Manual: How to Work with Difficult Psychedelic Experiences

A true psychedelic experience, even a so-called bad trip, is sacred. In earth-oriented, shamanic cultures, even a psychotic breakdown, induced by a psychedelic, is part of the initiation.

So remember the way of the ancients: this is a process, a process of awakening, healing, and ultimately celebrating life.

To avoid psychologizing the psychedelic experience I have avoided medical or traditional therapeutic language.

Overview of what we will cover:

  1. Role of the Sitter or Facilitator
  2. Varieties of Psychedelic-Induced Crises
  3. Working and Being with Psychedelic Emergencies
  4. Aftercare
  5. Related Readings

This is a short overview of the material we will cover in this hands-on training. It is based on 30 years of experience sitting for people. It has therapeutic value, but goes beyond therapy and moves into transpersonal and spiritual realms.

The manual is based on training, schooling, teachings and hands-on work with the leading people in the psychedelic movement, and on in-depth work with healers/shamans from Nepal, Ecuador, and the Navajo nation. It is based on my own healing and therapeutic work, using psychedelics, western psychology, body work, breathwork, art, and different eastern tools, like meditation, Zen koan study and nature work.


The work with psychedelics, entheogens, and plant teachers is an area of the healing arts that is ancient and has been rediscovered in the last 100 years. There are many different ways to work with and understand the psychedelic experience. When we work and sit with a person going through a psychedelic-induced crisis, it is important to understand that in a certain way this is a dialectic relationship, a way of relating that is ancient.


Every person is a psychospiritual system, meaning there is no separation of body, mind, emotion, soul, imagination and energy. Therefore it is very important to see each person as a unique individual.

There is always the tendency to overpower the other with our knowledge, wisdom, and insight. So let go of all knowledge regarding the experiences that the person is having. Just be with, listen, and observe. This brings us back to the dialectical relationship, paying full attention, allowing the other to express and communicate whatever they want. Just being, without a putdown or judgment.

It is important for the healer/sitter/helper to believe in her/his way of working. The belief in the method is important for the results.

The healer/sitter therefore is someone who has had their own psychedelic experience and has had some experience sitting for people, guiding her/his friends. Without any experience, it is impossible to just be with someone having a psychedelic experience or guiding someone having a psychedelic crisis. It is good to know that we all have blind spots and there is the danger that we might stop the experience if we have not explored this material or are afraid.

Rule #1, under any condition, is that we honor and respect the person having the crisis.

Even if we don’t understand what’s happening (the person having the crisis might be much more developed than we are, lost in worlds unknown to us, or reliving a drama we can’t comprehend), we serve as an anchor, a resting place, a quiet center. We know that our presence is helpful. At this moment we don’t have to solve all the problems and answer all the questions that the experience or the person’s life presents.

We have to remember that tens of millions of people have used psychedelics, in many different, sometimes not very supportive, environments, and returned home safely. With support, knowledge, and integrative work there is very little danger in the psychedelic experience itself. Even the most frightening and bizarre behavior, when explored and worked with, will turn out to be beneficial and enlightening.

As stated earlier, the positive outcome of our work requires trusting the wisdom of the ancients, trusting the wisdom of our modern teachers and healers, and trusting the built-in wisdom of our bodies, minds and souls.

We frequently pick up emotions and feelings and energies from others. We will cover ways of clearing, cleansing, and purification.


This is a vast area, so we will just touch on it. For a more in-depth study, see the reading list.


There is no clear manifestation of any substance or mixture of substances. But there are some generalities. It is very important to know the active duration of the different substances. All psychedelics have a similar pattern: there’s the doorway with different physical, mental and emotional manifestations. There is a buildup, then an extended stay on a plateau, then the coming down, re-entry.

The most common felt threat to sanity is the feeling/experience that one is going crazy, losing one’s mind, or that this will never end. This feeling/experience is supported by changing mental states and powerful (sometimes) changes in perception. Major shifts in ego/personality structure, regarding one’s belief and understanding of oneself, the world, and god, are common.

Old traumas can be remembered and relived. These memories can be of a physical nature (reliving one’s birth, childhood abuse and/or illness, memories of famine and/or war, accidents, rape are some of the possibilities of re-emergence). These memories can also be of an intellectual, emotional nature (reliving verbal abuse, a lack of basic emotions, body contact, love, nurture, or a disassociation due to a traumatic experience).

These traumas can also be of a transpersonal nature, meaning phenomena that go beyond our personal identity or biographical understanding of the universe. These could be experiences from another life, becoming one with the earth or other life forms, or experiencing the life cycle of an animal. One could leave one’s body, have the experience of merging with an archetype, or experience the world of a god or a goddess. The memory of a violent death can be a most traumatic experience.

