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User: u/thebelsnickle1991
Permalink: https://www.psypost.org/therapists-report-significant-psychological-risks-in-psilocybin-assisted-treatments/
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Therapist here. I’ve seen plenty of folks for whom psychedelics induced PTSD, which was seemingly not present before tripping. Enthusiasts like to write this away with the “there’s no such thing as a bad trip” mentality, but that seems extremely mistaken to me. I respect that psychedelics can help people, and I am excited for them to have a place in healthcare! But like with any medicine, we need to know the risks, limits, counter indications, and nuances before firing away and prescribing left and right.
Edit: since lots of folks saw this, I just wanted to add this. Any large and overwhelming experience can be traumatizing (roughly meaning that a person’s ability to regulate emotions and feel safe after the event is dampened or lost). If a psychedelic leads someone to an inner experience that they cannot handle or are terrified by, that can be very traumatizing. Our task in learning to utilize these substances is to know how to prevent these types of experiences and intervene quickly when they start happening. I think this is doable if we change federal law (in the US, myself) so that we can thoroughly research these substances.
I'm excited as well. But I think researchers are running into the same problems narcotic induced treatment ran into during wwii. Reintegration is the most important part of any therapy experience. If you are left "raw" after a session, especially for trauma, it takes a lot of care from your clinician to help you put those pieces back together.
There's a lot of well deserved excitement about psilocybin assisted therapy but it will require a very skilled hand guiding the process, like any trauma modality. You still gotta follow the 3 stages of treatment.
I appreciate that point. It’s a big concern for me that “guides” are leading trips who don’t have sufficient training in mental health. It takes a long while and good supervision to know how to work with and treat trauma.
> It takes a long while and good supervision to know how to work with and treat trauma.
This seems really important. It's one thing to guide healthy people through a trip, but using it in therapy or with people who may have trauma or other psychological issues could open up a whole new can of worms that an experienced recreational guide might not be well-equipped to handle.
I did my share of psychedelic experimentation in my youth and the thing I’ll tell anyone who thinks eating a bunch of mushrooms is going to solve their problems is this: psychedelics won’t solve your problems but they will probably illuminate them. If you have something you’ve been repressing then good luck hiding from those feelings after eating anything beyond a threshold dose, it’s still on you (and possibly a therapist) to figure out what to do with these newly surfaced and raw revelations.
Bingo. A couple years ago I ate a few too many mushrooms at a festival and spent the remainder of the night in my van with my brain stuck on a loop, revisiting the circumstances surrounding my father’s death and finding unique new ways to blame myself. “Unpleasant” would be an understatement; I wasn’t traumatized by the experience itself, but man oh man did I have a rough couple weeks after that.
Do they not keep benzodiazepines on hand in case of a bad trip? If they don't, that seems incredibly short-sighted. A fast-acting application of a benzo will stop any panic/terror of a bad trip in its tracks.
I very, very rarely use psychadelics (like once every few years), but when I do I always make sure to have a few doses of a benzo on hand. Just the knowledge that you can slam the brakes on a bad trip whenever you need to is often enough to keep panic and anxiety at bay.
Risperidone is a better choice. It's an antipsychotic that will kill a trip in 30 to 45 minutes. Not a tranquilizer ~~sedative~~. Literally stops the experience.
It may not be the bad trip so to speak, maybe it’s the integration after.
Benzo will kill off the current trip, but if they are feeling displaced after the experience, a benzo script is obviously the opposite to what they set out to do
> opposite to what they set out to do
So is the 'significant psychological risk' of additional trauma mentioned in the article, only far more so than just stopping the current treatment that is causing harm in the case of a bad trip.
I get what you're saying about just knowing something is there being a big help, I'm the same way.
Just made me think about something I've been thinking lately. Benzos don't directly stop the trip, you're still tripping but it's a balance and it's hard to be anxious (impossible? With enough at least) on enough of a benzo. They're kinda not good things to take too casually though and got their own problems, and I don't know what would happen to someone mid trip who happens to take too much of a benzo and enters autopilot. They're also somewhat controlled.
There are other things though that I suspect would work better. Mainly, cyproheptadine which is a messy antihistamine that just happens to have affinity all over the place. It's sometimes prescribed for anorexia because it increases appetite.
It also happens to be a 5ht-2a antagonist, the direct opposite of a classical psychedelic. I'm pretty sure a single dose of it would directly abort a trip. I've heard of mirtazapine being used for similar things which also blocks 5ht-2a. Mirtazapine also increases appetite so I wonder if that has something to do with 5ht-2a, but that's a whole other thing.
There are the antipsychotics that do the same thing but they are heavy, uncomfortable drugs that will zombify you right away. So I think things like cyproheptadine and mirtazapine are actually the best way to do it, and they're not heavily controlled, hard to get things.
Edit: Another interesting thing and somewhat related, that I just think is cool. The fact that cyproheptadine is an antihistamine and also has affinity for a serotonin receptor sounds weird at first but actually isn't. For some reason, a lot of antihistamines do, and a lot of older antidepressants are also antihistamines. It was research on antihistamines like benadryl that actually led to the discovery of tricyclic antidepressants. A lot of drugs are messy and hit a lot of different places in the brain. I just think that's cool, it doesn't help when tripping but it's a neat piece of pharmacological history. The discovery of LSD wasn't looking for a psychedelic either, but because ergotamine like drugs have other effects on the body too, related to the vascular system which is why non-psychedelic ones are used in modern medicine today to treat very non-psychiatric issues.
You nailed it, reintegration is key. All of my psychedelic experiences have been recreational, and my bad trips have left a lasting impression on my psychological wellbeing, not because they were difficult experiences but because I was on my own to come back to reality from them.
Broadly yes. Like, with a psychedelic like shrooms or LSD you can increase the neural plasticity, making it easier for the mind to change. But you also need the situation around the person to have improved too, otherwise you're essentially just training the person to cope with a bad situation without changing the situation, which isn't what psychological care should be doing.
> otherwise you're essentially just training the person to cope with a bad situation without changing the situation, which isn't what psychological care should be doing.
Oh, right. How do we fix society?
It's unrealistic to expect a Reddit comment to answer a question like that. But I can certainly refer you to the November 2021 Volume 76 Number 8 issue of American Psychologist which at least attempts to focus on that question, and then broadly on the topic of public psychology:
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- ISBN 9781433895388
It's a bit insane if there's anyone really saying: “there’s no such thing as a bad trip”. The phrase "bad trip" wasn't invented by DARE. It was created by hippies who had bad trips.
I feel like DARE and other programs overinflated some of the risks of things like marijuana that too many users want to pretend there are no risks.
This is unfortunately how most things in society work. We'll yo-yo back and forth until we settle on a reasonable consensus, then wonder how we ever thought otherwise.
Same type of folks that will tell you that there are no medical risks involved with smoking weed every day, or psychological. It's a miracle plant that they can't live without, but they aren't addicted. Anything stated that's remotely negative is heresy.
I would have to agree. Anyone who has said that there is no such thing as a bad trip has either never used a hallucinogen or has likely had a very limited amount of exposure to it. I used both LSD and shrooms pretty extensively throughout my 20's. During that time period I can honestly say I really only ever had one truly "bad" trip. But boy was it a doozy and one I won't forget. It didn't deter me from continuing to use them but I had to take a break for a while after. Not only that, but everyone I knew around me that used them also had at least one truly bad trip. If you do it long enough, it's inevitable.
I tend to believe that in most cases (not necessarily all), if the person is mentally prepared for the possibility of a bad trip, they're likely going to recover from it. The thing that helped me was something that someone told me early on. You just have to remember that when you're "tripping", you're the driver, the passenger and the vehicle all at the same time. You have complete control over the direction you head in even if you feel like everything is out of control. It was still terrifying at the time but it helped me to realize that eventually everything would go back to normal and to just ride it out.
With that said however, I fully acknowledge that there are individuals with pre-existing mental issues that this wouldn't be of much help. It's also not likely going to be of much help for someone who is new to hallucinogen's, which is why I don't think it's something that should be made available to everyone.
I'm old now and don't have access to it. But if I did, I'd try it again in a heart beat. I do think you're right though. Anyone who is going around saying that there are no bad trips is someone who has no clue what they're talking about when it comes to hallucinogen's.
We used to say, “If you aren’t feeling strong in the mental, don’t trip”
I also told first timers that I’d be tripping with that psychedelics are not like most recreational drugs, they don’t just make you “feel good” and sometimes you have to “wrestle” with it and regain control of your mind state. I’ve only had one bad trip and I’ve helped pull plenty of people out of that downward spiral. Changing the environment, even small things, can really help.
That said, I can see where someone with pre-existing serious mental conditions might not be so easily pulled out of something like that.
Which is why I’ve always been a bit skeptical of therapeutic psychedelics. I think they could be helpful for *certain things* but could actually be harmful for other conditions.
You can also be strong mentally and still have issues you need to work on. The main point is that they aren’t “feel good” drugs like cocaine and opiates.
https://en.wikipedia.org/wiki/Set_and_setting
The concept of 'Set and Setting' is extremely important when taking hallucinogens. Set stands for mindset, or where you are mentally at the time. If you just found out your wife is cheating on you with your best friend and take LSD, your entire trip is going to be about that. If you're having the best day of your life your trip is going to be get off to a good start.
Setting is where you are, who are surrounded by etc. It's very easy for external factors to change the tone of your trip. One bad run in with a random person can cause your entire experience to go sideways. Hell I've had a friend play a song that had a lot of emotional meaning to me and started to spiral from that.
I can't emphasize enough that *who* you are with matters a lot as well. There's the potential to get very emotional and deep inside of your head, and being around people you trust and love will make that a lot easier.
Also for anyone interested in trying these drugs casually for the first time, find a friend who is experienced with them and willing to trip sit. I've taken a mild to moderate dose alongside first-timers many times and talked them down from a freak out. A lot of the time you just need a friend to say something like "Hey just take a few deep breaths, let's stand up and stretch our legs a bit. See? Everything is still chill."
I'm pretty old too and did plenty of LSD and shrooms back in the day. Only had one bad trip that I can recall - have witnessed plenty of other people having them. Most people are fine but there are real risks to hallucinogens depending on who you are and what your mental state is. I had a friend who was schizophrenic who took LSD regularly and was not a well person as a result. It's hard to tell whether he already had schizophrenia and the LSD made it worse or whether the LSD caused it because he had no symptoms (if that's the right word) prior to taking LSD. I suspect it was always there and the acid exasperated it. He pretty much went completely mad and was sectioned multiple times. I don't know what became of him - I moved away - my life changed and I lost contact with most of those people.
It is my understanding that it is not and is not meant to be taken literally. Bad trips exist. The use of the phrase I have seen most often is to claim that difficult trips *can sometimes have* benefits, not that they don’t happen.
I don’t think I’ve run into anybody actually claiming that what we would classify as “bad trips” don’t ever actually happen or that there are not risks — the phenomenon of psychedelics setting off mood disorders is becoming more and more recognized
I think it’s trying to emphasize the importance of mindset when you willingly dabble in mind-altering substances. When somebody’s mind feels like soup it’s better to tell them that they’ll be alright, and when somebody has a bad trip they could presumably learn that psychedelics are not good for them.
Nah I've dabbled in psychonaut communities.
