Psychedelic therapy continues to gain traction all over the world, with 2023 already proving to be a year with some of the most exciting new developments, including new treatment innovations, an increase in the decriminalisation of psychedelics for therapeutic use in different geographies, and even greater research attention. While it holds immense promise for treating a wide range of mental health conditions, psychedelic experiences can also be a daunting experience for many.
Before my first psychedelic-assisted therapy journey, I had never had any experiences with mind-altering substances, and remember feeling nervous about the unknown, scared that I might never "come out of it" again, and mainly, that it would reveal things about my inner being that were better left undiscovered.
While it can be difficult to explain the experience to someone else, particularly because every person's experience will have unique elements to it, I found it comforting to know that my fears were not unusual and that I was in the hands of a professional.
In hindsight, my integration therapist had also prepared me very well for the experience, without me necessarily fully grasping at the time what role the preparation phase would play during my journey. So, to help you set your mind at ease, I thought I'd highlight some of the common fears that people tend to have about their psychedelic therapy experiences, and how our team helps to navigate them based on evidence-based research findings, as well as personal familiarity and professional experience.
Common Fears About the Psychedelic Therapy Experience
Fear of the Unknown
Many people have never taken psychedelics before and don't know what to expect. They may be worried about the effects of the substance, the memories and emotions that might come up, or even the duration of the experience.
This fear is usually addressed successfully by our team through education about the therapy, the substance used, what one could expect (in terms of typical sights, sounds, sensations, thoughts and feelings), as well as to ensure that each individual is equipped with skills to help them navigate their psychedelic journeys, including emotion regulation, mental flexibility, openness and curiosity, and trust in themselves and the process.
Fear of Losing Control
One of the biggest fears that people experience during a psychedelic therapy session is the fear of losing control. This fear is understandable, as psychedelics can cause a wide range of perceptual and cognitive changes, some of which can be quite intense. Physically, some people may experience nausea, impaired motor skills, dissociation and anxiety. This is all part of the process, and it helps to know that a trusted therapist and guide is near to offer support, encouragement and care if the experience becomes too difficult.
Fear of Having a 'Bad Trip'
A "bad trip" is a term used to describe an intense, negative experience that could happen during a psychedelic therapy session. This can include feelings of overwhelming anxiety, paranoia, and even hallucinations. The risk of having a "bad trip" is relatively low when a journey is couched within a thoughtful program, including thorough preparation and attention to both one's mindset and the trip setting.
Some argue that there are no "bad trips", believing that even challenging or difficult experiences during a psychedelic trip can be valuable and meaningful, ultimately contributing to personal growth and insight. While the concept of a 'bad trip' can be subjective, we make every effort to prepare individuals for challenging journey experiences. This includes emphasizing emotion regulation techniques, building resilience, and ensuring that each journey at EQNMT is guided and overseen by experienced professionals who are readily available for support. However, we also acknowledge that overwhelmingly negative or traumatic episodes during a trip may not be helpful to everyone and take such experiences seriously. For these individuals, the concept of "no bad trips" may not resonate with their lived experiences, and their struggles are acknowledged and always addressed with care and empathy.
Fear of Losing Your Mind
As the boundaries of ordinary perception blur, it's not uncommon to worry about losing touch with reality or sanity - and worse, to never regain it. The intense shifts in perception, thought patterns, and sensory experiences can be overwhelming. However, it's crucial to recognize that these experiences are temporary (often lasting only as long as the trip itself), and are part of the therapeutic process.
Psychedelic therapists are trained to guide clients through these moments, either during the preparation phase, or during the journey itself should the client require a more solid tether to reality in order to feel safe.
That being said, no substance is without risk. While recent studies have shown that psychedelics are generally safe and well-tolerated when administered in a therapeutic setting, and do not produce any significant long-term negative effects on cognitive function or mental health, it is not suited to everyone. Which is why psychedelics should always be used with caution; and where it is legal, in the care of trained professionals.
People with a history (or family history) of schizophrenia, or who are in a manic phase of Bipolar Disorder, amongst other mental health-related factors, typically should not use psychedelic substances due to the possibility of serious adverse health effects, including worsening of their symptoms. Appropriate medical and psychological screenings should always form a part of any responsible psychedelic-assisted therapy program to ensure the safety of and positive health outcomes for every individual; which is why we place such a high premium on our screening process.
