We’ve heard the story on repeat: psychedelics offer a promising alternative to traditional mental health treatment. Our interest and investment in the potential benefits of psychedelic substances for mental health, spiritual growth, and personal development is growing exponentially. Yet with all the progress and promise there exists a psychedelic shadow that needs to be acknowledged, addressed, and integrated in order for this movement to evolve and have lasting impact.
This is why I created a 6-week Psychedelic Integration Training to help practitioners, therapists, & coaches enhance their skills to effectively and safely provide integration care for their clients.
Integration means less psychedelics and more presence
Integration, from my perspective, means choosing to engage less with psychedelics and instead living more presently in the realities of our non-altered state. I believe this definition is what the psychedelic shadow attempts to disguise. This shadow is often ignored or dismissed in the hype around the benefits of these substances. These real and potential possibilities led to a rush to capitalize on their popularity and with little consideration given to the potential risks and challenges involved in their use.
We hear of the transformative experiences, the mystical insights, the healing journeys. These are legitimate and incredibly real for many people, and should not be rejected. These experiences have changed lives, myself included. Yet we cannot ignore the risks and therefore the reasons why we may not ever integrate our journeys. What are these “bad trips” about anyways, and should we call them “bad” in the first place? What are the physical and psychological risks of psychedelics? And why is “spiritual bypassing” a dangerous illusory shortcut to enlightenment?1
Before I lose some of you with a topic not in a typical sequence of an “Integration 101,” I’ve debated whether to introduce this topic so early on. It’s simpler to dive into the principles and at-home practices of integrating altered states journeys. Yet I believe first in unmasking some of the shadow faces of an industry, which is critical to understanding and pursuing integration in our daily lives.
Bad Trips: Rethinking “You get what you need, not what you want.”
An altered state experience can be a journey into the unknown where we are stripped of our usual defenses and confronted with the raw truth of who we are. This can be a terrifying experience, especially if we have been carrying deep-seated traumas and fears. Most of us have heard stories of “bad trips,” the terrifying visions and emotions that can be dredged up from the depths of our psyche and wished to be avoided at all costs. Yet integration teaches us that it is precisely by facing these fears and traumas that we can begin to heal and transform.
I reference “bad trip” with hesitation as I stand between the idea of a bad trip as rooted in truth and a hyped descriptor that needs a serious revision. I believe we can shift our perspective and view these challenging experiences as an opportunity for growth. I also believe we need to call it like it is: a bad trip. Some people didn’t do their harm reduction and preparatory homework and suffered needlessly. We need to rethink the overly simplistic maxim on bad trips merely being “what you needed, not what you wanted.”
Some psychedelic experts are choosing to reframe the bad trip as an “adverse” or “challenging” experience, given the implication that the word bad means the trip itself was a throw-away, and that there was nothing to be learned or integrated. Psychologist Stanislav Grof has referred to this as the theory of "psychedelic crisis" - the idea that difficult experiences during psychedelic sessions can actually be a catalyst for profound personal transformation.
When something is “bad,” we want to run away. When “challenging,” there is hope and learning. We learn to integrate with respect and gratitude to the challenges that surfaced during a trip and not to turn away from them with fear. I deeply resonate with this philosophy. Yet I can’t help but wonder that we might be missing the point if we just create euphemisms for a reality that psychedelic hopefuls are quick to sweep under the rug.
Research does show that challenging experiences can have therapeutic benefits when integrated properly. Recent studies are attempting to draw the arc of a challenging experience and how to cope with them during and immediately after a journey. Coming Home: The Challenging Psychedelic Experiences Research Project2 is one such study qualitatively digesting this topic with much success so far. It’s being led by the University of Greenwich and has received more than 600 responses (I’ve been tasked at increasing diversity in the dataset for participation, with a Portuguese language version of the questionnaire still available for those interested to participate).3 Reframing these experiences as "challenging" helps to break down the stigmas and fears that have long surrounded psychedelics, shifting the focus from a solely negative connotation to a growth and learning opportunity.
Risk or no Risk?