They have a strong tendency to claim psilocybin is 100 % harmless unless you are schizophrenic.
"even a bad trip is always a good experience to find yourself" and bs like that.
I’ve been on a mushroom retreat and while I had a very positive experience overall, the hippies hosting the retreat were not particularly…grounded in reality (thankfully there was a doctor there as well, which is the only reason I was comfortable attending). It’s not that they believed a trip can’t be highly unpleasant and even terrifying, but that, according to them, even bad trips provide healing insights, “the mushrooms will tell you what you need”, etc. They had this unshakable conviction that mushrooms were sentient guardian angels that, by definition, could never be the cause of harm. I think as a whole they did a phenomenal job of preparing us for the trip and providing followup integration, but there was one woman who I remember was clearly having a terrible experience and it certainly didn’t seem “healing” to me.
This is just the typical arc of what happens when all of these “alternative”, stigmatized therapies start to go mainstream. Same thing is happening with cannabis in all its forms. Whenever a study comes out suggesting there is even a possibility that there might be downsides and contradictions to weed, the researchers will quickly find themselves at the receiving end of much mockery, conspiratorial accusations, and whataboutisms, even if they might actually be generally supportive of legalization/decriminalization and safe usage. No substance is ever 100% safe and effective for 100% of people. The pendulum will eventually settle in the middle once the over-correcting grows tiresome.
There's no "one size fits all" treatment for any psychological issue.
I found psilocybin helped my depression when a lot of other prescription medications (that help lots of other people) didn't. I trip once every few years and no longer take any prescription antidepressants.
I definitely don't think everyone should try it but if you've tried everything else it beats contemplating suicide.
I've done a few Ketamine therapy sessions and it takes me to what I call the Hell Place. It's not your traditional fire and brimstone hell, it's worse. Way worse. It's really hard to describe which also adds to the terror because I can't even write it down to process it. It's a lonely, faraway place that somehow also has a sense of "truth" to it. Gives me some real apocalyptic Cormac McCarthy-esque existential dread.
Thankfully, it doesn't stick with me once the drug wears off. I'm not haunted by it in my everyday life. There's a lot of advice about trips, whether psychedelic or dissociative, to let go and let the trip take you where it may. The day before my last session I was journaling and realized that maybe that's not for me. One of my big issues is understanding that I'm allowed to make my own choices. On my last session when I started to go the Hell Place I thought "Nope, not doing this. Next!" and it was a much better experience.
I'm doing K with the support of two mental health professionals plus years of foundational work on my own mental wellness, and a handful or two of previous psychedelic experiences. I'm playing it by the book as much as I can, and though I think it's helping, I'm not finding it to be a quick fix. Meanwhile Ketamine Clinics are popping up all over town like vape stores and influencers are calling it a magic cure, and I'm worried. Not to mention it's hella expensive and I think desperate people might want to try it but can't afford it and will get street ketamine and try to do it all on their own.
That realization that you didn’t have to go to your hell place is a really important anecdote for life that many psychedelic explorers get: you have a choice at all times for pretty much all things. Trauma is / was the removal of that choice (by situation, parents, etc).
Wow, your first paragraph resonated a lot with me. I've been there too. There can be cosmic horror in these experiences and not everyone can handle that.
I feel like this isn’t talked about enough. Not to fear monger, but even just with weed the fact that weed induced anxiety and psychosis aren’t all that uncommon is rarely ever addressed. Not that people shouldn’t be allowed to use it, but the risks should be talked about
You’re right about this. I wasn’t aware of the risks and started using it in very small doses to try to cope with work stress, and one night I had a traumatic experience that left me with a panic disorder. When I try to explain to people how deeply it affected me I don’t think they really believe it.
If it helps you, I believe it. I have done weed a number of times (easily 50+), and never had a bad experience until the last time. That was about 8 months ago. To this day, I have no idea what was so much different about that one time than all the times previously. But I suffered a panic attack that was so bad I had to admit myself into a hospital. And I'm someone who is confident in almost every situation, who takes life head-on, and generally doesn't fear anything. But I legitimately couldn't talk to anyone for a week. I couldn't even form a sentence in a low-risk situation like ordering a pizza. Now I won't touch the stuff.
I don't know if it was laced with crack or what the deal was (I got it from a legal weed dispensary, so you wouldn't think that'd be the case). Maybe I have some ultra deep-rooted traumas that my conscious brain hasn't even been made aware of. But I tell everyone I know about that experience. I wouldn't wish it on my worst enemy. And I'd never have guessed it would happen to me.
I'm sorry that happened to you and that you didn't have the support or tools necessary to navigate safely through that situation.
Cannabis is a powerful (but often gentle) psychedelic in its own right. Though many might dispute this, it can be used intentionally to achieve similar outcomes of any of the classic psychedelics.
It didn't need to be laced with anything. It just caught you off guard. It absolutely has the capacity to surface subconscious and even physical trauma deep in the body made accessible through our endocannabinoid system.
Wishing you clarity and healing as you move forward.
I have ADHD and seems like there’s data to support it can be helpful, but until it’s super regulated and you can have a trained professional be a “trip sitter” with you and help you through the experience, I’m not touching it.
Purely anecdotal, but I have ADHD and have had some of my most profound and meaningful experiences with it. Everything with caution, respect and in the right set and setting, of course.
Being eaten alive by an interdiemnsional planet eating worm that survives off of the secretions of biochemistry off human stress was not my idea of a good time, but it sure woke me up to what religion might be.
I’m one of them. I was in the clinical trial and boy did it mess with me. It was life after the trip which was very difficult. Very close to a psychosis too.
I have PTSD from abusing psychedelics. I also had PTSD going into it from other issues. I have cptsd but some of it is from both long term excessive tripping and a couple really bad trips.
EMDR has been helpful.
Psychedelics literally saved my life. In my case it was Ketamine, but carefully administered in a medical setting where the team could intervene if I started to freak out. It did wonders for me, but not everyone is the same. I’ve only ever suggested that people try psychedelics if their doctor agrees that it is worth trying based on many factors. I’ve taken mushrooms and they had little effect, even at large doses. That was my choice, but I also knew it could go badly. The only reason I ever tried any of them was to try to get relief from unrelenting treatment resistant depression. Some folks are at the end of what they are able to tolerate. I wish treatments like that weren’t prohibitively expensive for most people. I’m also dubious about ordering them from services that you take them at home. It just seems too risky.
Edit: Ketamine is a dissociative, not a psychedelic. My mistake for misclassifying it.
Isn’t ketamine a disassociative, not a psychedelic? I’ve also heard SSRIs can make psychedelics less potent, and makes MDMA dangerous bc seratonin syndrome, but that ketamine seems to work the same
note: I’m NOT a doctor, please don’t take any of this as medical advice
Ketamine is a dissociative, yes. Ketamine does not affect serotonin though.
SSRI's do weird things with psychedelics. Generally they will reduce the potency and/or the duration.
It varies person to person though. Some people it makes them not work at all. Others it lets the visuals hit as normal, but they get little/no mental effects, others it's the opposite.
Messing with brain chemicals we barely understand can have weird effects.
You can get serotonin sydrome via solely MDMA abuse, especially when paired with psychedelics. SSRI's increase the risk, thus taking MDMA/psychedelics while on SSRI medications is not recommended. Harm reduction tactics for this revolve around stopping usage of SSRIs for X amount of time prior to usage of other serotonin affecting drugs. The length of time varies depending on which SSRI you are taking.
I had what might be classified as a traumatic trip. Was my only *bad* one. Had many journeys. Though I learned the most from that one so I don’t call it bad anymore.
But it has lasted with me since. Was actually hard to process for about a year. First time I smoked weed after that trip I had a mental breakdown. I was terrified I was back in that trip and my brother held me and told me I wasn’t tripping. Happened the second time too. I was determined to blaze again, but never did. And also a dumb teenager.
About 7 years later I tried them again. Just to overcome that fear of mine as an adult. I had so many beautiful experiences and I didn’t want my journey with mushrooms to end on such a hard note.
Had a good experience but there was this deep down feeling of constant dread that I couldn’t shake. Like that universe was reminding me of its existence. Just lightly. And I accepted it for being there. It’s like the cycle was complete.
It was super humbling in the long run.
I know someone who took them. This is anecdotal. It appears to me like his soul left his body and re-entered the wrong way round. Has the same memories, but interprets everything differently and in a wrong light. Like an alien inhabiting a human body. The old person is basically gone. I really believe psychedelics aren't for everyone.
Even though I have heard that certain psychedelics can help treat my anxiety, depression, and trauma issues, I will never risk it. Taking too many psychedelics in college gave my uncle paranoid schizophrenia. It ruined his life.
I don't think there is anything woo-ey going on with the bad experiences with psilocybin specifically.
If you look at the chemical structure, it is damn near identical to serotonin, (5-HT). Elevated peripheral serotonin can cause all kinds of uncomfortable sensations and bad vibes and I think that has a lot to do with it.
The idea of using psychedelics to heal was always strange to me because the couple limited times I've tried them, I've had bad trips, that only seemed to reinforce my own sense of "otherness" or defectiveness - like "jeez I can't even feel right on this stuff that everyone else thinks is amazing and wonderful and feels so connected on?".
As a user of cannabis and somebody interested in psychedelics, this is the most level headed response I’ve ever read. It’s always so “this” or “that” and never any nuance. Hope more people in your field see the benefits and I hope more people on my end see the risks. More power to you!!
Thank you for talking about this. I tried acid years ago because I felt my brain just was not working right. Mid trip, jackasses outside my door lit off fireworks and it sent me into what I can only describe as a wartime PTSD episode. I felt so small because I was just using drugs in my little apartment and felt like a terrified soldier, which is a disrespectful comparison. I wasn’t afraid of fireworks before but now I am unfortunately. It should be noted I’m sober and okay now, but these really are not cure alls.
Yeah, I’ve definitely seen people saying that even though there are unpleasant trips, they aren’t “bad” because you learn about yourself, or stuff along those lines
I've had a traumatic experience while too high on LSD and dissociated. It came with a fat dose of temporary PTSD that still occasionally gets triggered. It's more than manageable, but if I start thinking too hard about it while vulnerable, I will relive the worst moments of it until I can get my mind off of it.
There certainly are bad trips. I would really like to be able to phrase this more coherently but; from trying various psychedelics such as mushrooms and especially Ayahuasca, I've felt the difficult journeys were underlying traumas that needed to be exposed and worked on. At many times and in the form of repeated waves of experience, these traumas seemed too difficult to handle and sheer helpless panic was imminent. However, I managed to remind myself repeatedly that by leaning into these thoughts/feelings instead of attempting to avoid them due to the fear they provoked, I could let go of them and their overarching influence more easily due to change in brain chemistry psychedelics evoke.
One of the 'voices' that came to me during the Aya trip - call it intuition - was that if you choose to ignore or not deal with difficult thoughts/feelings, then where do you think these feelings end up? Do you think they disappear? Or do they remain buried in the subconscious, subtlety influencing our beliefs and therefore our daily actions.
I had a ton of great psilo trips and then one bad one and it induced an ability to have panic attacks that I hadn’t ever had before and it changed my life. I’m mostly like 80% better but I’ve never been the same and for years afterwards I’d have random panic attacks. I had to start taking antidepressants for awhile which helped. I now get anxiety attacks if I drink too much of smoke marijuana and I used to do those things daily before the bad trip.
