Understanding and Working with Difficult Psychedelic Experiences

This article was written by Sara Gael, M.A.and appeared in the MAPS Bulletin Spring 2017: Vol 27, No. 1 Special Edition: Psychedelic Science

Challenging psychedelic experiences are not uncommon. The very nature of the psychedelic state, with its limitless sensations, expressions, and dynamics, can be disorienting, confusing, and at times frightening. The same elements that can influence someone’s decision to explore psychedelics—change in perception, expanded awareness, and altered consciousness—can be the very things that can contribute to a difficult experience, challenging our beliefs and assumptions about ourselves and the universe.

Understanding Difficult Psychedelic Experiences

Psychedelic substances allow the subconscious—the part of our mind which stores our repressed memories, aspects, fears, and insecurities—to become conscious. The subconscious, sometimes referred to as the shadow, contains all the aspects of the self which society has taught us to hide, reject, or otherwise suppress. Given that the subconscious mind is comprised of the things we have suppressed, because they have been viewed as threatening or undesirable by a given culture or society, it is no wonder that when faced with these parts of ourselves, we may experience fear or challenge.

Various psychedelic substances have been used for thousands of years by different cultures to induce altered state experiences, which has been seen by many as a doorway into personal and collective healing. By seeing that which we have suppressed, we have an opportunity to heal it. When psychedelics are used in a ceremonial or therapeutic setting, difficulty is expected and even welcomed as part of the experience. With certain substances like ayahuasca or peyote, it is commonly understood that facing the fears and inner demons revealed by the medicine is a trademark of the experience. In psychotherapy sessions using MDMA, accessing and processing suppressed memories is the mechanism through which individuals are able heal from trauma.

Becoming conscious of our repressed aspects and memories and integrating them into our awareness is at the core of the psychological and emotional healing process. Psychedelics can catalyze this healing process, which is why they hold so much promise in mental health treatment. In recreational environments, however, this knowledge can often be forgotten and replaced with oft unspoken and misleading beliefs about the psychedelic experience, for instance that it is supposed to be fun, connecting, enjoyable, transcendent, peaceful, or euphoric. It can definitely be these things—and much more.

Because psychedelics are nonspecific amplifiers, the ingestion of these substances can allow us to expand our insight into every possible aspect of the human experience, everything from joy, bliss and love to fear and confusion, and hatred. If the individual under the influence is in a supportive environment free of shame and judgment they are more likely to be able to surrender to whatever the substance is revealing to them. One of the challenges with recreational environments like concerts, festivals, and parties is that these environments can be highly varied and unpredictable. Combined with a psychedelic this can create conditions in which the individual cannot surrender and can begin to resist, causing a spiral of more struggle and challenge. Helping someone having a difficult psychedelic experience means creating a safe environment for the individual to surrender to the experience.

How to help someone having a challenging psychedelic experience

Assisting someone who is having a challenging psychedelic experience is an opportunity to transform a potentially traumatic experience into an opportunity for learning and transformation. Since its inception in 2012, the Zendo Project, developed by the Multidisciplinary Association for Psychedelic Studies (MAPS), has assisted over 1900 guests and trained over 1500 individuals in the practices of peer counseling and psychedelic harm reduction. We have worked within the transformational festival community to create a safe space for those who might otherwise end up being hospitalized or arrested as well as less extreme cases, individuals who are looking to process and make sense of their journey. Many of our guests are brought in by their friends, who are uncertain how to provide support. Most people come to the Zendo because they are in some way feeling unsafe, disoriented, confused, or frightened. We often have guests who may themselves be having an enjoyable time themselves but their behavior is disruptive to others or inconvenient to the status quo—or consensual reality. Whatever the situation, we employ the following principles when providing peer support:

1. Create a safe space. The presence of a grounded, compassionate individual can go a long way in helping someone feel safe in a time of crisis. Approach with kindness and openness, creating an environment of acceptance and compassion. Let the person know that they are in a safe place and that their experience is welcome. Let them know that whatever is coming up for them emotionally or mentally is ok and invite them share their experience if they would like, making no expectations. If possible, move them to a quiet place with few inputs. Things like bright lights, loud music, and lots of people can contribute to disorientation. Rule out any potential medical complications. Learn about or receive training in the signs and symptoms of a medical emergency so that you can help determine if someone needs medical care.

2. Sitting and not guiding. Words can often confuse or get in the way. Use them sparingly unless the individual is desiring to engage in a dialogue about their process. Rather than analyze their experience, listen with an open mind and heart. If engaged in dialogue, ask questions which help the individual deepen into their experience. Listen from the heart and become curious about their reality. Allow the individual to come to their own insights or conclusions. It is ok to provide your perspective on their experience, but focus more on helping them come to their own insights through compassionate inquiry. Let go of your agenda and try not to get ahead of the process.

3. Talking through and not down. Help the individual turn toward their experience rather than away from it. Trust in the process and the persons inner guide. Trust that whatever is showing up for them is something that they are being invited to learn about. Never dismiss or invalidate someone’s perceived reality. Try to avoid rushing the experience, trying to fix the scenario, or find a solution. Rather than provide answers or solutions, remain in a place of not knowing, or beginners mind. If the individual is behaving in ways that are destructive or violent, set boundaries around behavior while validating the emotions behind the behavior such as “I hear that you are angry. You are welcome to express your anger with your words and emotions, just not with violence.”

4. Difficult is not the same as bad. Difficult life experiences can be some of the most valuable learning opportunities. Strength, resilience, surrender, and deep wisdom are often forged in the fires lit in our darkest times. Remembering the philosophies discussed earlier in this article will help the sitter trust that however challenging the situation may seem, being a calm and grounded presence will go along way in helping someone who is struggling. Reminding the individual that their experience may be an opportunity for them to look at aspects of themselves that want their attention in order to be healed can be helpful. Inviting in the possibility that they will emerge from the experience with new insights and understanding.

The Zendo Project was developed in response to a need for more compassionate interventions for those who choose to use psychedelic substances. Outdated ways of working with these experiences such as restraint or sedation are most often unnecessary and can cause harm. These approaches are often rooted in simple misunderstandings as well as decades of stigma and fear around psychedelics. The Zendo Project believes that through education about psychedelics and their effects, we can teach others including medics, law enforcement, and security personnel ways to respond with compassion and help deescalate situations when they arise. We aim to invite honest conversations about drug use, which facilitate understanding and change the way we respond to those in need of support.

Note: This article originally appeared as a blog on Global Drug Survey (globaldrugsurvey.com).

Sara Gael, M.A., is Director of Harm Reduction for MAPS’ Zendo Project. Sara received her Master’s degree in Transpersonal Counseling Psychology at Naropa University. She began working with MAPS in 2012, coordinating psychedelic harm reduction services at festivals and events worldwide with the Zendo Project. Sara was an Intern Therapist for the recently completed MAPS Phase 2 clinical trial of MDMA-assisted psychotherapy for PTSD in Boulder, CO. She maintains a private practice as a psychotherapist specializing in trauma and non-ordinary states of consciousness. Sara believes that developing a comprehensive understanding of psychedelic medicines through research and education is essential for the health and well being of individuals, communities, and the planet. She can be reached at sara@maps.org.