records. None was a placebo-controlled test of empathy in healthy adults.

What would a good study ask? Empathy would be measured as two or three separate things, with at least one behavior-based instrument rather than a single total score. It would include a placebo, a follow-up measured in months, a comparison with a trained route such as compassion practice, and records of what the material was, what the exposure was, the surrounding context, and the outcome. It would also use an outcome measure built for this dimension, because the existing measures each cover only part of it, as the measurement section above shows. This page lists questions. It does not describe a study that Metanoia is running.

Compared with other paths

The comparison is uneven. Training routes have decades of randomized trials and their own bias problems, and none has been tested head to head with a psychedelic.

Empathy training. A 2016 meta-analysis of 18 randomized trials (1,018 people), known here from its abstract, found a medium effect (g = 0.63), reduced to 0.51 after allowing for publication bias. Effects were larger with objective measures than with self-rating, and the longest follow-up was six months [32].

Mindfulness-based programs. A 2022 meta-analysis of 13 studies in healthy adults found a standardized difference of 0.37 (95% confidence interval 0.16 to 0.58), Programs of more than 24 hours (four data sets) gave 0.74 and shorter ones 0.27. Mindfulness-based stress reduction, one of the most used programs, gave 0.12, which was not significant. Nine of the 13 studies had no follow-up, and only one reported blinding. Every outcome was self-reported, and self-rated empathy predicts task performance only weakly, as noted above [33].

Compassion and loving-kindness meditation. A systematic review and meta-analysis of randomized meditation trials in healthy adults (22 studies, 1,685 people, searched in 2015) found an overall prosocial effect of r = .26. For empathy, which few trials measured, the estimate was r = .44 with a 95% confidence interval of .03 to .84, close to zero at its lower end. Effects on compassion appeared only when the teacher was a co-author of the study or the comparison group was a waiting list, and 61 percent of studies were rated weak in methodological quality [34]. One imaging training study of 25 women, with a non-randomized active control group and the two trainings given in a fixed order, found that training in empathic resonance increased self-reported negative feeling and activity in pain-related brain regions, and that subsequent compassion training lowered the negative feeling and raised positive feeling [35]. The pattern suggests that more empathy can mean more distress, but it rests on self-report after a short training, so it is a hypothesis, and a reason to keep empathy and compassion apart.

Reading and learning. A 2013 paper in Science reported that reading literary fiction improved performance on theory-of-mind tests [36]. A replication with 792 participants that used the eyes test found no advantage for literary fiction [37]. Both are known here from their abstracts. We found no randomized literature that treats exercise as an empathy intervention.

Where psychedelics stand. For acute emotional empathy ratings on a photo test, effects are real in some single studies and absent in others. For lasting change in healthy adults the question is untested. Training routes show moderate average effects, with weak controls and short follow-up. Comparing sizes across the two is invalid, because one measures a drug state for hours and the other a trained change weeks later, on different instruments.

History and tradition

Grade 4 sources. These describe what traditions teach. They are not evidence that any practice or substance works.

Practices for cultivating goodwill toward others are old. The Karaṇīya Mettā Sutta, a short discourse in the Pali canon, tells the practitioner to cultivate boundless love toward all beings, compares it to a mother protecting her only child, and says to radiate it in every direction [38]. The loving-kindness and compassion courses tested in the trials above are described as Buddhism-derived [34]. The ayahuasca ceremonies studied in the Netherlands were run by neoshamanic facilitators who were not clinically trained, so they should not be read as Amazonian tradition [21].

The book on all twelve dimensions   Back to the twelve dimensions