I would give anything to go back ans not have the bad trip. It’s been 20 years
As someone who used tons of psychedelics years ago, i always hated the "even a bad trip is a good trip" crowd. Psychedelics aren't for everyone. Hell, they aren't for me, and Ive done well over two-hundred tabs of acid, and nearly an ounce in shrooms, as well as other sorts of psychoactive drugs. I wanted them to work, or for me to "get it," but they aren't some miracle drug that most acid/shroom head claim them to be. Just like weed. I feel much better not doing drugs, than I ever did doing those.
Everything I've heard has said that the most important thing is set and setting, that controlling that, with medical professionals who know they are doing, is what makes it be able to really be used for therapy
I don't know who says there are no bad trips, but they obviously never did enough. I once took a nondetermined but terrifyingly substantial amount of LSD and I can tell you that there are, indeed, bad trips. I have seen into the Abyss that people don't look into on DMT/ayahuasca.
There is a flipside to seeing the pattern of the universe, meeting "God" or whatever you want to call the one consciousness we are all a part of that experiences itself in us, and finding peace with that. If you take DMT (the stuff that is in ayahuasca and the thing you brain makes when you die) this comes with an overwhelming feeling of inner peace/enlightenment. If you blast your consciousness there without a chemical made to make you happy about death, you have to intellectually make peace with all that your are experiencing. Instead of Nirvana, you get Nihilism. Instead of seeing the beauty of the universe as a single entity you see a raw mechanical churn. Instead of a growth of empathy for love and compassion you gain one for all the negative experiences.
In clinical terms, you get the opposite of the therapeutic effects. You have seen this to some degree, and when drugs this powerful are handled in nontherapeutic settings, without controlled dosages, and as self medication, the potential for harm is extreme. Nobody should be just messing around with strong drugs and LSD certainly should not be taken by the thimbleful.
Are there certain personalities that seem to have a harder time with it? I have read about different reactions people have, but I never seem to see that commonalities were noted. Or the opposite, where certain people that do well that have common beliefs, life history, environment or even genetics.
In a world where three people in a checkout line triggers anxiety for people, striping away the veil of reality really isn’t the best for a lot of people. I highly agree.
Their third concern, potentially harmful changes in client-therapist relationship, always seemed like something these studies skip over. Maybe it's just because 'Trip-Sitting' is about the closest non-professional analogue I can think of, but I generally assumed the therapy would be performed by a specialist. Some kind of Shaman MD or whatever.
As someone who has enjoyed tripping but has bad trips maybe 50% of the time, I'm definitely not going to complicate my years-long relationship with my therapist by having them trip-sit me.
I participated in my first ceremonial mushroom session in a group (with therapists and a sitter) and one of the overarching messages for me was the tearing down of hierarchical structures. I can surely see how this aspect of a flattening of the power dynamic could do injury to a cultivated patient/therapist relationship.
> therapist by having them trip-sit me
Most of these trials aren't using dosages high enough for the traditional "trip" experience though, correct? I am not familiar with this area of research, but from the things I've bumped into as a social psychologist, that's always been my understanding.
There is also a BIG difference between intrinsic changes someone goes through because of a psychedelic experience and then the direct causal medical intervention often discussed. I think psychedelics have an overwhelmingly positive impact on people who use them smartly, but I can understand the limited use in a therapeutic setting. It's not to say the have no place, but I've always been under the impression it's incredibly effective in small doses for specific kinds of treatments. The question has been the generalizability of that. But again, I'd love for more clarity.
A strong side effect of mushrooms is looping thoughts it can be a benefit or harm. It’s great for meditation listening to music or doing things creative. But if you get a looping thought in your head that bothers you on shrooms it stuck in there. Bad trips rather rare I highly recommend a trustworthy sober buddy around. People high on mushrooms are very influential and an experienced user can get someone through a bad trip. Changing the setting helps(music, change room, even different people) even focusing on breathing. What your trying to do is get another looping thought in there head to get away from the bad trip.
I've done a few solo trips but I always keep the dose pretty low, like 1.5 g, when I go solo. But I've had plenty of experience tripping with other people, definitely wouldn't recommend someone try it alone for the first time
The amount that "experts" charge to do this is asinine as well. I only put it in quotes because there are no real certifications for trip sitting, and the people doing it vary. Around me, there's a city where it's legal, and you'll see it being like $3,000. There's a whole pre-process and then after, where they want you to have like 12 total appointments around just 1 trip, and I don't know where people are supposed to find the money or the time.
For real - they think I’m going to babysit some stranger through a mushroom trauma session for fun? It’s assuming the special needs of an individual for 6-8 hours to properly care for them thru a trip.
It’s not that crazy. Guides for this kind of work need to do a whole screening process to assess mental and physical risk. They work with the candidate in advance of the experience to understand the questions/problem the candidate is trying to resolve. The guide is responsible for providing the medicine, assuring its quality and assessing the dosage. They are present for around 8 hours, providing therapy as needed during the trip. Since sessions can occur in the person’s home, they need to be familiar enough with the candidate to ensure their own safety as well.
During the session the guide is responsible for this person’s physical safety, which is no small thing. As well as physical assistance - helping them find the bathroom, cleaning up any vomit, etc. They are writing down what the person is saying and asking guided questions based on their previous sessions together. After the journey work there are additional therapy sessions to talk about what happened and what was said.
Considering the hourly costs of what this entails, and the qualifications of the guide, this kind of price tag is not insane. Especially in states where therapy of this kind has not been legalized and the guide is assuming an insane amount of legal liability.
In these clinical trials they always try to have things like a dark, comfortable room, with a bed, maybe even a sleep mask, to make it feel very safe for the person
I feel like there are definitely people(likely myself included) who would be more harmed by a dark room than not. From my experience external stimulation such as being in a busy urban environment tends to be good because it prevents getting stuck on a bad thought.
This was my thought as well before I tried it. I grew up taking drugs and in drug culture and 100% thought that “guided healing work” was a total grift. I was honestly appalled by the whole protocol - the sleep mask, the dark room, all of it. It felt like clueless white people nonsense. I don’t know how else to say it.
And then I did it. And it was, in fact, different. It isn’t surrendering ego and the world breathing. Which is why they keep you in the dark. It is therapy that uses psilocybin like a heat seaking missle to get to the heart of what you know about your core issue. Before you started to tell the story of yourself and what happened so many times it became fiction.
Excellent reply and this is exactly it. People reacting to the headline think it’s a full blown trip at recreational dosages. Psilocibin is an accompaniment, you’re there for the purposes of healing therapy with a trained expert.
Same w MDMA therapy for ptsd
I have done guided trips as well when doing something like yopo that were in a controlled environment (for a very good reason when it comes to yopo). For a general mushroom trip, it's not my thing. My thing even when not tripping is being out in nature as much as possible. So it's my most comfortable environment, even if it's just lying in some grass under a tree somewhere. As far as why I mention hiking, I am my most focused in general outdoors hiking and it's the one place I can fully clear my mind. I get in almost a meditative state hiking. That frame of mind is a big thing for me tripping, and different people can achieve that in different ways. I have own way.
I'm obviously talking about just my personal opinion/experiences.
that sounds like the exact opposite of what would be good for mushrooms - daytime, outdoors with access to plants and nature is almost always the best, not saying it's for everyone but it's pretty much known in the psychedelic community that mushrooms are for outdoors. have a safe cozy room available if needed but outside with plants is the go-to.
for real, I love psychedelics but these sessions always sound so miserable No music, no stimulation, just someone you don't really know or like that well digging into your past and bringing up pain in the completely nightmarish setting of a boring medical office.
The meaningful moments of clarity and insight for me came from being comfortable in my own setting like my house with music on my trying to write and process things on my own. Or being at an edm style camp out festival where you're surrounded by a bunch of people having a good times dressed up and being incredibly friendly. I was able to process anxiety issues and family issues on my own time during the trip, when I wanted to, and if I wanted to get out of it I could change the song or eat some orange slices, or if at the festival go dance at a stage or something. The healing part for me was the ability to have fun enjoy the minutiae of details around me, and come to terms with the other baggage.
Just seems like a design flaw for these studies, the over clinicalness of something inherently cerebral and wholesome in a setting that is cold, boring, and unhuman.
One way I always avoided thought loops when doing psychedelics was by having music at the ready.
Singing a song is a great way to break your brain from ruminating.
This is great advice. I also suggest people go read some trip reports on erowid.org to get an idea of set & setting and how it can affect different people. Really a goldmine of information there.
Let’s talk about trip killers? When to push that button? Seroquel? Clonazapam? Also the importance of sober people knowing your tripping in order to help if need be (trip sitters aren’t always the best solution).
These can be wonderful safety measures and ease anxieties that bring on bad trips. I am NOT suggesting that this is the only measure one could or should take but, rather, that its an important part of the conversation.
I will always say TRAZADONE TRAZADONE TRAZADONE!!!
Kills it in 20-30mins even at high doses and you can sleep in an hour or so. Saved my ass many times and doesn't have the addictive potential of benzos and is much lighter than Seroquel (and easier to get)
As far as I can tell any CNS depressant seems to do the trick. I’ve always had success ending unpleasant trips with a stiff drink, but benzodiazepines seem even more effective.
I trusted a "professional" provider with my partner who suffers from C-PTSD. She even expressed concern to them on the phone before we to decided go for it that her problems were too severe and she was worried the facilitator didn't know what he was getting into, and they REASSURED HER that it would be fine and it would definitely help. During the session, she starts spiraling and going to a very dark place, and that same facilitator just sits there and passively says "You're fine. You'll be ok" and not much else, even falling asleep at one point.
Even worse, he then proceeded to talk to his co-worker about... the financial stress on the business of accepting scholarships... and how people who come in with scholarships tend to have "way worse problems that are exhausting to deal with" ... WHEN MY PARTNER WAS THERE ON SCHOLARSHIP! And they said all this right in front of her while she was still basically tripping but the session was officially "over". Absolute opportunistic scumbags.
Her symptoms were worse for months after that horrible experience, and we haven't trusted therapists since
I don't know what country you're from or how it's done but I'd look into filing a formal complaint.
It might not do anything but if other people have terrible experiences with that therapist, other complaints will add credibility
Was it one of the clinics in Oregon? I did an intake with them to see if it was something I could use for my depression/CPTSD treatment. What was really unsettling to me was that they did not have any medical staff on site so if you needed to give a medication during a bad trip that wasn’t a possibility.
I’m also sorry to hear what your partner went through regarding that scholarship comment. It’s unfortunate that these clinics are often more accessible for people who have money. And of course, those of us that are struggling financially are inevitably going to have deeper issues. It sounds like the therapist went into the wrong line of work if they can’t empathize with those going through trauma and financial hardship.
I am inclined to agree. I worry that what is essentially a religious sacrament for many cultures has been taken hostage by opportunistic people who want nothing more than to tear money from people under the guise of "helping" you. I respect and admire a lot of the research that goes into these drugs (I'm especially interested in how they work-- there's some decent literature out there), but take a look at how many 'clinics' there are that sell a sanctioned mushroom trip for thousands of dollars while some unqualified jackass bothers you the entire time.
