How to Deal With a Troubling Psychedelic Experience

Plant medicines and psychedelics, used in thoughtful and intentional ways, can be incredibly life changing and transformative. They offer the potential for profound spiritual experiences and deep healing.

But these experiences can also be very challenging, difficult, dark, or painful. This is especially true when the person is unprepared for the magnitude of what they experience. Even people going through positive transformative journeys with psychedelics can find themselves struggling to come to terms with what happened or return to a balanced state. It is not always a smooth process.

There are a variety of experiences that can be particularly troubling for someone journeying with psychedelics or planet medicines. Based on my experience working with hundreds of people before, during, and after psychedelic and plant medicine journeys, I have identified the following common themes. I would also add that I have personally experienced just about all of these at one point or another:

  • The Bad Trip / Dark Night of The Soul
  • Tour Through The Hell Realms
  • Unexpected Revelations
  • Rocky Return
  • Spiritual Crisis
  • Psychotic Break

The Bad Trip / Dark Night Of The Soul

Some people have really rough, nightmarish experiences. These usually involve a significant amount of fear or terror. The participant can feel persecuted or tormented by what is happening. This almost always occurs at a very high intensity for that person and they experience an intensity that overwhelms their capacity to cope. Frequently they reach a point where the self or the ego begins to dissolve or fragment and is struggling to hold on. The person may feel that they are actually dying or going insane. This can be very terrifying and as a result the person may go into a state of panic.

The irony is that these experiences, by bringing the person to the cusp of total ego dissolution, offer the potential to experience a true mystical experience, total unity with the universe, and the experience of pure consciousness. But to get there, the self has to temporarily go away. These mystical experiences are almost always characterized by an experience of universal love and awe and most people consider them to be one of the if not the most important experiences of their lives.

To get there, however, one has to surrender, and this is usually the sticking point. People experiencing tremendous fear at this point will contract, resist, and try to hold on in any way they can. This creates a tremendous amount of anguish, friction, and turbulence. It is almost the archetypal definition of suffering: there is both holding on and resisting occurring simultaneously.

The best thing to do here is to relax, surrender, and allow oneself to “die.” In many ways, these experiences are good practice for actual death since eventually we all have to give everything in our lives back. The phrase “you can’t take it with you” is true on the deepest of levels: you can’t even take your “self” with you. And the experience can illuminate what your biggest attachments and fears are, which can then become the focus of deep spiritual or personal work.

A Tour Through The Hell Realms

Another type of “bad trip” is what I call the tour through the hell realms. These are very dark experiences where the visions or feelings are characterized by dread, fear, human suffering, and encounters with what feels like evil or evil beings, demons, etc.

While the hellish realms share a very common set of elements, there are many different reasons why these can occur. Sometimes the experience can relate to the current state of suffering or unhappiness that someone is living in. Other times they may relate to the ways in which the person is creating suffering for others. A hell realm experience can also be a result of mixing different substances together (e.g. alcohol and psychedelics) or a poor setting (e.g. a party setting, urban environment, etc.) that creates the conditions for such an encounter.

The best prophylactic for these experiences is being in a positive emotional state, having a positive intention for the experience and having a safe, peaceful and appropriate setting. This is where the concept of “set and setting” came from.

While the experience is often of an absence of love, love is the best antidote to the hell realms. Focusing on the feeling of love, the heart, loved ones, divine love, can result in a significant shift into a better place. No matter what the hellish experience, eventually it ends and there is usually a huge relief of having survived it. In the moment it may feel eternal, but reminding oneself that this is a temporary visit can really help. Relaxing oneself, slowing down, and breathing deeply, if possible, is helpful as well (assuming one is still in touch with their body during the experience.)

Integrating a hellish experience offers particular challenges. Often there is a strong desire to make sense of it, why it happened, and what it means. Exploring this can be helpful. However, one doesn’t always get immediate clarity on what the purpose of that experience was. These are experiences that can take a long time to digest and clarity may not come right away.

