Is this what comes to mind for you when you think of a “bad” psychedelic trip? Well, let’s talk about that.
Before I get into what a bad trip can entail, I want to first talk about perspectives on bad trips because that’s what I hope you take with you.
Challenging is not the same as bad.
A psychedelic “bad” trip can be truly awful. But, many who work in the psychedelic space, including researchers and the broader community, hold the perspective that challenging trips can provide some of the most valuable learning experiences and personal growth. Surveys of psychedelic users have also shown that a majority (e.g. 84%) of users report having benefited from challenging trips, even when the trips were described as having been the most challenging of their lives (1,2). In fact, in one study the more difficult the trip, the more likely a participant was to report an increase in enduring personal meaning, spiritual significance, and life satisfaction (1). To be clear, though, challenging trips are certainly not required for therapeutic or psychological benefit from a psychedelic substance. Even Dr. Roland Griffiths, a renowned psychedelic researcher, has discussed how challenging experiences with psychedelic substances can help us become more resilient. This makes sense considering psychedelics can help us heal past traumas, fears, or issues, leading to catharsis, or the release of emotional tension (3).
Now, this comes with a lot of asterisks. I must mention that what you experience on a psychedelic is highly dependent on “set and setting,” where “set” refers to the user's personality, preparation, expectation, and intention at the time of use and “setting” to the physical, social, and cultural environment, which I discuss in more detail below. To get the most out of a challenging trip, the person also has to be willing to face and accept the (hard) lesson(s) that arise during the trip, and subsequently, work to integrate the lesson(s) into their life – and this would ideally be accomplished with the assistance of a trusted and experienced guide (4).
What is a “bad trip?”
Before I ever took psychedelics, my idea of a bad trip was seeing frightening images of a distorted external reality, like scorpions coming out of the wall, or something like that. And it can be that – but it can also be much worse.
The flip side of the feelings of profound peace, serenity, bliss, cosmic unity, and extraordinary well-being of a psychedelic trip, are the depths of indescribable despair, panic, sadness, and anxiety (see also) – but with an added emotional intensity that you cannot imagine from your everyday state of consciousness. You can feel like you’ve completely lost your mind, gone insane, and will never be sane again. You can encounter paranoia, deep grief, rage, pain, and loss of self-control. You might feel nausea, physical discomfort, and fear of death. You might even think you’ve actually died. Past traumas can resurface, forcing you to face your greatest fears and deal with difficult emotions. Your identity can dissolve, causing you to feel you’ve lost yourself, and then cause you to feel terror and eternal doom. With your eyes opened or closed, you might see the most terrifying images of your entire life. [There are even scales to measure how bad of a trip you had (5,6).]
On a really bad trip, one can behave in a physically aggressive or violent manner and put themself or others at risk of physical harm. There is a chance of enduring psychological symptoms and, in rare cases, psychotic symptoms.
Essentially, there is the potential to encounter all the emotions we do our best to avoid during our normal waking states. Even with preparation, there is some risk.
But, again, challenging trips aren’t necessarily bad because…
To heal, we need to feel
As I discussed in a previous newsletter about MDMA-assisted psychotherapy for PTSD, psychedelics allow access to suppressed, unconscious – and sometimes traumatic – material. This material can cause personal and interpersonal issues in one’s life when ignored. With proper support and preparation, if you can face those fears/issues/traumas, and feel through the emotions and surrounding personal issues, catharsis can lead to a transformative resolution and personal growth (e.g. emotional, interpersonal, spiritual) (2). In other words, you can have a huge life-altering breakthrough that impacts your overall wellbeing. If you prefer a neuroscientific explanation, psychedelics alter brain networks in such a way that a user can see personal issues from new perspectives or confront traumas and rewrite these personal stories while altering neural pathways.
“The full experience of a negative emotion is the funeral pyre of that emotion.”
– Stanislav Grof
In these states, we can get through the defenses we have unconsciously built around our deepest wounds (7). It certainly takes a degree of courage – courage to surrender – to face the intense, and possibly challenging, experiences of a psychedelic, but when this is done with acceptance and proper planning rather than resistance, the experience can provide one of the greatest healing opportunities (8).
When this kind of challenging personal material arises in an unsupported environment, though, that is when problems can occur, such as re-traumatization, resistance, severe anxiety, and in extreme cases even psychotic breaks (9). So, taking the personal responsibility to fully mentally, emotionally, and physically prepare for the trip with the assistance of an experienced and trusted guide cannot be stressed enough!
Trying to Prevent Bad Trips
Many people will simply avoid psychedelics altogether because of the fear of bad trips and since researchers and users have not found dependable methods for predicting bad trips (10,11), that’s understandable. On the other hand, some have criticized the desire to prevent bad trips as “playing into a Western fantasy of control: ‘if we just do everything right, we can prevent negative experiences (4).’” But what if these negative experiences can have profound, life-changing benefits? How much of our life experiences do we lose by trying to control and prevent everything?
In any case, “set and setting” are important for the trip, and there are certain actions one can take to prevent a bad trip (as much as possible). Ideally, the substances would be taken in a safe, comfortable, and controlled environment with social support (preferably an experienced guide/sitter/therapist) to reduce the possibility of harm to self and others (4). Bad trips have been found to be related to higher doses, recreational use, large outdoor spaces, as well as the emotional state of the person before the trip, availability of social support during the trip, and physical comfort during the trip (1,12).
Having an experienced guide with you (especially through integration work after the psychedelic session) can be pivotal to finding the meaning you need in the experience.
If you really understand therapeutic use of psychedelics -- which we must ensure that people do before they engage with the substances -- you should be a bit apprehensive about the experience. Remember that the only way out of an emotion is through it, and while the news on psychedelics has been focusing on the culmination of the positive healing journey, getting there can be hell. The difference with psychedelics is that accepting the challenge has the potential to provide personal breakthroughs that provide therapeutic relief that other therapies simply cannot bring. So, it might be worth the arduous journey. You can walk away with a better understanding of yourself and your life, in addition to having relieved symptoms or improved personal issues.
Although our society has been escaping from itself into an endless ocean of screens lately, it was once recognized as a worthwhile pursuit to understand the things that individually drive us, rather than leaving our behavioral manipulation to tech corporations. Wouldn’t it be nice to participate in our self-understanding and healing again?
1. Carbonaro TM, Bradstreet MP, Barrett FS, et al. Survey study of challenging experiences after ingesting psilocybin mushrooms: Acute and enduring positive and negative consequences. J Psychopharmacol; 30. Epub ahead of print 2016. DOI: 10.1177/0269881116662634.
2. Gashi L, Sandberg S, Pedersen W. Making “bad trips” good: How users of psychedelics narratively transform challenging trips into valuable experiences. Int J Drug Policy; 87. Epub ahead of print 2021. DOI: 10.1016/j.drugpo.2020.102997.
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