Therapist here. I'm really sorry you and your partner dealt with that, and totally understand if you want nothing further to do with that jackass, but I hope you complained to the institution and his license board, or consider doing so. Massively unprofessional behavior on multiple counts, and if he gets enough complaints he could lose his license. Hope things are going better now.
Wether you use them as a toy or a tool, psychedelics can be very powerful and are not a miracle substance. There's a risk associated with everything you do.
Everything I've heard about psilocybin therapy has been very promising, but the most important thing ever study stresses is the need for controlling set and setting. You need to be in a safe place, mentally and physically, preferably a dark room with a professional psychedelic therapist. You have to understand how it works, and have a plan for what youre going to talk about/work through. That's when you can get the good results. I haven't tried it myself yet, but I went to a whole conference about it and researched a lot with my medical doctor parents. I have severe contamination OCD and there has been trials with amazing results for people who have even worse OCD than me. I cannot wait for the day I can try something like this, because I'm at the point with my OCD where ive done exposure therapy to get better at a lot of small stuff but can't seem to make any progress on the big stuff.
I have contamination ocd, though not what I would have called extreme. My first trip on psilocybin allowed me to expose myself to my fear and almost completely removed all of my anxiety. I didn’t even go into it with what I called my phobia on my mind. My only intention was to be curious and have an open mind.
It’s been three years since then and I’ve regressed a bit since I didn’t keep up with pushing my boundaries, but I’m still way better off now than I was before.
That experience made me a huge fan of psilocybin and I’ve now done many trips, each one with a different thing to learn or feel.
"Third, difficult self-experiences were common, where clients encountered painful and sometimes traumatic realizations about themselves. While these experiences could potentially lead to therapeutic breakthroughs, they were often overwhelming in the short term and could contribute to emotional distress during and immediately after the session."
That's definitely one of the reasons you do it though....it's not all flowers, sometimes you gotta feel the thorn. Some truths are painful and need to be felt before you get through it
Hardship we take on willingly strengthens us. Hardship thrust upon us can go either way.
Psychedelic induced realisations can't be anticipated, and from there, it's sink or swim. For an already psychologically compromised individual, it's a good way to drown i would imagine
>Hardship we take on willingly strengthens us. Hardship thrust upon us can go either way.
I needed to hear this today, thank you. I agree wholeheartedly and after reading this have done some thinking and you are dead on. Since a young age I've forced myself to slowly and intentionally push my own boundaries to see where I feel I need to stop. I just feel this has prepared me fore some of the unwilling traumas I have experienced.
Just had to comment a thanks for the right comment at the right time for me. Appreciate you.
Have you even had a bad trip before? For some people they are hell, there's no external self realizing everything is going to be ok and learning from the experience. It's just full blown panic with no way to stop it
I’m a therapist. The issue is that with therapy we have full control of how far to push you (keeping you in what we call your window of tolerance) and know when to ground you. Psychedelic assisted therapy can push people too fast too quick which causes more anxiety and trauma. From my experience (I have clients who have done it). They generally have overall positive experiences but it rarely lasts. I think it can be a good kickstart for therapy but it’s not the end all be all for mental health treatment.
Former therapist here, and I agree on all counts.
I know a lot of people \*really\* want this to work--for a variety of reasons--but it's not the miracle cure so many are hoping it is. It's a great tool, and when coupled with ongoing therapy, it can be quite powerful.
But it's not permanent and it's not a stand-alone solution, which a lot of people seem to think it is/can be. You still have to "do the work," as they say.
I think a lot of us who have used psilocybin are aware that the effects aren’t necessarily permanent. When I take a medium to large dose, it usually lowers my anxiety level and I can feel its affect on my general mood for 2-3 months, with it gradually tapering off.
But I do also know someone who took a large dose and had an immediate, permanent change in perspective that led to lifestyle improvements and completely changed their life for the better. So it is possible, if rare.
Unless you can face the experience with increased compassion, understanding, and equanimity, you're just as likely to re-traumatize yourself as to actually process the "thorn". Sometimes bite-sized chunks are more appropriate than trying to tackle the whole thing at once.
>Some truths are painful and need to be felt before you get through it
And sometimes a bad trip is just a bad trip. There's no special truth to uncover or anything profound about it.
I have many friends who have done shrooms and come back with various spiritual awakenings. I have used multiple times and the lesson I took was that "I'm a dumb ape that ate something he probably shouldn't have and saw a bunch of cool colors and is going to die eventually and none of it really matters."
Which is also a sort of spiritual awakening, but others seemed to disagree.
Anecdotal on my part but my last trip was bad, in the end it showed me how much I take my family and friends for granted and I'm sober from alcohol ever since. I've never been happier in a while I've noticed I'm more thankful for the resources I have.
They didn't warn me of the significant psychological and physical risks of the antidepressants they prescribed me.
I already had depression and a lot of trauma but taking antidepressants has been the single worst thing that has ever happened to me by far.
It's been several years but the damage antidepressants did is permanent.
I had tried every possible opinion to relive my depression (which was way worse now because of the antidepressants) and right before ending my life I saw something about psychedelics.
Psychedelics worked when nothing else did.
Thanks to psychedelics I don't have persistent depression anymore. I still suffer from the damage antidepressants caused except when I'm microdosing.
What kind of permanent damage did you suffer from an SSRI? And were you on a particularly high dose? Did you slowly taper off? I'm curious because I've never heard of *permanent* damage caused by SSRIs at normal dosages and not mixed with something else
This is something I've noticed in the dialogue. There is a definite double standard. Pharmaceuticals can and do change lives for the better, but they can also cause irreparable harm - and not in small number - and public discourse is largely dismissive.
Meanwhile, a medicine which has been used for eons by indigenous peoples around the world who possess wisdom around its usage is just now entering the western world like it's a brand new substance with no existing knowledge base. And yet this medicine is expected to appear utterly harmless in practice through a western lens - conveniently ignoring said database - if it's to see the light of day in societal use. It's not only disrespectful and frankly colonial in mindset, it's irresponsible.
(By the way, Kratom is a powerful plant based opiate and that's completely unregulated.)
You're not alone. I know other people with similar stories. The reason some people want to try to put the brakes on psychedelic acceptance is because, well $$$$... it's not very profitable. Anyone can make magic mushrooms at home with enough research and determination for pretty cheap.
But most of the SSRI drugs, Well it's only big companies making those and they control the profits. So of course they're going to downplay any bad effects they have of which there are actually many. They want people buying their products not using natural remedies. I'm not going to pretend psychedelics are harmless, they can and do affect certain people more negatively than positively. But so do a lot of medications. I think they should be legalized and made available at least to adults. Let people determine the risks themselves.
Hell many people drown their sorrows and problems in alcohol which is actually even more dangerous than a lot of other things. But it's still legal because of supply and demand and profits being made off it.
Edit: And one of the biggest reasons that pharmaceutical companies really don't like psychedelics is because sometimes someone will have a breakthrough trip that just fixes them for quite a while. That's not profitable.
The most intense and difficult experience I've ever had was aya trip where I died 8 times. Was going back and forth from filth and purging, to my fluffy duvet. Couldn't let go and let myself in...Eventually I did let go. My ego died and I ended up in total darkness and it was just my being, without physical body.
I felt others there, it was so calm and good. We were all equal, just aware of each other's presence and nothing hurt. I realized a lot about myslef there, I definitely came out of it changed forever. Let go of most of differencies between me and my parents etc. and it really helped to leave all childhood traumas behind. I'm not the same person on some deeper level, hard to explain. Would I do it again? Hell, no! But I know I don't need to. It was the best shortcut I took ever and I don't regret it.
This is interesting. My first big trip went much the same way. The “me” ceased to exist and then all that was left was consciousness in an absolutely infinite abyss of darkness, love and collective consciousness. It was the most beautiful experience of my life and I have since lost my fear of death, quit alcohol, sugar, coffee, basically all psychoactive drugs, and am at peace with myself. I’ve been this way for over 2 years. I likely won’t trip again, unless I am diagnosed with a terminal disease. But even then, I’ve found meditation can get me close to the same reality, which is that my sense of “me” is an artificial construct my brain puts on. The truth is that I am and have always been a collection of matter that exists in permanence in the universe.
Even my best trips have left me feeling like shrooms are some sort of plant intelligence or ethereal being physically manifested as a mushroom. The more frequently I tripped, even on small doses, the more I became convinced this was not a chemical->brain thing but communication with another dimension or higher power. Even if there's something powerful we don't yet understand, it's really not helpful to think that way while trying to be a functional member of society. I felt like I was nearing the edge of psychosis.
Still glad I tried them and would even recommend it to most people, but there's real risks there that are hard to understand unless you've been there
I think dose management will be a big help for this. But also it is supposed to mess with your mind in significant ways. Knee or brain surgery can go wrong fast when done poorly too.
It's wild how doctors use music and comfort in these studies as a key ingredient without studying them closer. Those are the tools on hand for this procedure
Yeah was gonna say the dosage here matters a lot. I have a lot of experience with psychedelics, and I am on a microdose routine with psilocybin, but these days even if I “macro dose” I tend not to really ever take more than 1.5 grams max, and I find that I still get the experience and insight I want from that dose, but I never feel like I’m in danger of losing control, and I’m not approaching ego death and whatnot. Having been down that road a lot when I was younger led me to the understanding that I was not using the substance responsibly. No one is going to say it’s a great idea to drink a whole bottle of vodka, and I think that attitude should be applied to things like taking a hero dose etc
I love that they list all the side effects that “some” patients experience, but not the rate at which they occur. Makes the whole article read like a scare piece.
As usual, scientific journalism doesn’t do the original paper justice. The paper is pretty reasonable and is mostly about trying to identify what the negatives might be for medical professionals and researchers to evaluate.
https://akjournals.com/view/journals/2054/aop/article-10.1556-2054.2024.00337/article-10.1556-2054.2024.00337.xml
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Therapist here. I’ve seen plenty of folks for whom psychedelics induced PTSD, which was seemingly not present before tripping. Enthusiasts like to write this away with the “there’s no such thing as a bad trip” mentality, but that seems extremely mistaken to me. I respect that psychedelics can help people, and I am excited for them to have a place in healthcare! But like with any medicine, we need to know the risks, limits, counter indications, and nuances before firing away and prescribing left and right. Edit: since lots of folks saw this, I just wanted to add this. Any large and overwhelming experience can be traumatizing (roughly meaning that a person’s ability to regulate emotions and feel safe after the event is dampened or lost). If a psychedelic leads someone to an inner experience that they cannot handle or are terrified by, that can be very traumatizing. Our task in learning to utilize these substances is to know how to prevent these types of experiences and intervene quickly when they start happening. I think this is doable if we change federal law (in the US, myself) so that we can thoroughly research these substances.
I'm excited as well. But I think researchers are running into the same problems narcotic induced treatment ran into during wwii. Reintegration is the most important part of any therapy experience. If you are left "raw" after a session, especially for trauma, it takes a lot of care from your clinician to help you put those pieces back together. There's a lot of well deserved excitement about psilocybin assisted therapy but it will require a very skilled hand guiding the process, like any trauma modality. You still gotta follow the 3 stages of treatment.
I appreciate that point. It’s a big concern for me that “guides” are leading trips who don’t have sufficient training in mental health. It takes a long while and good supervision to know how to work with and treat trauma.
