Updated: Jan 9
The term "psychedelic harm reduction" refers to active measures taken before, during, and after a psychedelic experience to reduce the chances of physical and psychological harm to the individual. Ever wonder why it's not called "psychedelic harm elimination"? Well, because despite the best intentions and efforts of facilitators, guardians, and psychonauts themselves, no one can predict or control what unfolds in an individual's psyche during a psychedelic journey. And sometimes, what unfolds is challenging, confronting, traumatizing, and on rare occasions even physically harmful.
We need to have transparent and informed conversations about these experiences so we can better prepare the participants, equip the guardians, and train the facilitators to effectively reduce harm. Unfortunately, many are either completely ignoring these realities or even worst, declaring "there is no such a thing as a bad trip! You just haven't found the gift yet!". This narrative is not only factually inaccurate but outright harmful and dangerous.
While reframing is a powerful tool for transforming many challenging experiences into learning, growth, and healing opportunities, it is by no means appropriate or authentically accessible under every circumstance and is not a reflection of the participant's competence in integration. Suggesting otherwise is simply uninformed, privileged, and cruel.
Individuals and communities with a significant history of trauma are especially susceptible to challenging psychedelic experiences. An informed, effective, and compassionate response that creates an opportunity for healing requires acknowledgment, validation, curiosity, and a judgment-free approach.
It is not uncommon for well-intentioned individuals to engage in active denial, dismissal, minimizing, and spiritual bypassing of challenging experiences in an effort to inspire a change in perspective away from "a victim narrative". Although psychedelic substances are often rightfully credited with offering empowering and illuminating shifts in perspectives that facilitate deep healing of old wounds, they only serve as transformational agents when experienced authentically by the individual, not projected and lectured by a third party.
When privileged individuals with no understanding and education on trauma and social justice proclaim that "all challenging experiences are actually teaching experiences", they consciously or subconsciously engage in active denial and bypass another's suffering simply because they are incapable of relating. A trauma-informed approach is far more nuanced and requires deliberate education, mindfulness, and attunement to cultivate and practice.
If psychedelic medicines are here to help transform consciousness and act as agents of healing and change, that goal can not possibly be fulfilled by disenfranchising and alienating the very populations that can benefit from the healing qualities of these substances.
It is the duty and responsibility of facilitators, community organizers, coaches, healers, and public persons who speak on this topic to adequately educate themselves on trauma.
As a psychedelic advocate and facilitator for well over a decade, and a trauma-informed mental health professional who also happens to be a survivor of developmental and trans-generational trauma, a survivor of war, a refugee, a chronic pain warrior, and a neurodivergent human who experienced a significant life-threat and lasting harm under the force of psychedelics, I feel uniquely qualified to shed light on this topic with the hope that it will further harm reduction efforts for traumatized populations and reduce suffering and alienation for those who struggle with psychedelic experiences.
Here I outline the most common types of experiences often referred to as "bad trips". While some of these experiences sometimes under the right circumstances can be profoundly healing, denying the real possibility of their negative psychological impact is a disservice to the psychedelic communities and the therapeutic future of these substances:
Loss Of Control
Loss of control is a classic hallmark of psychedelic experiences. As the famous motto in psychedelic communities goes, "trust & surrender" is the path although much easier said than done. In fact, much of the struggle of individuals under the force of psychedelics is experienced as a result of their inability to let go of control and allow a completely novel and unpredictable experience to unfold.
The intensity of the experience varies widely across different substances. With substances like 5-Meo-DMT, the experience unfolds so quickly (within seconds) that there is little time to resist the loss of control whereas, with ayahuasca, the experience unfolds slowly over many hours making it an especially potent experience of sitting with, witnessing, and living through the resistances to loss of control in what can feel like a lifetime.
While these challenging experiences and perspectives are profoundly illuminating, healing, and transformative for the most part, they present a particularly high risk of intense psychological terror for individuals and populations with a significant history of trauma.
Sometimes loss of control is experienced as a sense of the individual "losing their mind". Depending on the intensity of the experience, dosage, type of substance, and the experience of the participant, this can present as a feeling of a non-stop racing mind and a loss of identity. This can be extremely terrifying, especially for individuals whose identity is closely tied to their cognition, rationality, and intelligence. Hyper-rationality is a common survival response amongst traumatized populations; without adequate preparation and active support, loss of cognitive coherence can present as a traumatizing event.
Often the loss of control is experienced as a loss of self also referred to as "Ego Dissolution" or "Ego Death". Here the participant experiences a complete dissolution of the self in an experience much like the known phenomenon of near-death experiences (NDEs). While NDE reports suggest an overwhelmingly positive experience, psychedelic participants often find themselves struggling to let go of control; sometimes due to fear of death but often due to a history of severe trauma.
Trauma in its most simple description is "loss of control". It is therefore not surprising that individuals with a significant history of trauma are likely to experience flashbacks when experiencing loss of control. Actively attuned and present guides can help reduce the harm potential of such experiences by providing reassurance, support, and psychological safety.