Yet some bad trips could actually be physically and emotionally harmful. A large survey study found that nearly 11% of respondents put themselves or others at risk for physical harm during their bad trip, and 39% listed it in their top five most difficult experiences in their lifetime.4 Bad trips along with other psychedelics risk factors are known (although not all have been thoroughly examined): psychological distress and potential for re-traumatization, interaction with other medications like MAO inhibitors (at risk for serotonin syndrome), cardiovascular risks, and potential for physical and/or psychological dependency (ketamine has a known abuse profile, for example).5
Despite the substantial debate in research about the link between psychosis and psychedelics use,6 the long-held belief is that psychedelics can trigger underlying mental health issues such as mania, bipolar disorder, psychosis, or suicidal ideation. Young people that use these substances are more likely to be impulsive, feel hopeless and suicidal, and have mental health problems.7 Finally, the largely untreatable prevalence of Hallucinogen Persisting Perception Disorder (HPPD), where psychedelic users continue to experience perceptual distortions from months to even years after a trip, can affect 1 in 25 people.8
We’re not just talking about substance-induced adverse effects. Meditation has been found to be emotionally and functionally debilitating for many,9 is unsurprisingly underreported, and most interestingly – there are no consistent variables, neither in meditation experience nor type of meditation, drug use, or mental health history – to determine who is most likely to experience negative consequences.10 The risks of meditation warrants a separate discussion, but I mention it briefly here to shed light on the shadows of what’s considered the most harmless of any altered-state experience.
Michael Pollan might disagree with my presentation of these risks, although I appreciate his report of psychedelic risk assessment,11 which evaluates the reasons that we need to be wary of the inflation of adverse effects due to sensational storytelling and evidence of unsubstantiated, statistically distorted research results.
Medicalizing psychedelics and the cult of the magic pill to cure all mental illness has placed pressures on scientific study, often funded by big pharma companies, to produce results focusing on positive, therapeutic experiences. Any deviations to the ideal are subdued as statistical outliers or inconsistencies in set and setting. Patient vulnerabilities are sometimes dismissed. Most studies have relatively small sample sizes and predominantly white male participant groups.
Sometimes I find myself unsure of what to believe and by which standards to base my beliefs on. All I know is that research isn’t innocent to data distortion and misleading outcomes - and this fact needs to be acknowledged before we make our own decisions about whether or not to engage with these substances.
Integrating the language of the psychedelic shadow
There’s the idea that we have limited language to articulate the depth and complexity of experiences that would be considered adverse or challenging. The problem isn’t just semantics: it’s a reflection of how our society operates. We’re impatient and we like putting things in boxes when we don’t understand them clearly. Our desire to trigger the psychedelic silver bullet means we’re shooting at whatever target in range – and we’re often shooting blindly.
Integration means decoding how people differentiate between their vocabulary to describe the journey. Rachel Peterson so eloquently reflects on bad trips and suggests that we find ways to articulate and move away from appraisal, such as something being “good” or “bad,” towards phenomenology, or descriptions of what happened.12 She surfaces inquiries like: was it challenging physically and/or emotionally? Was it beyond expectations or did the journey not come close to the depth that the person hoped for? Were the challenges resolved during the trip or was it challenging to integrate the experience afterwards?
“If we believe psychedelics afford new vantages on mind, matter, and spirit, how do bad trips—in all their dazzling, endless diversity—complicate our prevailing notions? What methods does examining the full array of psychedelic experiences require? We must hold all these experiences up to the light; see how they refract our expectations; watch how, when we turn them, we see the kaleidoscope constellating, the same pieces reconfiguring into horror, beauty, meaning, nothingness.” -Rachel Peterson, Theological Reckoning with Bad Trips
While some may argue that bad trips are simply part of the journey and should be instead used as opportunities for personal growth and self-discovery, we need to be aware that they can also be extremely traumatic with potentially lasting negative effects. Although not everyone will have a bad trip, we need to be more aware of the many variables that can influence the likelihood of a difficult experience, including the preparation, dosage, set, and setting.