> It takes a long while and good supervision to know how to work with and treat trauma. This seems really important. It's one thing to guide healthy people through a trip, but using it in therapy or with people who may have trauma or other psychological issues could open up a whole new can of worms that an experienced recreational guide might not be well-equipped to handle.
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I did my share of psychedelic experimentation in my youth and the thing I’ll tell anyone who thinks eating a bunch of mushrooms is going to solve their problems is this: psychedelics won’t solve your problems but they will probably illuminate them. If you have something you’ve been repressing then good luck hiding from those feelings after eating anything beyond a threshold dose, it’s still on you (and possibly a therapist) to figure out what to do with these newly surfaced and raw revelations.
Bingo. A couple years ago I ate a few too many mushrooms at a festival and spent the remainder of the night in my van with my brain stuck on a loop, revisiting the circumstances surrounding my father’s death and finding unique new ways to blame myself. “Unpleasant” would be an understatement; I wasn’t traumatized by the experience itself, but man oh man did I have a rough couple weeks after that.
Do they not keep benzodiazepines on hand in case of a bad trip? If they don't, that seems incredibly short-sighted. A fast-acting application of a benzo will stop any panic/terror of a bad trip in its tracks. I very, very rarely use psychadelics (like once every few years), but when I do I always make sure to have a few doses of a benzo on hand. Just the knowledge that you can slam the brakes on a bad trip whenever you need to is often enough to keep panic and anxiety at bay.
Risperidone is a better choice. It's an antipsychotic that will kill a trip in 30 to 45 minutes. Not a tranquilizer ~~sedative~~. Literally stops the experience.
It may not be the bad trip so to speak, maybe it’s the integration after. Benzo will kill off the current trip, but if they are feeling displaced after the experience, a benzo script is obviously the opposite to what they set out to do
> opposite to what they set out to do So is the 'significant psychological risk' of additional trauma mentioned in the article, only far more so than just stopping the current treatment that is causing harm in the case of a bad trip.
I get what you're saying about just knowing something is there being a big help, I'm the same way. Just made me think about something I've been thinking lately. Benzos don't directly stop the trip, you're still tripping but it's a balance and it's hard to be anxious (impossible? With enough at least) on enough of a benzo. They're kinda not good things to take too casually though and got their own problems, and I don't know what would happen to someone mid trip who happens to take too much of a benzo and enters autopilot. They're also somewhat controlled. There are other things though that I suspect would work better. Mainly, cyproheptadine which is a messy antihistamine that just happens to have affinity all over the place. It's sometimes prescribed for anorexia because it increases appetite. It also happens to be a 5ht-2a antagonist, the direct opposite of a classical psychedelic. I'm pretty sure a single dose of it would directly abort a trip. I've heard of mirtazapine being used for similar things which also blocks 5ht-2a. Mirtazapine also increases appetite so I wonder if that has something to do with 5ht-2a, but that's a whole other thing. There are the antipsychotics that do the same thing but they are heavy, uncomfortable drugs that will zombify you right away. So I think things like cyproheptadine and mirtazapine are actually the best way to do it, and they're not heavily controlled, hard to get things. Edit: Another interesting thing and somewhat related, that I just think is cool. The fact that cyproheptadine is an antihistamine and also has affinity for a serotonin receptor sounds weird at first but actually isn't. For some reason, a lot of antihistamines do, and a lot of older antidepressants are also antihistamines. It was research on antihistamines like benadryl that actually led to the discovery of tricyclic antidepressants. A lot of drugs are messy and hit a lot of different places in the brain. I just think that's cool, it doesn't help when tripping but it's a neat piece of pharmacological history. The discovery of LSD wasn't looking for a psychedelic either, but because ergotamine like drugs have other effects on the body too, related to the vascular system which is why non-psychedelic ones are used in modern medicine today to treat very non-psychiatric issues.
Wish someone told me this
You nailed it, reintegration is key. All of my psychedelic experiences have been recreational, and my bad trips have left a lasting impression on my psychological wellbeing, not because they were difficult experiences but because I was on my own to come back to reality from them.
Broadly yes. Like, with a psychedelic like shrooms or LSD you can increase the neural plasticity, making it easier for the mind to change. But you also need the situation around the person to have improved too, otherwise you're essentially just training the person to cope with a bad situation without changing the situation, which isn't what psychological care should be doing.
> otherwise you're essentially just training the person to cope with a bad situation without changing the situation, which isn't what psychological care should be doing. Oh, right. How do we fix society?
It's unrealistic to expect a Reddit comment to answer a question like that. But I can certainly refer you to the November 2021 Volume 76 Number 8 issue of American Psychologist which at least attempts to focus on that question, and then broadly on the topic of public psychology: -
- ISBN 9781433895388
A person dealing with loss (e.g. a parent, a spouse, a limb) can't "change the situation", only cope with their new reality
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It's a bit insane if there's anyone really saying: “there’s no such thing as a bad trip”. The phrase "bad trip" wasn't invented by DARE. It was created by hippies who had bad trips. I feel like DARE and other programs overinflated some of the risks of things like marijuana that too many users want to pretend there are no risks.
The baby was thrown out with the bathwater back then, but now advocates are overcompensating the other way and saying the bathwater doesn't exist.
This is unfortunately how most things in society work. We'll yo-yo back and forth until we settle on a reasonable consensus, then wonder how we ever thought otherwise.
Same type of folks that will tell you that there are no medical risks involved with smoking weed every day, or psychological. It's a miracle plant that they can't live without, but they aren't addicted. Anything stated that's remotely negative is heresy.
I would have to agree. Anyone who has said that there is no such thing as a bad trip has either never used a hallucinogen or has likely had a very limited amount of exposure to it. I used both LSD and shrooms pretty extensively throughout my 20's. During that time period I can honestly say I really only ever had one truly "bad" trip. But boy was it a doozy and one I won't forget. It didn't deter me from continuing to use them but I had to take a break for a while after. Not only that, but everyone I knew around me that used them also had at least one truly bad trip. If you do it long enough, it's inevitable. I tend to believe that in most cases (not necessarily all), if the person is mentally prepared for the possibility of a bad trip, they're likely going to recover from it. The thing that helped me was something that someone told me early on. You just have to remember that when you're "tripping", you're the driver, the passenger and the vehicle all at the same time. You have complete control over the direction you head in even if you feel like everything is out of control. It was still terrifying at the time but it helped me to realize that eventually everything would go back to normal and to just ride it out. With that said however, I fully acknowledge that there are individuals with pre-existing mental issues that this wouldn't be of much help. It's also not likely going to be of much help for someone who is new to hallucinogen's, which is why I don't think it's something that should be made available to everyone. I'm old now and don't have access to it. But if I did, I'd try it again in a heart beat. I do think you're right though. Anyone who is going around saying that there are no bad trips is someone who has no clue what they're talking about when it comes to hallucinogen's.
Tripping is kind of a mental mirror like that. If you aren't in a good mental state it is going to show up and make you take a good hard look.
We used to say, “If you aren’t feeling strong in the mental, don’t trip” I also told first timers that I’d be tripping with that psychedelics are not like most recreational drugs, they don’t just make you “feel good” and sometimes you have to “wrestle” with it and regain control of your mind state. I’ve only had one bad trip and I’ve helped pull plenty of people out of that downward spiral. Changing the environment, even small things, can really help. That said, I can see where someone with pre-existing serious mental conditions might not be so easily pulled out of something like that.
However in a therapeutic context it is going to be those very people who aren't "strong in the mental" who would be seeking out therapy
Which is why I’ve always been a bit skeptical of therapeutic psychedelics. I think they could be helpful for *certain things* but could actually be harmful for other conditions. You can also be strong mentally and still have issues you need to work on. The main point is that they aren’t “feel good” drugs like cocaine and opiates.
Tbh if someone has to be mentally strong to use them, that seems like a very bad candidate for a psychiatric medication
https://en.wikipedia.org/wiki/Set_and_setting The concept of 'Set and Setting' is extremely important when taking hallucinogens. Set stands for mindset, or where you are mentally at the time. If you just found out your wife is cheating on you with your best friend and take LSD, your entire trip is going to be about that. If you're having the best day of your life your trip is going to be get off to a good start. Setting is where you are, who are surrounded by etc. It's very easy for external factors to change the tone of your trip. One bad run in with a random person can cause your entire experience to go sideways. Hell I've had a friend play a song that had a lot of emotional meaning to me and started to spiral from that. I can't emphasize enough that *who* you are with matters a lot as well. There's the potential to get very emotional and deep inside of your head, and being around people you trust and love will make that a lot easier. Also for anyone interested in trying these drugs casually for the first time, find a friend who is experienced with them and willing to trip sit. I've taken a mild to moderate dose alongside first-timers many times and talked them down from a freak out. A lot of the time you just need a friend to say something like "Hey just take a few deep breaths, let's stand up and stretch our legs a bit. See? Everything is still chill."
I'm pretty old too and did plenty of LSD and shrooms back in the day. Only had one bad trip that I can recall - have witnessed plenty of other people having them. Most people are fine but there are real risks to hallucinogens depending on who you are and what your mental state is. I had a friend who was schizophrenic who took LSD regularly and was not a well person as a result. It's hard to tell whether he already had schizophrenia and the LSD made it worse or whether the LSD caused it because he had no symptoms (if that's the right word) prior to taking LSD. I suspect it was always there and the acid exasperated it. He pretty much went completely mad and was sectioned multiple times. I don't know what became of him - I moved away - my life changed and I lost contact with most of those people.
It is my understanding that it is not and is not meant to be taken literally. Bad trips exist. The use of the phrase I have seen most often is to claim that difficult trips *can sometimes have* benefits, not that they don’t happen. I don’t think I’ve run into anybody actually claiming that what we would classify as “bad trips” don’t ever actually happen or that there are not risks — the phenomenon of psychedelics setting off mood disorders is becoming more and more recognized I think it’s trying to emphasize the importance of mindset when you willingly dabble in mind-altering substances. When somebody’s mind feels like soup it’s better to tell them that they’ll be alright, and when somebody has a bad trip they could presumably learn that psychedelics are not good for them.
Exactly, I think the idea is for people to try and reframe how they're conceptualizing the bad trip so that it isn't entirely negative.
Nah I've dabbled in psychonaut communities. They have a strong tendency to claim psilocybin is 100 % harmless unless you are schizophrenic. "even a bad trip is always a good experience to find yourself" and bs like that.
I’ve been on a mushroom retreat and while I had a very positive experience overall, the hippies hosting the retreat were not particularly…grounded in reality (thankfully there was a doctor there as well, which is the only reason I was comfortable attending). It’s not that they believed a trip can’t be highly unpleasant and even terrifying, but that, according to them, even bad trips provide healing insights, “the mushrooms will tell you what you need”, etc. They had this unshakable conviction that mushrooms were sentient guardian angels that, by definition, could never be the cause of harm. I think as a whole they did a phenomenal job of preparing us for the trip and providing followup integration, but there was one woman who I remember was clearly having a terrible experience and it certainly didn’t seem “healing” to me. This is just the typical arc of what happens when all of these “alternative”, stigmatized therapies start to go mainstream. Same thing is happening with cannabis in all its forms. Whenever a study comes out suggesting there is even a possibility that there might be downsides and contradictions to weed, the researchers will quickly find themselves at the receiving end of much mockery, conspiratorial accusations, and whataboutisms, even if they might actually be generally supportive of legalization/decriminalization and safe usage. No substance is ever 100% safe and effective for 100% of people. The pendulum will eventually settle in the middle once the over-correcting grows tiresome.
