Hopes&Fears explores the various circumstances that can negatively influence a psychedelic experience, highlighting expert perspectives about methods to reduce the risks associated with psychedelics. A variety of harm reduction techniques are detailed, noting that the most prominent causes of a difficult psychedelic experience include the user’s mindset, environment, lack of education, and past mental health history. “When people come to the Zendo Project [an organization that does harm reduction at festivals like Burning Man, providing a place for people having difficult psychedelic experiences to rest and talk to trained staff], there’s a few main reasons,” explains Brad Burge of MAPS. “Sometimes they’ve taken too much because of lack of education or proper dosing, or sometimes somebody dosed them without their knowledge. Sometimes they come in and they don’t now what they took or they can’t remember.”
Originally appearing here.
Though they’re illegal as ever, psychedelic drugs no longer have quite the bad rap they accumulated in the decades after the 1960s. Though memories of the notorious brown acid of Woodstock still haunt young trippers, scientists recently have been more focused on the positive, even healing effects these substances can produce when they’re used in controlled settings. But, as many music festival attendees know, bad trips can still happen. We asked experts what circumstances conspire to produce these difficult experiences, and how we can avoid them in the first place.
Faculty Member at Johns Hopkins University School of Medicine, Psychiatry and Behavioral Sciences Department
"Let me preface the following by saying that I am willing to share and represent the science on these compounds, and I am trying to reflect the best practices for research administration of these compounds, but I am not in any way encouraging or supporting the use of these compounds outside of controlled and sanctioned settings.
There is still a lot to learn scientifically about "bad trips," and it is possible that many things could contribute to experiencing a "bad trip." Among the elements that could contribute to a "bad trip" (or "challenging experience") are the constructs of "set" (internal motivation, intention, and preparation for a psychedelic experience) and "setting" (physical environment, people that accompany you during the experience). When you optimize set and setting, you are supposed to minimize challenging experiences, but bad trips can still occur despite optimal set and setting. Sub-optimal elements of "set" might include anxiety, lack of sleep, poor mental hygiene, or lack of understanding or preparation for what you are about to experience. Sub-optimal elements of "setting" might include a distracting or chaotic environment, the presence of others who are also ingesting hallucinogens who may themselves be primed for a challenging experience, or the presence of those who may evoke either paranoia or distrust.
Best clinical practices for research have included optimizing set and setting, with methods including strict medical and psychiatric screening criteria, the presence of two sitters during each session, extensive preparation to build trust and rapport between sitters and study volunteers and to inform the volunteers of what they may encounter, and providing a safe and supportive environment for the experience. In doing this, we try to minimize the likelihood that participants will have challenging experiences. The presence of unresolved psychological or psychiatric trauma or pathology in a person’s past or present may increase the odds of having a challenging experience, and this could be considered an element of "set." Family history with mental health problems may also put individuals at risk. People who find themselves in situations where they are unable to "let go" and experience whatever happens (or people who are a bit more neurotic) may be more likely to have a challenging experience. This could be considered another element of "set," in so far as it is an element of the individual.
Though these things may not guarantee a bad trip, they probably increase the odds. One of the maxims of psychedelic experiences seem to be that there are no guarantees. Someone with immense personal experience with hallucinogens can end up with a challenging experience when they weren’t expecting it."
Jessica L. Nielson
PhD Brain and Spinal Injury Center, Department of Neurological Surgery, University of California, San Francisco
"I would imagine it has a lot to do with the classical notion of ‘set and setting.’ There is also a distinction between a bad trip and a challenging trip. One can be traumatizing while the other can be transformational. The key there is whether the person can find a way out of the difficult phase and find a way to assign some kind of context and meaning to it, rather than walking away with the memory of a horrible experience that didn’t help them with some aspect of their life."
David Nutt, Edmond J. Safra
Chair in Neuropsychopharmacology, Imperial College, London
"All we know is that anxiety before the trip – and a history of trauma and distress increases the risk of bad trips. I can’t [give a specific example of this] as we have excluded such people from our research!"
Director of Communications and Marketing, MAPS (Multidisciplinary Association for Psychedelic Studies)
"When people come to the Zendo Project [an organization that does harm reduction at festivals like Burning Man, providing a place for people having difficult psychedelic experiences to rest and talk to trained staff], there’s a few main reasons.
Sometimes they’ve taken too much because of lack of education or proper dosing, or sometimes somebody dosed them without their knowledge. Sometimes they come in and they don’t now what they took or they can’t remember. Those are often the most difficult cases because the volunteers who are there with the guests don’t know if they’re going to be sitting with them for two or three more hours or for 15 or 20 more hours.
Other times they’ve gotten separated from their friends or lost their water. They’re severely dehydrated, they’re hungry they’re lost, they don’t know where their campsite is or where they’re staying, they can’t find anyone they know. Sometimes it’s just the setting, the context, where otherwise they might have been ok. They’ll find a quiet space and rest. In those cases they just lack the practical necessities.
It’s a combination of things. One is lack of education, not knowing what they’re taking or how strong it is, just being unaware. The other one is the direct result of the war on drugs, the fact that people want to find these substances and they don’t know 100% what they are, so they end up getting something else. Then the venues, the festivals themselves, don’t provide things like free water or resting spaces."