A significant function and benefit of some psychedelic substances like ayahuasca and ibogaine are experienced as intense physical purges. Many credit these purges with healing physical, emotional, and mental dis-eases.
While these purges, although unpleasant, are generally well managed and tolerated by most participants, strict dietary adherence is required to minimize extreme discomfort. When such measures are not taken prior to the experience, the resulting discomfort can completely debilitate the individual for many hours and even days resulting in a
Although physically challenging experiences are mostly not life-threatening, the very few documented instances of mortality under the force of psychedelics have predominantly resulted from choking, suffocation, and other physical accidents. Individuals who experience severe physical danger during a psychedelic journey are likely to experience PTSD and require professional support.
Traumatic Memory Recall
One of the most common trauma responses is memory repression; sometimes the trauma is so great that the only way one can survive is by suppressing the memories of an event or period of time. Sometimes, under the force of psychedelics, individuals experience spontaneous memory recall and sometimes that recall is associated with repressed traumatic memories.
If the individual is well-resourced in their nervous system, a traumatic memory recall can be incredibly informative, insightful, and healing. In the context of psychedelic experiences, often this is experienced as an opportunity to reprocess the experience in a new context and from a different more empowering, insightful, or compassionate perspective which allows for the potential for significant healing of old wounds often in a single psychedelic experience. There is no denying the power of psychedelic experiences when it comes to healing trauma.
It is however irresponsible to ignore the very real possibility that sometimes the traumatic memory recall can be extremely shocking and disorienting to the individual requiring extensive professional support to restore psychological safety that allows for processing of the past. Informed facilitators and communities understand the limits of their capabilities under such severe circumstances are have procedures in place to ensure appropriate professional support for participants in active crisis following a psychedelic experience.
While psychosis under the force of psychedelics is extremely rare, individuals with a history of severe mental illness personally or in their immediate family are at an elevated risk of experiencing psychosis. Although skilled facilitators screen for these conditions ahead of time, genetically predisposed individuals, often from marginalized socioeconomic backgrounds, who are not informed about their family history are at a high risk of experiencing psychosis.
Even though there is, unfortunately, no way to identify these cases ahead of time, immediate and adequate response and care have a significant impact on the outcome of a psychologically challenging experience.
Although a significant majority of guided psychedelic experiences are held with integrity, unfortunately, opportunistic and abusive conduct by the few "shady shamans" presents a real threat to the physical and psychological safety of participants.
Inappropriate physical touch, unprofessional conduct, and manipulative language during a psychedelic experience can cause serious harm and threaten the safety and well-being of the participant.
Individuals with a history of trauma are especially susceptible to experiencing triggers and flashbacks in response to touch. A thorough pre-screening of participants must include capturing any history of trauma and taking active measures to create a safe space for physical and psychological safety before, during, and after a psychedelic experience.
Spiritually Bypassing Language
Unfortunately, spiritual bypassing language is widely practiced and promoted as not only accepted but rather an"evolved" perspective amongst psychedelic communities; which ironically begs the question: are these holier-than-thou expressions themselves not an indication of strong ego identification, spiritual superiority, and the absence of heart-centered integration?
Well-intentioned but nevertheless uninformed and privileged individuals perpetuate active harm and confusion for trauma survivors by ignoring and minimizing the very present and real experiences of pain and struggle. While in the right context, some of these narratives can be empowering and inspiring for some, they are nevertheless problematic for others and are best completely avoided. Here are some common examples of spiritually bypassing language:
"Everything is a gift" - including rape and assault?
"You create your own reality" - does this apply to children with cancer?
"Just trust and surrender" - is this helpful for a sex trafficking survivor?
"That's a victim narrative" - how does one turn incest into an empowering narrative?
"You just have to change how you look at it" - does this apply to genocide? how about slavery?
During A Crisis
Challenging psychedelic experiences are in some ways a rite of passage for every psychonaut. While often individuals are able to move through these experiences and emerge stronger and more inspired with a fresh perspective, sometimes the intensity of the experience, history of trauma, and other unpredictable factors can result in an experience of intense fear and terror. Having an informed and compassionate guide to help navigate the challenges during the experience as well as healthy processing and integration after can help reduce the possibility of long-term harm.
Psychedelic harm reduction services are often available through local psychedelic community chapters as well as support hotlines like The Fireside Project
If you or someone you know is in need of support during or after a psychedelic experience, you can call or text 62-FIRESIDE for free peer-to-peer support.
In conclusion, as a general compass, leaning into radical compassion and love is a safe bet to minimize harm. When it comes to making sense of psychedelic experiences, properly trained and certified psychedelic integration coaches and trauma-informed mental health professionals are the only reliably informed voices. Spiritual coaches, public personalities, and even many traditional facilitators are simply not equipped to properly and adequately support trauma survivors in their psychedelic integration process.
As psychedelic communities continue to expand, the need for active and deliberate trauma-informed training of facilitators, organizers, and support staff is imperative to the ethos of psychedelic harm reduction and the future of the psychedelic renaissance.
For inquiries on trauma-informed training workshops and curriculum, contact Anahita Parseghian at firstname.lastname@example.org