When psychedelic therapy isn't therapeutic

Why psychedelic experiences sometimes don't help, make us feel worse, or are flat-out terrifying

Nearly a year ago, the psychedelic renaissance got its blue checkmark when The New York Times ran a cover story announcing that “the psychedelic revolution is coming” and that “psychiatry may never be the same”.

It had been decades in the making. Psychedelics have slowly but surely trickled from underground subcultures into the mainstream. The premise is intriguing: trans-diagnostic medicines, many of which are found in nature, that can help us resolve virtually all major forms of inner suffering plaguing our modern minds: depression, anxiety, addiction.

No longer are these substances drugs, but medicines. While mainstream reporting and advocacy efforts by well-intentioned psychonauts tout the magical healing properties of mushrooms, LSD, and ayahuasca, they often miss critical nuances in the process.

Yes, there are those people whose lives are permanently transformed after just one experience. Those people exist. I’ve met them. They’re not the majority, however. What’s more common is to have a healing experience, yet still struggle afterward. Some people will perpetually feel drawn to medicine experiences because life outside the psychedelic journey still hasn’t changed in the way they hoped it would. Then, of course, there are those flat-out terrifying experiences seemingly devoid of any therapeutic value that—albeit much rarer—do happen.

What do we make of this? What happens when psychedelics don’t feel like medicine and not only don’t seem to help but perhaps make us feel even worse?

The problematic narrative of the “miracle cure”

While the world is getting ready for psychedelic therapy to disrupt mental health care, some practitioners and researchers are getting nervous about the bold claims dominating mainstream narratives. At the forefront of those claims are places like Rythmia Life Advancement Center, a prominent upscale spiritual retreat center in Costa Rica that advertises a 97.65% “miracle rate” for its Ayahuasca retreats.

It was such claims, amongst other things, that prompted me to shell out a whopping $5,000 for a week-long dive into the world of shamanic plants. A big chunk of money, but if it would get me my miracle, well worth it. My miracle being recovery from an eating disorder I’d struggled with for nearly a decade, which was accompanied by increasingly debilitating episodes of depression. Despite enduring, multi-faceted efforts to recover, my mental health was only getting worse. I was running out of options. Psychedelics felt like my last hope.

When Rythmia asked me if I’d “received my miracle” by the end of the 7-day retreat, I ticked yes without hesitation. It had been the most transformative week of my life.

Yet, a few weeks back home the glow had faded, I’d relapsed in my eating disorder, and reality had knocked me off my feet. The reality that magic pills do not exist. Not even exotic, psychedelic magic pills from the Amazonian jungle.

Hopelessness compounded and just a few months after my first ceremonies, I felt worse than ever before. Ayahuasca, the thing that was supposed to save me, hadn’t worked for me. Perhaps I was too broken to fix, I thought.

Here’s the thing, though.

It did end up working. I returned to the medicine over a year later and eventually emerged without mental illness. It just wasn’t a matter of one retreat, but multiple ceremonies over the course of many months. It also wasn’t just a matter of ceremonies, but how much work I put in before and after those ceremonies.

Modern mental health care has drilled a deeply problematic belief into us: that mental disease means a part within us is broken and that there’s something outside of us that can fix it. A pill that will fix our brain chemistry. A therapist that will help fix our messed up minds. A rehab center that will fix our addiction, once and for all. A nice, neat, linear solution to our problem.

When we apply that same mindset to psychedelic healing, we run into a problem.

Psychedelics cannot fix anyone.

First of all, we don’t need fixing to begin with—the whole notion of needing to be fixed is inaccurate, unhelpful, and disempowering.

The real path is not one of fixing but of healing. Healing is the journey towards the understanding that you’ve been whole all along.

While psychedelics can help us in our healing journey, they cannot themselves heal us. They may help uncover insights and capacities within ourselves that propel us into the next step of our healing journey and show us a map. We still have to walk the path ourselves, though. For most, walking that path is not a quick process, there are no shortcuts. Not even psychedelics.

Making sense of “bad trips” and mitigating difficult experiences

Whenever I say that I don’t believe there’s such a thing as a bad trip, people usually get all fired up. While I don’t believe in bad trips, I do believe in hard trips. The difference being that bad trips are senseless, disturbing experiences while hard trips are challenging but therapeutic. No matter how difficult the experience, you learn from it. Psychedelics can be harsh in their delivery, but I do believe they always have a message. There’s always a lesson.

Some hard trips make more sense than others. There are journeys that are hard because we’re revisiting difficult emotional material or aspects of our shadow. It’s uncomfortable but we’re able to recognize the therapeutic value of processing our traumas. Then there are trips that just suck, and we don’t get an explanation straight away about why it had to suck so much. Writing those experiences off as a “bad trip” is a quick way to make meaning (“there was something evil about the psychedelic and it got the better of me”), but it’s also the easy way out. It’s the easy way out because psychedelics are amplifiers. They magnify only what’s already there—whether that’s in our individual or collective unconscious.