If we continue to dismiss bad trips as population outliers or just misused phraseology, we’re doing a disservice to the conscious discipline required to evolve in the landscape of psychedelic therapy. We’re in the dance of taking two steps forward, one step back, and it’s a dance we frankly can’t afford to do anymore. We want so much to help people get well, but by denying the potential consequences of using these alternative therapeutic tools we may be harming people in the process.
I am not your guru: The cult of spiritual bypass
The biggest risk is in viewing the psychedelic experience as a shortcut to enlightenment without doing the necessary inner work. Spiritual bypassing is the tendency to use these transformational experiences as a way of avoiding or denying unresolved issues. It’s repeatedly going from one ceremony to another to find answers in the substances themselves for a fast-track to flipping the light bulb switch, without knowing when to dim the lights or turn them off.
Unintegrated psychedelics-use breeds individualistic, narcissistic, and extractive patterns that tear us apart. They reverse the course of what should be unified, interconnected, humble, and giving. I can write ad-nauseum about the rise of spiritual materialism, commodification, and white-washed psychedelic tourism, happening both IRL and on social media. We’ve all likely seen hilarious yet scarily relatable memes of the instagram shaman that rose to enlightenment after 5 ayahuasca ceremonies. We laugh until we cry knowing that these people do exist (and that we may even know them personally). Dennis Walker aptly writes, “the psychedelics space has a credibility problem,” and asks “who’s left holding the bag when something goes wrong?”13 He so accurately parallels our society’s relationship to social media with our tendency to move fast and expect results now – which our modern gurus seem to encourage. “Social media and the hypermodern digital age encourage people and projects to move blisteringly fast to accomplish their agendas, but the visions and downloads you may experience while in mystical states are under no obligation to manifest according to wishful thinking and your expedited timeline.”
The psychedelic false God and our Sacred longing
Our need for a guru follows an even greater hunger to gorge on a psychedelic spiritual buffet. Why is this shadow important to unmask? Because it reveals our deep longing to reach something bigger than ourselves and achieve greater meaning in our lives – perhaps we can call it Sacred. That sacred longing that has little to do with psychedelics. It has everything to do with how, when it comes to finding our purpose, we’re easily getting lost in a more disconnected world.
Ed Prideaux so eloquently questions the purity of a psychedelic experience in a recent essay14 asking whether psychedelics are “ripe for becoming that false God. More often, it may not be psychedelics themselves, but a colorful and nostalgic memory of a particular trip, and the promise of its repetition. There’s little else out there amid the Crisis of Meaning in our culture that can offer a taste of the Sacred with such speed and power. That it’s Sacred at all - or seems that way - may render it doubly deceptive, when everything else has been de-sacralised.”
The cult of spiritual bypass is a signal that we need to bring integration into the foreground more than ever before. While psychedelics can be powerful tools for personal growth and spiritual exploration, they are not the only path to finding greater meaning and connection in our lives; there are many ways to reach the Sacred we’re longing for.
I unmask just a sliver of the shadow so that we can incorporate integration from the beginning, before we place our bets and play the psychedelics game. Integration starts with awareness. This feeds our intentions. Awareness is an embodied presence. Integration, then, is being fully present with this shadow. It’s asking questions and staying curious about what we discover when we bring these hidden aspects to light. Integration can happen when we realize that it’s not the psychedelics themselves that will take us where we need to go: in fact we are the ones in the driver’s seat.
Speaking of the psychedelic shadow, this article does not address the very real and harmful accounts of sexual abuse within psychedelic treatment and ceremonial contexts. It also does not detail the trajectory of psychedelic investment and the patent wars among big pharma. Finally, the consequences of psychedelic tourism and the industry’s unethical and extractive behaviors with plant medicines are also not discussed here. These elements and others I believe require separate and lengthier reflections.
Thanks for this important and informative voice, Amanda.
I didn’t even register before the statistic saying that 39% people listed psychedelic experience in their top five most difficult experiences in their lifetime. We just like to repeat another number speaking about one of the most meaningful experiences in people’s lives, but it seems only fair to speak about both sides.
But I also resonate with Pollan’s view that we need to be wary of the inflation of adverse effects. It’s the context that changes everything. In the medical context, no effective medicine is without risk and the benefits of a medicinal product always need to be weighed up against its risks. Also, when we speak about risks related to psychedelic therapies, we should be comparing them with risks of other licenced medicines for similar indications. And finally, with often catastrophic risks that several mental health conditions expose people to.