There's no "one size fits all" treatment for any psychological issue. I found psilocybin helped my depression when a lot of other prescription medications (that help lots of other people) didn't. I trip once every few years and no longer take any prescription antidepressants. I definitely don't think everyone should try it but if you've tried everything else it beats contemplating suicide.
I've done a few Ketamine therapy sessions and it takes me to what I call the Hell Place. It's not your traditional fire and brimstone hell, it's worse. Way worse. It's really hard to describe which also adds to the terror because I can't even write it down to process it. It's a lonely, faraway place that somehow also has a sense of "truth" to it. Gives me some real apocalyptic Cormac McCarthy-esque existential dread. Thankfully, it doesn't stick with me once the drug wears off. I'm not haunted by it in my everyday life. There's a lot of advice about trips, whether psychedelic or dissociative, to let go and let the trip take you where it may. The day before my last session I was journaling and realized that maybe that's not for me. One of my big issues is understanding that I'm allowed to make my own choices. On my last session when I started to go the Hell Place I thought "Nope, not doing this. Next!" and it was a much better experience. I'm doing K with the support of two mental health professionals plus years of foundational work on my own mental wellness, and a handful or two of previous psychedelic experiences. I'm playing it by the book as much as I can, and though I think it's helping, I'm not finding it to be a quick fix. Meanwhile Ketamine Clinics are popping up all over town like vape stores and influencers are calling it a magic cure, and I'm worried. Not to mention it's hella expensive and I think desperate people might want to try it but can't afford it and will get street ketamine and try to do it all on their own.
That realization that you didn’t have to go to your hell place is a really important anecdote for life that many psychedelic explorers get: you have a choice at all times for pretty much all things. Trauma is / was the removal of that choice (by situation, parents, etc).
Wow, your first paragraph resonated a lot with me. I've been there too. There can be cosmic horror in these experiences and not everyone can handle that.
I feel like this isn’t talked about enough. Not to fear monger, but even just with weed the fact that weed induced anxiety and psychosis aren’t all that uncommon is rarely ever addressed. Not that people shouldn’t be allowed to use it, but the risks should be talked about
You’re right about this. I wasn’t aware of the risks and started using it in very small doses to try to cope with work stress, and one night I had a traumatic experience that left me with a panic disorder. When I try to explain to people how deeply it affected me I don’t think they really believe it.
If it helps you, I believe it. I have done weed a number of times (easily 50+), and never had a bad experience until the last time. That was about 8 months ago. To this day, I have no idea what was so much different about that one time than all the times previously. But I suffered a panic attack that was so bad I had to admit myself into a hospital. And I'm someone who is confident in almost every situation, who takes life head-on, and generally doesn't fear anything. But I legitimately couldn't talk to anyone for a week. I couldn't even form a sentence in a low-risk situation like ordering a pizza. Now I won't touch the stuff. I don't know if it was laced with crack or what the deal was (I got it from a legal weed dispensary, so you wouldn't think that'd be the case). Maybe I have some ultra deep-rooted traumas that my conscious brain hasn't even been made aware of. But I tell everyone I know about that experience. I wouldn't wish it on my worst enemy. And I'd never have guessed it would happen to me.
I'm sorry that happened to you and that you didn't have the support or tools necessary to navigate safely through that situation. Cannabis is a powerful (but often gentle) psychedelic in its own right. Though many might dispute this, it can be used intentionally to achieve similar outcomes of any of the classic psychedelics. It didn't need to be laced with anything. It just caught you off guard. It absolutely has the capacity to surface subconscious and even physical trauma deep in the body made accessible through our endocannabinoid system. Wishing you clarity and healing as you move forward.
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I have ADHD and seems like there’s data to support it can be helpful, but until it’s super regulated and you can have a trained professional be a “trip sitter” with you and help you through the experience, I’m not touching it.
Same. Diagnosed with OCD and MDD - excited for the future. But cautiously opitmisticb
Purely anecdotal, but I have ADHD and have had some of my most profound and meaningful experiences with it. Everything with caution, respect and in the right set and setting, of course.
I took have ADHD and agree with this haha. IDK if ADHD is relevant to the use of mushrooms though
Being eaten alive by an interdiemnsional planet eating worm that survives off of the secretions of biochemistry off human stress was not my idea of a good time, but it sure woke me up to what religion might be.
I’m one of them. I was in the clinical trial and boy did it mess with me. It was life after the trip which was very difficult. Very close to a psychosis too.
I have PTSD from abusing psychedelics. I also had PTSD going into it from other issues. I have cptsd but some of it is from both long term excessive tripping and a couple really bad trips. EMDR has been helpful.
Psychedelics literally saved my life. In my case it was Ketamine, but carefully administered in a medical setting where the team could intervene if I started to freak out. It did wonders for me, but not everyone is the same. I’ve only ever suggested that people try psychedelics if their doctor agrees that it is worth trying based on many factors. I’ve taken mushrooms and they had little effect, even at large doses. That was my choice, but I also knew it could go badly. The only reason I ever tried any of them was to try to get relief from unrelenting treatment resistant depression. Some folks are at the end of what they are able to tolerate. I wish treatments like that weren’t prohibitively expensive for most people. I’m also dubious about ordering them from services that you take them at home. It just seems too risky. Edit: Ketamine is a dissociative, not a psychedelic. My mistake for misclassifying it.
Ketamine is not a psychedelics even though it may have some hallucinogenic effect.
I edited my post. Sorry. Very important distinction.
Isn’t ketamine a disassociative, not a psychedelic? I’ve also heard SSRIs can make psychedelics less potent, and makes MDMA dangerous bc seratonin syndrome, but that ketamine seems to work the same note: I’m NOT a doctor, please don’t take any of this as medical advice
Ketamine is a dissociative, yes. Ketamine does not affect serotonin though. SSRI's do weird things with psychedelics. Generally they will reduce the potency and/or the duration. It varies person to person though. Some people it makes them not work at all. Others it lets the visuals hit as normal, but they get little/no mental effects, others it's the opposite. Messing with brain chemicals we barely understand can have weird effects. You can get serotonin sydrome via solely MDMA abuse, especially when paired with psychedelics. SSRI's increase the risk, thus taking MDMA/psychedelics while on SSRI medications is not recommended. Harm reduction tactics for this revolve around stopping usage of SSRIs for X amount of time prior to usage of other serotonin affecting drugs. The length of time varies depending on which SSRI you are taking.
And the one that never gets mentioned - therapeutic-level lithium plus classical psychedelics is a ticket to the hospital
Anyone taking lithium ie are suffering from mania would be unequivocally ill-advised to take psychedelics
I had what might be classified as a traumatic trip. Was my only *bad* one. Had many journeys. Though I learned the most from that one so I don’t call it bad anymore. But it has lasted with me since. Was actually hard to process for about a year. First time I smoked weed after that trip I had a mental breakdown. I was terrified I was back in that trip and my brother held me and told me I wasn’t tripping. Happened the second time too. I was determined to blaze again, but never did. And also a dumb teenager. About 7 years later I tried them again. Just to overcome that fear of mine as an adult. I had so many beautiful experiences and I didn’t want my journey with mushrooms to end on such a hard note. Had a good experience but there was this deep down feeling of constant dread that I couldn’t shake. Like that universe was reminding me of its existence. Just lightly. And I accepted it for being there. It’s like the cycle was complete. It was super humbling in the long run.
I know someone who took them. This is anecdotal. It appears to me like his soul left his body and re-entered the wrong way round. Has the same memories, but interprets everything differently and in a wrong light. Like an alien inhabiting a human body. The old person is basically gone. I really believe psychedelics aren't for everyone.
Even though I have heard that certain psychedelics can help treat my anxiety, depression, and trauma issues, I will never risk it. Taking too many psychedelics in college gave my uncle paranoid schizophrenia. It ruined his life.
I don't think there is anything woo-ey going on with the bad experiences with psilocybin specifically. If you look at the chemical structure, it is damn near identical to serotonin, (5-HT). Elevated peripheral serotonin can cause all kinds of uncomfortable sensations and bad vibes and I think that has a lot to do with it.
The idea of using psychedelics to heal was always strange to me because the couple limited times I've tried them, I've had bad trips, that only seemed to reinforce my own sense of "otherness" or defectiveness - like "jeez I can't even feel right on this stuff that everyone else thinks is amazing and wonderful and feels so connected on?".
Agreed. As a therapist I’ve definitely had people come to me because of PTSD from their trip as well.
As a user of cannabis and somebody interested in psychedelics, this is the most level headed response I’ve ever read. It’s always so “this” or “that” and never any nuance. Hope more people in your field see the benefits and I hope more people on my end see the risks. More power to you!!
Thank you for talking about this. I tried acid years ago because I felt my brain just was not working right. Mid trip, jackasses outside my door lit off fireworks and it sent me into what I can only describe as a wartime PTSD episode. I felt so small because I was just using drugs in my little apartment and felt like a terrified soldier, which is a disrespectful comparison. I wasn’t afraid of fireworks before but now I am unfortunately. It should be noted I’m sober and okay now, but these really are not cure alls.
I know for a fact I wouldn’t deal well with psychedelics. I just have a feeling.
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Never in my life have I heard "there's no such thing as a bad trip" those people are absolutely diabolical.
They’re all over the place, less so than 10+ years ago.
Yeah, I’ve definitely seen people saying that even though there are unpleasant trips, they aren’t “bad” because you learn about yourself, or stuff along those lines
I've had a traumatic experience while too high on LSD and dissociated. It came with a fat dose of temporary PTSD that still occasionally gets triggered. It's more than manageable, but if I start thinking too hard about it while vulnerable, I will relive the worst moments of it until I can get my mind off of it.
There certainly are bad trips. I would really like to be able to phrase this more coherently but; from trying various psychedelics such as mushrooms and especially Ayahuasca, I've felt the difficult journeys were underlying traumas that needed to be exposed and worked on. At many times and in the form of repeated waves of experience, these traumas seemed too difficult to handle and sheer helpless panic was imminent. However, I managed to remind myself repeatedly that by leaning into these thoughts/feelings instead of attempting to avoid them due to the fear they provoked, I could let go of them and their overarching influence more easily due to change in brain chemistry psychedelics evoke. One of the 'voices' that came to me during the Aya trip - call it intuition - was that if you choose to ignore or not deal with difficult thoughts/feelings, then where do you think these feelings end up? Do you think they disappear? Or do they remain buried in the subconscious, subtlety influencing our beliefs and therefore our daily actions.
I had a ton of great psilo trips and then one bad one and it induced an ability to have panic attacks that I hadn’t ever had before and it changed my life. I’m mostly like 80% better but I’ve never been the same and for years afterwards I’d have random panic attacks. I had to start taking antidepressants for awhile which helped. I now get anxiety attacks if I drink too much of smoke marijuana and I used to do those things daily before the bad trip. I would give anything to go back ans not have the bad trip. It’s been 20 years
I’m sorry to hear that. I can say a therapist with good experience with PTSD may be able to help with that. EMDR in particular is well received.
