It's pent up emotions and feelings which flow freely after the drug has removed any blocks. That's the therapeutic part.

> In follow-up psychotherapy, patients process emotions and insights brought up during the MDMA session. The current protocol calls for patients to take MDMA two or three times, each a month apart, interspersed with psychotherapy.

> “The MDMA alone or the therapy alone don’t appear to be as effective,” Dr. Mithoefer said. “The MDMA seems to act as a catalyst that allows the healing to happen.

https://www.nytimes.com/2018/05/01/us/ecstasy-molly-ptsd-mdm...

MDMA and LSD affects your perception and brain chemical reactions just like food or cigarettes. The pleasure or sluggish of eating food is real or just chemical reactions?

Does it really matter if it's the drug directly or the shared experience it makes possible indirectly? (I don't which it is)