In my experience, at a minimum a hellish psychedelic experience offers some increased understanding of our own darkness or shadow-nature (i.e. the capacity for negative intent that we all have within us) and as a result increase empathy and compassion. It can also illuminate the nature of suffering which can be a very meaningful and important life lesson. In addition, it serves as a reminder to treat these substances with reverence and respect as they offer the potential for great highs and great lows.

Unexpected Revelations

These occur when people are shown things they didn’t want to see or know. Often time there is a painful realization that something in their life isn’t working. This could be a relationship, a job, or something very important to them.

Other times repressed issues and themes can surface, including inner conflicts and old traumas that the person may have buried. These can be very challenging to deal with especially as they seem to come out of nowhere.

No matter what the revelation, it is unsettling and destabilizes the person’s homeostasis. This leads to both turbulence and volatility after the psychedelic experience but also leaves the person sitting with a dilemma or an open question that needs to be answered or resolved.

What is typically needed here is patient reflection and examination on what was illuminated. If some deep wound was revealed, there may be a need for healing or therapeutic work. If some unsustainable life situation or pattern was highlighted, the person may need to examine what about this pattern isn’t working, how they got into it in the first place, and what the options are to change it.

In none of these cases is the person served by impulsive or reactionary action. Often something does need to be done to address the situation but that doesn’t need to be done immediately and in fact they won’t be in a good place to do something about it until they have truly digested and integrated the revelation or insight. This takes time and work.

The Rocky Return

A rocky return occurs when someone’s consciousness is still flying high and their energy still quite open even after the effects of the psychedelic or plant medicine have worn off. This occurs even if they’ve had a very positive experience. In fact, the biggest predictor of this occurring isn’t whether it was a “good” or “bad” trip, it is the intensity of the experience they went through. They may feel “high” walking on a cloud, or conversely may feel caught in darkness, for days after. Often times the person may be quite emotional or labile, with a rapid succession of alternating feelings and racing thoughts. Or they may feel tuned into spirits, higher levels of consciousness, or find that they are easily accessing non-ordinary awareness.

What is needed here is grounding and balancing of their energy. The person’s mind, body, and overall energy needs to be grounded back to earth. Grounding exercises can be helpful for this. So can physical self soothing, such as a nice comforting heavy meal or a gentle massage. Anything that helps anchor the person back in their body can be helpful. I find that spending time in nature, especially in the mountains, by the ocean, or in a forest can really help to ground someone and balance their energy.

Talking to someone about the experience and what they are going through and processing can also be very helpful here, as long as it is someone who will listen non-judgmentally and be supportive.

It is important that the person not open up their energy or consciousness any further until they have truly come back and integrated the experience. This means no psychedelics or other altered state work (hypnosis, shamanic journeys, trances, etc.) Even regular meditation can be too much for some people, although a gentle guided visualization focused on grounding can be of help. The point is the direction of attention should be back into the body, back to the earth, and back to the present until the person has stabilized and fully integrated what they experienced.

The Spiritual Crisis

Sometimes people can experience such a powerful spiritual opening or awakening that they are left not only fundamentally altered but stunned or shocked as well. Their entire understanding of reality has fundamentally shifted and they struggle to fit this new understanding into their existing cosmology or worldview. Frequently it doesn’t fit, and integrating the experience involves expanding their cosmology to incorporate the new experiences and understandings.

They may return to their regular life but feel very differently about it. Life may take on an unreal quality. Similar to the Rocky Return scenario, they may have trouble coming back and grounding into their new reality. They may be dazed or in a state of semi-shock for days or weeks after.

The person may also be dealing with deep questions about who they are, the meaning of life, what life is about and other existential issues. As a result, every day activities may seem unimportant and meaningless.