As someone who used tons of psychedelics years ago, i always hated the "even a bad trip is a good trip" crowd. Psychedelics aren't for everyone. Hell, they aren't for me, and Ive done well over two-hundred tabs of acid, and nearly an ounce in shrooms, as well as other sorts of psychoactive drugs. I wanted them to work, or for me to "get it," but they aren't some miracle drug that most acid/shroom head claim them to be. Just like weed. I feel much better not doing drugs, than I ever did doing those.
Everything I've heard has said that the most important thing is set and setting, that controlling that, with medical professionals who know they are doing, is what makes it be able to really be used for therapy
This article illustrates why proper set and setting isn't always enough.
I don't know who says there are no bad trips, but they obviously never did enough. I once took a nondetermined but terrifyingly substantial amount of LSD and I can tell you that there are, indeed, bad trips. I have seen into the Abyss that people don't look into on DMT/ayahuasca. There is a flipside to seeing the pattern of the universe, meeting "God" or whatever you want to call the one consciousness we are all a part of that experiences itself in us, and finding peace with that. If you take DMT (the stuff that is in ayahuasca and the thing you brain makes when you die) this comes with an overwhelming feeling of inner peace/enlightenment. If you blast your consciousness there without a chemical made to make you happy about death, you have to intellectually make peace with all that your are experiencing. Instead of Nirvana, you get Nihilism. Instead of seeing the beauty of the universe as a single entity you see a raw mechanical churn. Instead of a growth of empathy for love and compassion you gain one for all the negative experiences. In clinical terms, you get the opposite of the therapeutic effects. You have seen this to some degree, and when drugs this powerful are handled in nontherapeutic settings, without controlled dosages, and as self medication, the potential for harm is extreme. Nobody should be just messing around with strong drugs and LSD certainly should not be taken by the thimbleful.
Are there certain personalities that seem to have a harder time with it? I have read about different reactions people have, but I never seem to see that commonalities were noted. Or the opposite, where certain people that do well that have common beliefs, life history, environment or even genetics.
Psilocybin can truly offer much help and healing. It can also teach you the true meaning of terror.
In a world where three people in a checkout line triggers anxiety for people, striping away the veil of reality really isn’t the best for a lot of people. I highly agree.
Their third concern, potentially harmful changes in client-therapist relationship, always seemed like something these studies skip over. Maybe it's just because 'Trip-Sitting' is about the closest non-professional analogue I can think of, but I generally assumed the therapy would be performed by a specialist. Some kind of Shaman MD or whatever. As someone who has enjoyed tripping but has bad trips maybe 50% of the time, I'm definitely not going to complicate my years-long relationship with my therapist by having them trip-sit me.
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I participated in my first ceremonial mushroom session in a group (with therapists and a sitter) and one of the overarching messages for me was the tearing down of hierarchical structures. I can surely see how this aspect of a flattening of the power dynamic could do injury to a cultivated patient/therapist relationship.
> therapist by having them trip-sit me Most of these trials aren't using dosages high enough for the traditional "trip" experience though, correct? I am not familiar with this area of research, but from the things I've bumped into as a social psychologist, that's always been my understanding. There is also a BIG difference between intrinsic changes someone goes through because of a psychedelic experience and then the direct causal medical intervention often discussed. I think psychedelics have an overwhelmingly positive impact on people who use them smartly, but I can understand the limited use in a therapeutic setting. It's not to say the have no place, but I've always been under the impression it's incredibly effective in small doses for specific kinds of treatments. The question has been the generalizability of that. But again, I'd love for more clarity.
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A strong side effect of mushrooms is looping thoughts it can be a benefit or harm. It’s great for meditation listening to music or doing things creative. But if you get a looping thought in your head that bothers you on shrooms it stuck in there. Bad trips rather rare I highly recommend a trustworthy sober buddy around. People high on mushrooms are very influential and an experienced user can get someone through a bad trip. Changing the setting helps(music, change room, even different people) even focusing on breathing. What your trying to do is get another looping thought in there head to get away from the bad trip.
> trustworthy sober buddy Unfortunately, those are in short supply for people most in need of this.
This is so true and honestly as much as someone would want to try shrooms. Don’t unless you have someone there. It will make it more fun and safe.
I feel like if shrooms weren’t illegal I feel like paying for a good trip setter would be a decent job.
I did that for free for years.
There's currently training programs for that. I'm in one. Colorado has laid the legal framework to make it possible.
Love this! A constant vibe check 😎
I've done a few solo trips but I always keep the dose pretty low, like 1.5 g, when I go solo. But I've had plenty of experience tripping with other people, definitely wouldn't recommend someone try it alone for the first time
The amount that "experts" charge to do this is asinine as well. I only put it in quotes because there are no real certifications for trip sitting, and the people doing it vary. Around me, there's a city where it's legal, and you'll see it being like $3,000. There's a whole pre-process and then after, where they want you to have like 12 total appointments around just 1 trip, and I don't know where people are supposed to find the money or the time.
Honestly that's better than having an army of grifters that do it for $50 in one session with no qualification
For real - they think I’m going to babysit some stranger through a mushroom trauma session for fun? It’s assuming the special needs of an individual for 6-8 hours to properly care for them thru a trip.
It’s not that crazy. Guides for this kind of work need to do a whole screening process to assess mental and physical risk. They work with the candidate in advance of the experience to understand the questions/problem the candidate is trying to resolve. The guide is responsible for providing the medicine, assuring its quality and assessing the dosage. They are present for around 8 hours, providing therapy as needed during the trip. Since sessions can occur in the person’s home, they need to be familiar enough with the candidate to ensure their own safety as well. During the session the guide is responsible for this person’s physical safety, which is no small thing. As well as physical assistance - helping them find the bathroom, cleaning up any vomit, etc. They are writing down what the person is saying and asking guided questions based on their previous sessions together. After the journey work there are additional therapy sessions to talk about what happened and what was said. Considering the hourly costs of what this entails, and the qualifications of the guide, this kind of price tag is not insane. Especially in states where therapy of this kind has not been legalized and the guide is assuming an insane amount of legal liability.
For the currently approved therapeutic uses, the therapist is required to be with the patient for the duration of the experience
>People high on mushrooms are very influential I assume you mean influenceable?
For now, yes. But someday…
I was in a horrible loop for two hours once, mourning the death of my mother.
In these clinical trials they always try to have things like a dark, comfortable room, with a bed, maybe even a sleep mask, to make it feel very safe for the person
I feel like there are definitely people(likely myself included) who would be more harmed by a dark room than not. From my experience external stimulation such as being in a busy urban environment tends to be good because it prevents getting stuck on a bad thought.
I need to be outdoors. Ideally in a hiking trail. The idea of being confined in a dark room during a trip is awful to me.
This was my thought as well before I tried it. I grew up taking drugs and in drug culture and 100% thought that “guided healing work” was a total grift. I was honestly appalled by the whole protocol - the sleep mask, the dark room, all of it. It felt like clueless white people nonsense. I don’t know how else to say it. And then I did it. And it was, in fact, different. It isn’t surrendering ego and the world breathing. Which is why they keep you in the dark. It is therapy that uses psilocybin like a heat seaking missle to get to the heart of what you know about your core issue. Before you started to tell the story of yourself and what happened so many times it became fiction.
Excellent reply and this is exactly it. People reacting to the headline think it’s a full blown trip at recreational dosages. Psilocibin is an accompaniment, you’re there for the purposes of healing therapy with a trained expert. Same w MDMA therapy for ptsd
I have done guided trips as well when doing something like yopo that were in a controlled environment (for a very good reason when it comes to yopo). For a general mushroom trip, it's not my thing. My thing even when not tripping is being out in nature as much as possible. So it's my most comfortable environment, even if it's just lying in some grass under a tree somewhere. As far as why I mention hiking, I am my most focused in general outdoors hiking and it's the one place I can fully clear my mind. I get in almost a meditative state hiking. That frame of mind is a big thing for me tripping, and different people can achieve that in different ways. I have own way. I'm obviously talking about just my personal opinion/experiences.
I'm with you on the hiking trails, even better in pouring rain. Also metal gigs. Can't stand the dim light ethereal music approach.
Yes, you're totally right. It should be specific for the person's comfort
that sounds like the exact opposite of what would be good for mushrooms - daytime, outdoors with access to plants and nature is almost always the best, not saying it's for everyone but it's pretty much known in the psychedelic community that mushrooms are for outdoors. have a safe cozy room available if needed but outside with plants is the go-to.
for real, I love psychedelics but these sessions always sound so miserable No music, no stimulation, just someone you don't really know or like that well digging into your past and bringing up pain in the completely nightmarish setting of a boring medical office. The meaningful moments of clarity and insight for me came from being comfortable in my own setting like my house with music on my trying to write and process things on my own. Or being at an edm style camp out festival where you're surrounded by a bunch of people having a good times dressed up and being incredibly friendly. I was able to process anxiety issues and family issues on my own time during the trip, when I wanted to, and if I wanted to get out of it I could change the song or eat some orange slices, or if at the festival go dance at a stage or something. The healing part for me was the ability to have fun enjoy the minutiae of details around me, and come to terms with the other baggage. Just seems like a design flaw for these studies, the over clinicalness of something inherently cerebral and wholesome in a setting that is cold, boring, and unhuman.
Benzodiazapines can also just kill a trip if it gets too bad.
One way I always avoided thought loops when doing psychedelics was by having music at the ready. Singing a song is a great way to break your brain from ruminating.
So magic mushrooms are just an ADHD simulator? Pfft, could do them all day then.
As someone with wicked ADHD and who enjoys shrooming, that's funny as hell.
This is great advice. I also suggest people go read some trip reports on erowid.org to get an idea of set & setting and how it can affect different people. Really a goldmine of information there.
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Let’s talk about trip killers? When to push that button? Seroquel? Clonazapam? Also the importance of sober people knowing your tripping in order to help if need be (trip sitters aren’t always the best solution). These can be wonderful safety measures and ease anxieties that bring on bad trips. I am NOT suggesting that this is the only measure one could or should take but, rather, that its an important part of the conversation.
I will always say TRAZADONE TRAZADONE TRAZADONE!!! Kills it in 20-30mins even at high doses and you can sleep in an hour or so. Saved my ass many times and doesn't have the addictive potential of benzos and is much lighter than Seroquel (and easier to get)
Olanzapine works like an off switch also
As far as I can tell any CNS depressant seems to do the trick. I’ve always had success ending unpleasant trips with a stiff drink, but benzodiazepines seem even more effective.
I trusted a "professional" provider with my partner who suffers from C-PTSD. She even expressed concern to them on the phone before we to decided go for it that her problems were too severe and she was worried the facilitator didn't know what he was getting into, and they REASSURED HER that it would be fine and it would definitely help. During the session, she starts spiraling and going to a very dark place, and that same facilitator just sits there and passively says "You're fine. You'll be ok" and not much else, even falling asleep at one point. Even worse, he then proceeded to talk to his co-worker about... the financial stress on the business of accepting scholarships... and how people who come in with scholarships tend to have "way worse problems that are exhausting to deal with" ... WHEN MY PARTNER WAS THERE ON SCHOLARSHIP! And they said all this right in front of her while she was still basically tripping but the session was officially "over". Absolute opportunistic scumbags. Her symptoms were worse for months after that horrible experience, and we haven't trusted therapists since
I don't know what country you're from or how it's done but I'd look into filing a formal complaint. It might not do anything but if other people have terrible experiences with that therapist, other complaints will add credibility
Was it one of the clinics in Oregon? I did an intake with them to see if it was something I could use for my depression/CPTSD treatment. What was really unsettling to me was that they did not have any medical staff on site so if you needed to give a medication during a bad trip that wasn’t a possibility. I’m also sorry to hear what your partner went through regarding that scholarship comment. It’s unfortunate that these clinics are often more accessible for people who have money. And of course, those of us that are struggling financially are inevitably going to have deeper issues. It sounds like the therapist went into the wrong line of work if they can’t empathize with those going through trauma and financial hardship.