There can be many different, sometimes never experienced, sensory, energy, and body sensations. These can range from hearing colors to seeing music. It could be an extremely heightened sense of smell, taste, hearing and vision. Some of the most frightening manifestations of the psychedelic experience are energetic. People go through powerful releases, rendering their bodies out of control, shaking, twisting and vibrating. These energies, being activated by the psychedelic substances, could be related to birth, an opening of a frozen body pattern, bioenergetic, neo-Reichian type of release, or be a reconnecting with the universal life force. The life-force is called the kundalini and it manifests in a powerful opening of the body’s energy center. It could also be an intensive sexual or other emotional release.

The body sensations also cover a wide range of sensations and feelings. This can be the feeling (for the first time in one’s life) of coming home into the body.

Here’s a small list of other possible experiences:

  • Relieving birth
  • Remembering different deaths
  • Relieving accidents
  • Reliving illness
  • Reliving drowning, torture, and many other physical experiences from this and other lives
  • Reliving mystical states
  • Identifying with and reliving in detail the victimization of humans throughout history.
  • Leaving the body and traveling in the spirit realm
  • Merging with rocks, animals, plants and experiencing the pollution and death of the planet and different species
  • Merging with people, reading their minds, feeling their emotions
  • Being caught in a certain experience
  • Having a UFO experience
  • Being overwhelmed by feelings and emotions

In a psychedelic experience and crisis the person may react to the healer/sitter and project her/his own feelings and experiences onto the healer/sitter. This could be a sexual, demonic, godlike or fearful transference. When this takes place it is important just to be with, not to defend the transference.


The experience of the person’s crisis is, many times, one of letting go on all levels of one’s being. So we have to create a space where it is possible to be open, a space that’s quiet, warm, safe, and beautiful. This space is as important as the sitting/facilitating itself. If possible, have flowers, candles, art and writing supplies, blankets, quiet music and soft light.

Pay attention to the body language while you listen to what’s being expressed verbally and emotionally. Follow the expression of the person. If they have a lot of energy, let the energy move, let it express itself (we provide a safe space) in whatever form: uncontrolled shaking, yoga postures, dancing, ritualistic type of movements, hyperventilation, kundalini type release.

If the person wants to speak, if sounds come out uncontrolled, support the expression. This might be: a different or dead language, prayers from the different spiritual traditions, far-out stories and memories, jibberish, animal sounds, looping sentences (repeating over and over the same words), lamenting, cries, or screams.

Respond when needed, do not take over, try to (if appropriate) engage in a calm conversation, responding to fear and anxiety.

The most appropriate response to a powerful psychedelic crisis might be to just sit quietly with the person, making them feel safe.

If the person is stuck there are several different ways to respond:

  • Wait and calm them down through talk, knowing the duration of the substance taken
  • Walk with them, talking or not, until they calm down
  • Have them express the experience through sound
  • Have them move through it, through a physical expression, holding a certain posture or letting the body go
  • One could do some deep, focused bodywork, just hold someone (meeting their needs) or gently massage them. Always ask for permission regarding any kind of physical contact.
  • Have appropriate sitter regarding male/female, important when recall of sexual abuse takes place.
  • The person could recline, eyes closed or blindfolded, being in a safe place, listening to comforting music and grounding the experience.
  • If their emotions are overwhelming them, encourage their expression.
  • When the person is calm enough or has come back from their difficult psychedelic experience, have art supplies and writing material available.

Reassure them:

  1. This will pass, this is a process.
  2. This is an experience other people have had.

There will be support afterwards.


There are many ways to integrate the experience and to continue working with the opening that took place. It is important to complete any unfinished gestalt. Further reading should be encouraged, and the person should work with a trained practitioner to complete the experience. This could be:


  • Transpersonally-oriented psychotherapy
  • Holotropic Breathwork
  • Shamanic Integration work
  • Different forms of bodywork
  • Different forms of energy release work
  • Work with archetypes
  • Different art forms, making music, dancing, painting, sculpting
  • Meditation and other spiritual practices (following the images or insights of the experience)

There are certain medical conditions that should be treated by the medical management. There can be medical pre-existing conditions that are adverse to the taking of psychedelics. Some of the most common are: pregnancy, mental illness, cardiovascular problems like abnormal blood pressure or other heart problems, recent surgeries and/or accidents, and epilepsy.


This is a very short list of some of the in-depth work regarding the psychedelic experience and crisis:


1. Psychedelic Reflections, Ed. Lester Grinspoon & James B. Bakalar
2. The Adventure of Self-Discovery, Stanislav Grof
3. LSD Psychotherapy,Stanislav Grof
4. Spiritual Emergency, Stanislav and Christina Grof
5. Green Psychology, Ralph Metzner
6. The Unfolding Self, Ralph Metzner
7. The Healing Journey,Claudio Naranjo
8. The Cosmic Serpent,Jeremy Narby
9. The Secret Chief, Myron Stolaroff (full text online)
10.The Ethics of Caring, Kylea Taylor
11. Shamanism, Roger Walsh

Manual: How to Work with Difficult Psychedelic Experiences