Fear of Dying
Firstly, a fear of dying could relate to a fear that sparks during a psychedelic journey when confronted with thoughts about one's mortality. Secondly, it could relate to the fear that the trip itself will result in dying. Let's discuss each of these in turn:
i. In addressing the fear of confronting one's mortality during a trip, many people report a heightened awareness of their mortality during a psychedelic experience, which could trigger anxiety and distress. However, this fear is often symbolic in nature, and when interrogated with gentle curiosity, it can lead to profound insights about life and death. In a supportive therapeutic setting, particularly during integration therapy, clients can explore this fear, gaining a deeper understanding of their relationship with mortality, and ultimately, finding peace, acceptance, and a deeper appreciation for life in all its facets.
In fact, psychedelics have demonstrated remarkable potential in helping people with terminal illnesses overcome death anxiety. Studies have shown that these substances can facilitate experiences of interconnectedness and transcendence, providing individuals with a profound sense of acceptance and serenity about their mortality. For many, confronting the fear of dying during a psychedelic session can lead to transformative, life-affirming realizations, allowing them to approach their remaining time with a newfound sense of tranquility and purpose. This therapeutic aspect of psychedelics is increasingly being explored as a valuable tool for end-of-life care and psychological support for those facing terminal conditions.
ii. In addressing the fear of dying during the trip itself, it's important to mention that the likelihood of physically dying during a psychedelic trip, when using standard doses of commonly used psychedelics is extremely low. These substances are not typically toxic at the doses used in therapeutic settings.
Individuals with heart or blood pressure conditions, brain injuries, schizophrenia, or those in a manic phase of Bipolar Disorder, among other health-related factors, typically should avoid using psychedelic substances due to the potential for adverse health effects. In such cases, our team assists in finding suitable alternative forms of treatment.
We take the safety of every client seriously, ensuring that journeys are supervised at all times to avoid harm, such as accidents or injuries, whether due to momentarily impaired judgement, or falling due to expected fluctuations in blood pressure.
How to Lean In & Shift Fears into Opportunities for Exploration
Whatever apprehension you have about a psychedelic journey, whether it's your first time or whether you're a seasoned "traveller", it is totally normal and expected. Even after having had several therapeutic psychedelic journeys, I still experience nerves before every trip.
What I have found immensely helpful in easing my anxiety before a journey is holding on to the knowledge that I'm in a safe space, among seasoned professionals, and most importantly, that I have everything I need inside myself to cope with whatever the journey may bring: trust in myself and the process, openness, patience, curiosity, and heaps and mounds of self-compassion.
In addition, EQNMT's clinical team usually recommend the following:
One way to work with your fears is to have a conversation with your therapist or guide before the psychedelic session. This can help to address any concerns that you may have and can provide a sense of safety and security. You can rest assured that we will treat every concern with compassion, respect, and zero judgement.
Additionally, reminding yourself of your therapeutic intentions during the experience may offer both an anchor and a roadmap, which may help to reduce feelings of anxiety or fear. Prior to your journey with us, your Guide will support you in developing and refining these intentions. [If you're curious about intention-setting, please head on over to our Home page and subscribe to our Newsletter for a FREE guide].
Mindfulness and meditation practices before and after a psychedelic session may offer helpful reprieve from overwhelming emotions and sensations. Mindfulness practices like meditation may help to reduce feelings of anxiety while supporting feelings of calm and openness. These practices further increase general self-awareness, which allows for deeper reflection, insight and healing.
We would welcome hearing from you!
Have you experienced any of these or other fears during a journey? Please send us your comments and questions to inquire@eqnmt.co.
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NOTE: Psychedelic-assisted therapy is not necessarily suited to or desired by everyone; it is one of many viable, available treatment modalities. Our mandatory pre-treatment screening process is conducted by qualified healthcare professionals, and is intended to safeguard the mental and physical wellbeing of all prospective treatment candidates. This blog post should not be treated as medical advice; it is intended to inform and direct readers to credible sources of information. Please always consult a suitably qualified healthcare professional before starting any new treatment.