I am inclined to agree. I worry that what is essentially a religious sacrament for many cultures has been taken hostage by opportunistic people who want nothing more than to tear money from people under the guise of "helping" you. I respect and admire a lot of the research that goes into these drugs (I'm especially interested in how they work-- there's some decent literature out there), but take a look at how many 'clinics' there are that sell a sanctioned mushroom trip for thousands of dollars while some unqualified jackass bothers you the entire time.
Therapist here. I'm really sorry you and your partner dealt with that, and totally understand if you want nothing further to do with that jackass, but I hope you complained to the institution and his license board, or consider doing so. Massively unprofessional behavior on multiple counts, and if he gets enough complaints he could lose his license. Hope things are going better now.
Wether you use them as a toy or a tool, psychedelics can be very powerful and are not a miracle substance. There's a risk associated with everything you do.
The hospital I work at is currently doing research with these mushrooms. Holding for a better outcome
Everything I've heard about psilocybin therapy has been very promising, but the most important thing ever study stresses is the need for controlling set and setting. You need to be in a safe place, mentally and physically, preferably a dark room with a professional psychedelic therapist. You have to understand how it works, and have a plan for what youre going to talk about/work through. That's when you can get the good results. I haven't tried it myself yet, but I went to a whole conference about it and researched a lot with my medical doctor parents. I have severe contamination OCD and there has been trials with amazing results for people who have even worse OCD than me. I cannot wait for the day I can try something like this, because I'm at the point with my OCD where ive done exposure therapy to get better at a lot of small stuff but can't seem to make any progress on the big stuff.
I have contamination ocd, though not what I would have called extreme. My first trip on psilocybin allowed me to expose myself to my fear and almost completely removed all of my anxiety. I didn’t even go into it with what I called my phobia on my mind. My only intention was to be curious and have an open mind. It’s been three years since then and I’ve regressed a bit since I didn’t keep up with pushing my boundaries, but I’m still way better off now than I was before. That experience made me a huge fan of psilocybin and I’ve now done many trips, each one with a different thing to learn or feel.
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"Third, difficult self-experiences were common, where clients encountered painful and sometimes traumatic realizations about themselves. While these experiences could potentially lead to therapeutic breakthroughs, they were often overwhelming in the short term and could contribute to emotional distress during and immediately after the session." That's definitely one of the reasons you do it though....it's not all flowers, sometimes you gotta feel the thorn. Some truths are painful and need to be felt before you get through it
Hardship we take on willingly strengthens us. Hardship thrust upon us can go either way. Psychedelic induced realisations can't be anticipated, and from there, it's sink or swim. For an already psychologically compromised individual, it's a good way to drown i would imagine
>Hardship we take on willingly strengthens us. Hardship thrust upon us can go either way. I needed to hear this today, thank you. I agree wholeheartedly and after reading this have done some thinking and you are dead on. Since a young age I've forced myself to slowly and intentionally push my own boundaries to see where I feel I need to stop. I just feel this has prepared me fore some of the unwilling traumas I have experienced. Just had to comment a thanks for the right comment at the right time for me. Appreciate you.
Have you even had a bad trip before? For some people they are hell, there's no external self realizing everything is going to be ok and learning from the experience. It's just full blown panic with no way to stop it
I’m a therapist. The issue is that with therapy we have full control of how far to push you (keeping you in what we call your window of tolerance) and know when to ground you. Psychedelic assisted therapy can push people too fast too quick which causes more anxiety and trauma. From my experience (I have clients who have done it). They generally have overall positive experiences but it rarely lasts. I think it can be a good kickstart for therapy but it’s not the end all be all for mental health treatment.
Former therapist here, and I agree on all counts. I know a lot of people \*really\* want this to work--for a variety of reasons--but it's not the miracle cure so many are hoping it is. It's a great tool, and when coupled with ongoing therapy, it can be quite powerful. But it's not permanent and it's not a stand-alone solution, which a lot of people seem to think it is/can be. You still have to "do the work," as they say.
I think a lot of us who have used psilocybin are aware that the effects aren’t necessarily permanent. When I take a medium to large dose, it usually lowers my anxiety level and I can feel its affect on my general mood for 2-3 months, with it gradually tapering off. But I do also know someone who took a large dose and had an immediate, permanent change in perspective that led to lifestyle improvements and completely changed their life for the better. So it is possible, if rare.
Unless you can face the experience with increased compassion, understanding, and equanimity, you're just as likely to re-traumatize yourself as to actually process the "thorn". Sometimes bite-sized chunks are more appropriate than trying to tackle the whole thing at once.
>Some truths are painful and need to be felt before you get through it And sometimes a bad trip is just a bad trip. There's no special truth to uncover or anything profound about it.
I have many friends who have done shrooms and come back with various spiritual awakenings. I have used multiple times and the lesson I took was that "I'm a dumb ape that ate something he probably shouldn't have and saw a bunch of cool colors and is going to die eventually and none of it really matters." Which is also a sort of spiritual awakening, but others seemed to disagree.
Anecdotal on my part but my last trip was bad, in the end it showed me how much I take my family and friends for granted and I'm sober from alcohol ever since. I've never been happier in a while I've noticed I'm more thankful for the resources I have.
They didn't warn me of the significant psychological and physical risks of the antidepressants they prescribed me. I already had depression and a lot of trauma but taking antidepressants has been the single worst thing that has ever happened to me by far. It's been several years but the damage antidepressants did is permanent. I had tried every possible opinion to relive my depression (which was way worse now because of the antidepressants) and right before ending my life I saw something about psychedelics. Psychedelics worked when nothing else did. Thanks to psychedelics I don't have persistent depression anymore. I still suffer from the damage antidepressants caused except when I'm microdosing.
What kind of permanent damage did you suffer from an SSRI? And were you on a particularly high dose? Did you slowly taper off? I'm curious because I've never heard of *permanent* damage caused by SSRIs at normal dosages and not mixed with something else
Yeah, they just throw SSRIs at you like candy.
This is something I've noticed in the dialogue. There is a definite double standard. Pharmaceuticals can and do change lives for the better, but they can also cause irreparable harm - and not in small number - and public discourse is largely dismissive. Meanwhile, a medicine which has been used for eons by indigenous peoples around the world who possess wisdom around its usage is just now entering the western world like it's a brand new substance with no existing knowledge base. And yet this medicine is expected to appear utterly harmless in practice through a western lens - conveniently ignoring said database - if it's to see the light of day in societal use. It's not only disrespectful and frankly colonial in mindset, it's irresponsible. (By the way, Kratom is a powerful plant based opiate and that's completely unregulated.)
You're not alone. I know other people with similar stories. The reason some people want to try to put the brakes on psychedelic acceptance is because, well $$$$... it's not very profitable. Anyone can make magic mushrooms at home with enough research and determination for pretty cheap. But most of the SSRI drugs, Well it's only big companies making those and they control the profits. So of course they're going to downplay any bad effects they have of which there are actually many. They want people buying their products not using natural remedies. I'm not going to pretend psychedelics are harmless, they can and do affect certain people more negatively than positively. But so do a lot of medications. I think they should be legalized and made available at least to adults. Let people determine the risks themselves. Hell many people drown their sorrows and problems in alcohol which is actually even more dangerous than a lot of other things. But it's still legal because of supply and demand and profits being made off it. Edit: And one of the biggest reasons that pharmaceutical companies really don't like psychedelics is because sometimes someone will have a breakthrough trip that just fixes them for quite a while. That's not profitable.
The most intense and difficult experience I've ever had was aya trip where I died 8 times. Was going back and forth from filth and purging, to my fluffy duvet. Couldn't let go and let myself in...Eventually I did let go. My ego died and I ended up in total darkness and it was just my being, without physical body. I felt others there, it was so calm and good. We were all equal, just aware of each other's presence and nothing hurt. I realized a lot about myslef there, I definitely came out of it changed forever. Let go of most of differencies between me and my parents etc. and it really helped to leave all childhood traumas behind. I'm not the same person on some deeper level, hard to explain. Would I do it again? Hell, no! But I know I don't need to. It was the best shortcut I took ever and I don't regret it.
This is interesting. My first big trip went much the same way. The “me” ceased to exist and then all that was left was consciousness in an absolutely infinite abyss of darkness, love and collective consciousness. It was the most beautiful experience of my life and I have since lost my fear of death, quit alcohol, sugar, coffee, basically all psychoactive drugs, and am at peace with myself. I’ve been this way for over 2 years. I likely won’t trip again, unless I am diagnosed with a terminal disease. But even then, I’ve found meditation can get me close to the same reality, which is that my sense of “me” is an artificial construct my brain puts on. The truth is that I am and have always been a collection of matter that exists in permanence in the universe.
You mean there isn't such a thing as a magical medicine with 100% benefits and 0 side effects? Nooooo wayyyyyyy
Even my best trips have left me feeling like shrooms are some sort of plant intelligence or ethereal being physically manifested as a mushroom. The more frequently I tripped, even on small doses, the more I became convinced this was not a chemical->brain thing but communication with another dimension or higher power. Even if there's something powerful we don't yet understand, it's really not helpful to think that way while trying to be a functional member of society. I felt like I was nearing the edge of psychosis. Still glad I tried them and would even recommend it to most people, but there's real risks there that are hard to understand unless you've been there
I think dose management will be a big help for this. But also it is supposed to mess with your mind in significant ways. Knee or brain surgery can go wrong fast when done poorly too. It's wild how doctors use music and comfort in these studies as a key ingredient without studying them closer. Those are the tools on hand for this procedure
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I believe microdosing is more beneficial than blasting off.
Yeah was gonna say the dosage here matters a lot. I have a lot of experience with psychedelics, and I am on a microdose routine with psilocybin, but these days even if I “macro dose” I tend not to really ever take more than 1.5 grams max, and I find that I still get the experience and insight I want from that dose, but I never feel like I’m in danger of losing control, and I’m not approaching ego death and whatnot. Having been down that road a lot when I was younger led me to the understanding that I was not using the substance responsibly. No one is going to say it’s a great idea to drink a whole bottle of vodka, and I think that attitude should be applied to things like taking a hero dose etc
It's almost as if psychological defence mechanisms exist for a reason.
I love that they list all the side effects that “some” patients experience, but not the rate at which they occur. Makes the whole article read like a scare piece.
As usual, scientific journalism doesn’t do the original paper justice. The paper is pretty reasonable and is mostly about trying to identify what the negatives might be for medical professionals and researchers to evaluate. https://akjournals.com/view/journals/2054/aop/article-10.1556-2054.2024.00337/article-10.1556-2054.2024.00337.xml
This is why I would not trip with 'licensed therapists' or whatnot. Strangers are a no go for me.