The combination of all of these aspects (i.e. the change in worldview, existential dilemmas, and the ungroundedness) make the Spiritual Crisis very challenging territory to navigate and frequently help is needed. More often than not what is helpful here is working through the new understandings and the questions it has brought up in a spiritual framework.

Working with a spiritual teacher or psycho-spiritual guide is usually a better fit than seeing a traditional psychotherapist. Regardless of the approach taken, the difference aspects that have shown up will all need to be addressed, including grounding practices, exploration of the experience, and fitting the new understandings into a coherent worldview. The end-result of this kind of work is often significant changes in terms of how the person is living their life, what their life compass is, and how they relate to the experience of life. As such the spiritual crisis, when worked-with purposefully can lead to major positive life transformation.

Psychotic Break

In very rare cases, certain people can begin experiencing psychotic symptoms where there was no history of this before. These include easily getting lost in thought and appearing “spaced out”, odd thinking, difficulty relating to others, persistent audio or visual hallucinations, delusions of all kinds, and increasing mental disorganization preventing them from navigating basic activities. Often, but not always, there is a family history of psychosis, schizophrenia or bipolar disorder.

These are very serious cases and someone going through this absolutely needs to stop doing psychedelics, even though they often feel pulled to do more. Similar to the Rocky Return, they should refrain from all kinds of altered states (including mindfulness) until more grounded. And they should really consult a psychotherapist or psychiatrist as soon as possible. Depending on how far out the person is, psychiatric medication may be needed.

These situations, while very rare, are very serious and need to be treated as such. Psychotic-spectrum experiences from a one-time use of psychedelics, if handled skillfully by a professional, can often be resolved. However, if the person continues to work with psychedelics and experiences or shows increasing psychosis symptoms, it becomes much harder to help them stabilize, which is why refraining from further psychedelics is a key step.

Getting Help

No matter what type of troubling psychedelic experience one may have, getting help with it is important. Depending on the nature of the experience, different kinds of help may be needed. Sometimes a professional psychotherapist is needed, other times a spiritual teacher or guide may be more helpful. In general, it is important that the person be familiar with and understand psychedelics and the territory of altered states of consciousness.

With the right help, even these troubling experiences with psychedelics can become springboards for healing and personal transformation. More often than not, I find that people who proactively engage with their difficult psychedelic experience and work with what it brought-up end up benefiting greatly on psychological, emotional, and spiritual levels. It then becomes the source of powerful positive life-changes.

The catch-all category for people who specialize in this kind of work is a psychedelic integration counselor or psychedelic integration coach and there are many people offering these kinds of services (see below for links to integration directories). But while there are many excellent psychedelic integration counselors, the quality may vary quite widely.

First, not everyone on these lists are very experienced with psychedelics. Especially as this kind of work is drawing more attention, there are many people offering psychedelic integration work that have had limited experiences with psychedelics themselves. They may have the professional credentials and have training on how to do healing or therapeutic work but a limited understanding of psychedelics based in only a handful of personal experiences.

On the one hand, there are people with lots of psychedelic experience but no professional training or real understanding of how to be of service. These are essentially psychedelic explorers that are so excited about psychedelics that they want to help but don’t really have the skills or the knowledge for dealing with challenging experiences nor have they engaged in the personal work needed to cleanly help others.

There are also a variety of “new age” spiritualists or practitioners of many stripes who want to be of help but aren’t able to maintain the neutrality needed for this kind of work. The challenge here is that they don’t know how to help without putting their own spiritual beliefs on their clients. And this is often the opposite of what the client needs, which is help in coming to their own spiritual or existential understandings.

In my opinion, the safest option of the three is a licensed professional, even if they have limited psychedelic experience because at a minimum they have done some personal work, have received training on how to help others, and most importantly have been taught how to maintain good boundaries and neutrality when helping others. They also most likely have a lot more experience helping and guiding others than a para-professional. Either way, make sure to vet whoever you are thinking of working with.

*Full Disclosure: I am listed in both of these directories.