The hardest trip I ever endured was a six-hour death loop Ayahuasca put me in. For an entire night, I cycled through all the different ways one can die — drowning, suffocating, melting. It was the most physical discomfort I’ve ever experienced. Three helpers were trying to console me as I cried and screamed for my life throughout the night. I also didn’t die to be reborn, I just died. The following night, I eventually learned to surrender to the experience of being held, upon which, I met my inner child for the first time (I had barely any childhood memories prior to then, so this felt huge).

For months after the experience, I still didn’t comprehend why I had to suffer so severely on the first night. Until one day, it finally clicked: What died that night were all the parts within me that had protected my inner child so fiercely. This was the majority of my personality. All those different aspects of my ego that were convinced she was too vulnerable or shameful to be seen. To get to her, they needed to go.

It’s important to note that whether that was what “really” happened or not doesn’t matter. All that matters is the meaning we attribute to our experiences.

While such experiences are part of the package, the majority of psychedelic users will tell you that most “bad trips” can be avoided by carefully managing those variables that are in our control. Namely set, setting, substance, and skillset. Setting an intention, making sure you’re in a supported, controlled environment, choosing the right medicine based on set and setting (as well as the right dosage), and educating yourself on how to navigate psychedelic journeys (aka, learning to surrender) will usually weed out the majority of what people write off as a bad trip.

We don’t want to face our childhood traumas at a festival surrounded by thousands, similarly, we don’t want to feel like our ego is dissolving in the middle of a party with friends where no one is able to hold space for you. When those things happen and we’re not with the right support and in the right mindset, we’ll resist. It’s that precise resistance that will turn a difficult trip into a terrible one. There’s a saying that goes, oftentimes the difference between a good and a bad trip is simply just a “yes”.

Whether a psychedelic journey is blissful or terrifying, the real work begins afterward

Psychedelics did end up saving my life, but they also didn’t. It was the integration of those experiences that saved my life. Integration that evolved into the hardest inner work I’ve ever done, catalyzed and deepened by a handful of medicine experiences.

Whether we’ve had a blissful or hard experience—one’s not better than the other in terms of our healing process. In fact, integration has turned many of my hardest experiences into the most profound shifts. While I’ve had experiences after which I felt like a new person, I’ve had many that left me feeling worse than before.

Psychedelics can catapult you right into your deepest traumas, opening up wounds you didn’t even know existed. Sometimes, that wound is healed during the journey itself and you emerge with a scar. A scar that no longer hurts but simply tells a story.

That’s not always the case, however. Not all processes come to closure within the course of your journey. Some experiences open up a process and then leave you to deal with it afterward. I’ve left ceremonies feeling like I had open-heart surgery and they forgot to close me back up. I returned home and experienced nightmares and flashbacks of those traumas that were previously repressed for weeks after the experience. Floods of emotions overwhelmed my system.

This is why it’s so critical to have the right integration support in place. What specific support that may be is individual, personally I’ve gotten the most out of integration coaching, therapy (especially IFS and Jungian), community circles, authentic relating groups, breathwork, somatic therapies, embodiment and mindfulness practices, as well as creative endeavors such as writing (read more about integration here).

Lastly, contrary to common belief, integration is not a matter of months but years. I’d go as far as to argue that integration is actually perpetual, it’s a lifestyle.

When we fail to integrate our experiences, we may continue to escape into mystical experiences to cope

The nature of the psychedelic experience will invite you to spiritually bypass. Carl G. Jung warned psychedelic enthusiasts to “be aware of unearned wisdom”. It’s so easy to fall into the trap. What monks work towards over decades of rigorous meditation practice, psychedelics let you experience within a few hours—often at a disproportionate magnitude.

Psychedelics reveal the reality that there’s this whole other world out there, one you weren’t aware existed. A world where everything is conscious, where we’re all one, a world where love is the fabric of the universe. A world beyond your ego. This insight is invigorating. Once you’ve met this world, you can’t simply forget about it. Once you’ve “woken up”, you’ll never be able to close your eyes to truth again.

Unless you find access to this world in your day-to-day and regular state of consciousness, you’ll be tempted to re-experience psychedelics over and over again to connect with this reality. You’ll escape into the world of non-ordinary states because your ordinary world has become mundane, perhaps even more painful.

So, how do you find access to the deeper reality of truth that psychedelics reveal in your every day then?

By doing the work to remove all the barriers within you that block you from experiencing the world in this way. That’s another way of saying, by doing your integration work.

Instead of taking more psychedelics, proper integration will make your life more psychedelic. You won’t crave journeys as much anymore because you’re able to recognize and cultivate what psychedelics have shown you in your everyday life. You won’t need substances to experience universal love, acceptance, and bliss because you radiate it out into the world. You won’t need anything to open your heart, because your heart’s already wide open.

The real challenge of integration then becomes that of keeping your heart open, despite the inconveniences and workings of our ordinary, mundane world.

That’s a daily, life-long practice.

It’s the longest journey we’ll ever embark on, the journey inward, the journey from our mind to our heart.