29 April 2024 21:27
Topic starter
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In the report "Therapeutic applications of psychedelics: Opportunities, challenges and care innovation for treatment-resistant psychiatric disorders" by ZonMw, it is noted that ‘’With good supervision and preparation, unsafe situations can be avoided and people can usually be reassured. However, even in the presence of good counselling, people can have intense or negative experiences and become emotionally and psychologically quite upset.’’
Do you have experience with individuals who become emotionally and psychologically disturbed during a psilocybin session? If so, what approaches would you recommend to help these individuals regain their composure?
1 May 2024 13:39
Do you have experience with individuals who become emotionally and psychologically disturbed during a psilocybin session? If so, what approaches would you recommend to help these individuals regain their composure?
It is true that proper screening, preparation and guidance can greatly reduce the chances of a "bad trip". Preventing negative experiences is the most important part of providers of psychedelic sessions. Still, it happens that despite screening and preparation, a difficult part of the trip can occur or the whole session can be labelled as a negative experience. Fortunately, according to our statistics, the chance of such a disruptive experience is only about 1 in 500.
In order to calm people down during a difficult start of the psilocybin session, it is useful to discuss tips and tricks during the conversation before the actual intake in case a piece occurs that might upset someone. This can help to get through difficult pieces and if intervention is needed, the tips can be repeated. Repeating the tips can be more effective than introducing them only when someone is already going 'bad'.
Other ways to regain composure are a calm presence and reassurance. Once people have a challenging start to the trip and they know it is temporary and can happen, then the worries can go away, after all, it is normal. If restlessness persists, distraction or changing music and surroundings can help.
Furthermore, giving someone a tranquilliser can sometimes help. Eating sugars and calming supplements can take away the peak effects of the trip. These small reductions in the effects of psilocybin may be just enough to calm someone down.
If the turmoil does not go away
During two of the 2,300 psilocybin sessions, we called the emergency services. For one, we had the ambulance come because this person was afraid of his heart. Despite knowing that the symptoms arose from panic, we sent for the ambulance for reassurance. After the ambulance staff tested and reassured this man, the symptoms were immediately gone.
During another session, the police were called in. This man had developed so much mistrust and wanted the police to come. For his own safety, the police were informed and called in. After the police arrived, he told them that we had drugged him. The police answered him by asking if he had paid for it. After this, this customer said, "Yes, but still they drugged me". After this, calm returned and the problems were resolved.
So it is important to avoid negative experiences. Should someone be disrupted, it is very important to find out what someone really needs and provide for it. Furthermore, it is important to ensure proper integration after a bad trip. After all, bad trips can provide important insights and be turned to one's advantage.
See also: Bad trips
1 Answer
1
13 April 2025 13:29
Yes, within psilocybin-based sessions, it sometimes happens that participants temporarily become becoming emotionally or psychologically disturbed. This is not an error or complication per se, but rather a part of the therapeutic process. It often involves emerging repressed emotions, intense memories or loss of control, which can be overwhelming for some.
Experience and explanation:
In Triptherapie's practice, where thousands of sessions have been supervised, clear protocols and techniques have been developed for dealing with such moments. These moments are not seen as undesirable, but as opportunities for healing - provided they are well taken care of.
Recommended approaches to soothe and safely guide someone through a difficult phase:
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Presence without intervention (holding space): It is often enough for a supervisor to silent presence, physically close, without direct direction. As a result, the client does not feel alone and knows there is supervision. This prevents panic or dissociation.
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Mirroring confidence in the process: Supervisors gently name that what happens is part of the process, that it is temporary, and that it is “may be felt through”. Phrases like “Just breathe easy with me” or “You're safe, just let it happen” are powerful.
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Body-centred interventions: For panic, hyperventilation or dissociation, simple techniques can help, such as grounding through touch (e.g. a hand on the shoulder or feet), breathing guidance, or encouraging contact with the body.
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Using sensory anchors: Sometimes it helps to employ soft music, scent (aromatherapy), or tactile objects (such as a rug, stone, or pillow) as anchor point to the here and now.
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Don't push away but guide: Avoiding or suppressing the experience can actually intensify anxiety. The trick is to make someone helping to admit what presents itself, in a way that feels like ‘holding without steering’.
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Debriefing and integration: After the session, it is crucial to giving meaning to the difficult experience. Often, what was terrifying in the moment turns out to be a key to healing or insight in retrospect.
The key is a combination of trauma-informed counselling, empathetic presence, and knowledge of psychedelic processes. Within Triptherapie, this is exactly why sessions always take place with experienced facilitators, focusing on both preparation as integration.