But I couldn’t agree more with you about a fallacy of viewing the psychedelic experience as a shortcut to enlightenment without doing the necessary inner work and that integration should be at the very forefront of our efforts. And your remark: “Integration, from my perspective, means choosing to engage less with psychedelics and instead living more presently in the realities of our non-altered state” is spot on!
I believe that creating sustainable integration models is currently one of the most urgent issues. I like Thomas Insel approach to mental health. He advocates broad care involving integrated teams of psychiatrists, psychologists, primary-care nurses and social workers. Because just getting a person through a mental-health crisis doesn’t necessarily help their long-term prospects. They need support to stay on their medication or work on sustaining the beneficial outcomes from therapy, to look after their general health and to get their personal lives back on track.
Related to this, in the psychedelic circles there’s a lot of talk about integration meaning processing one’s trip. But of course, integration is not just an individual matter. Healing is not. For integration to be truly beneficial, on one level it’s realizing it’s not just me and you. We are living in a culture that is suffused in anxiety, epidemic of loneliness. We need each other, we need to be heard and seen. Healing is not an individual matter. This is why it’s a dead-end to “biologise” all mental illness, which can ignore the cultural dynamics that are producing the problem in the first place. Then, one level up, psychedelics should be integrated into a social vision of equality and justice.
There needs to be more conducive environments for healing rather than damaging us further. And more planetary awareness. I mean, just think about this: Clinical trials of psychedelic therapies are being conducted in the western world and culture, in rich countries, yet 84% of people affected by mental illness live in low and middle-income countries. Will these western-style psychedelic therapeutic modalities be even appropriate or effective in, say, India who is taking over this year as the most populated nation? And when will they reach them, 10 years later as this is often the case with innovative treatments? Shame on us and our colonial mindsets.
Another important issue you raise is medicalization/magic pill and how all this is putting pressure on science, often funded by big pharma companies, to produce results focusing on the positive. This is pushing us towards a drive-thru prescription mentality. And it is touching on hugely systemic issues such as patents and capitalism. What is more specific to psychedelics here is the international drug-scheduling system that needs to be reformed to ensure that psychedelics with strong medicinal potential are more accessible to scientists and patients before they are approved by regulators like EMA and FDA. Scheduling created mountains of stigma and resulted in decades of no funding, especially public one. The lack of public funding has been further undermining the ability of academics to pursue psychedelics research. Disadvantaged scientists, who are not affiliated with the industry, are often less resourced than their industry counterparts. Consequently, industry and private donors typically fund psychedelic trials. This situation artificially stifles competition, therapeutic innovation, and access by granting monopolies to companies that develop proprietary therapeutics. As such, the regulatory constraints and patent incentives create a pharmaceutical landscape that privileges high-cost synthetic variants over existing substances. For these reasons, relying predominantly on industry-supported research to achieve the regulatory approval is not an equitable solution to rescheduling psychedelics with medicinal properties. And yet, currently approval of scheduled medicines and rescheduling are effectively synonymous.
Regarding your thoughts about research not being innocent to data distortion and misleading outcomes, it’s helpful to have a wider context. It is estimated that about 20% of clinical trials are false. Very few papers are retracted. Check this must read from the 2021 BMJ publication: “Time to assume that health research is fraudulent until proven otherwise?” https://bit.ly/428VX91
Lastly, but this is so important, voices like yours help people who had challenging/unresolved experiences to validate their experiences and often their suffering. It’s so important to be actively creating this open culture which encourages sharing things that are not positive and thank you for doing so.
This may be an oversimplified approach but 9 our of 10 times, a "bad trip" teaches people they a) are not qualified to be their own sitter b) took too much c) are in an unsafe place with unsafe people. I totally agree that individuals can be re-traumatized...but it's not the psychedelics fault. A rock in "bad" hands killed Abel. A rock in "good" hands killed Goliath. What you call the psychedelic shadow, I think points more closely at the shadow of the user.