What happens during a psychedelic therapy session?

During a psychedelic therapy session, a psychedelic is not used in isolation, but as part of a guided process involving preparation, a safe setting, support during the experience and integration afterwards. Exactly what happens depends very much on the form of psychedelic therapy. A microdosing programme is very different from a psycholytic session, a group ceremony, a retreat or a private session involving a macrodose.

Psychedelic therapy is therefore the umbrella term. This may involve microdosing with support, group sessions with therapeutic guidance, psycholytic therapy, macrodosing combined with psychotherapy in a medical or BIG context, or a private macro session with a therapeutic, non-medical and coaching approach. At Triptherapie, we also work with trip therapy as a holistic approach: psychedelics are combined with preparation, intention, set and setting, guidance, body awareness, music, rest, nutrition, lifestyle and integration.

Beforehand: intake, screening and preparation

In virtually every serious form of psychedelic therapy, the process begins before the session. Consideration is given to why someone wishes to undertake a session, their mental and physical background, any medication they are taking, previous experiences with psychedelics, their expectations, fears and personal intentions.

This is important because psychedelics are not suitable for everyone. Certain mental health conditions, specific medication or unsafe circumstances may be reasons not to proceed or to seek further advice first. Proper preparation also involves discussing what someone can expect, how the day will unfold, what an appropriate dose might be, and how someone can prepare themselves practically, emotionally and physically.

In the holistic approach to trip therapy, preparation goes beyond safety alone. It also takes into account lifestyle, sleep, diet, stress, intention, personal issues, mental space and the setting in which the session takes place. The aim is not simply to “give someone a substance”, but to increase the likelihood of a safe, meaningful and well-integrated experience.

During a microdosing programme

With microdosing, there is usually no full psychedelic trip. The dose is low and intended not to disrupt day-to-day functioning. A session or programme then focuses primarily on guidance, reflection and adjustment.

It is common practice for a person to be given an explanation of a microdosing regimen, its potential effects, pitfalls and points to monitor. Afterwards, they often keep a diary recording their mood, energy levels, sleep, creativity, focus, anxiety or behavioural patterns. The therapist or counsellor helps to interpret these experiences and link them to practical choices in daily life.

With microdosing, the emphasis is therefore less on a profound inner journey and more on subtle change, increased awareness and support over a longer period.

During psycholytic therapy

Psycholytic therapy usually involves low to medium doses. The experience is noticeably psychedelic, but the patient often remains more in touch with the therapist or counsellor than they would be during a full macro-dose session.

During such a session, there may be more opportunity for conversation. Emotions, memories, images or physical sensations may arise and be explored immediately. The facilitator may ask questions, help the participant to slow down, reflect what is being expressed, or support them in staying with a feeling without being overwhelmed by it.

Psycholytic therapy thus lies somewhere between standard talk therapy and a deep psychedelic journey. The substance initiates the process, whilst the conversation and the therapeutic relationship remain more actively present.

During a private macro-dosing session with therapeutic support

With a macro-dose, the experience is usually deeper and more inward-focused. The session often begins calmly with arrival, introductions, practical instructions, setting an intention and building trust. The psychedelic is then taken, for example in the form of magic truffles where this is legally permissible.

The build-up phase follows ingestion. A person may notice changes in their body, emotions, perception, thoughts and sense of time. During the peak phase, the experience can become intense. People may see visions, feel emotions, gain insights, process memories, experience physical tension or feel a strong sense of connection, letting go or surrender.

The support worker is there to provide safety, calm and a sense of security. This does not usually mean constant conversation. Often, it is silence, music, their presence and reassurance that are important. The facilitator helps when someone becomes anxious, gets stuck, needs practical assistance or needs to be reminded to breathe, let go or feel safe.

At Triptherapie, this approach is treated as a holistic session. It is not just about the substance, nor is it just about talking. The combination of preparation, intention, music, a safe environment, body-oriented support, emotional grounding, personal guidance and integration together form the methodology of trip therapy.

During psychedelic-assisted psychotherapy

In psychedelic-assisted psychotherapy, the psychotherapeutic treatment model takes centre stage. This form of therapy is often carried out in a medical, clinical or BIG-registered setting, depending on legislation, the setting and the substance used. At present, this is formally permitted only with esketamine.

The session is then usually part of a course of treatment with clear therapeutic goals, preparatory consultations, one or more dosing sessions and integration sessions. The psychotherapeutic approach may, for example, focus on trauma, depressive symptoms, anxiety, addiction or existential issues, depending on the protocol and the practitioner’s qualifications.

So this is one form of psychedelic therapy, but not the only one. Psychedelic therapy is not automatically the same as psychedelic-assisted psychotherapy.

During a group session or ceremony

During group sessions or ceremonies, there is a group energy field as well as individual guidance. The session often begins with a welcome, practical instructions, introductions, setting intentions and, sometimes, an opening round. After that, participants take the substance and everyone then focuses primarily on their own inner process.

During the experience, the focus is usually on safety, music, tranquillity, supervision and support where needed. Facilitators keep an eye on the group and help individuals if anyone becomes restless, feels emotionally stuck or needs practical assistance.

Afterwards, there is often time to settle down, have a meal, rest and perhaps share something. On retreats, this can be extended to include an overnight stay, integration discussions, breathing exercises, bodywork, silence, time in nature or several days of guidance.

A group session is therefore not simply “tripping with a group of people”. In a therapeutically guided group setting, structure is important: preparation, setting, guidance, rest, aftercare and integration.

During a couples’ or relationship-focused session

In a duo session, two people undertake a psychedelic session together. They may be partners, but they could also be friends, family members or two people who wish to embark on a journey together. The session can be partly individual and partly relational.

In practice, this means that both participants have their own inner experience, but that attention can also be paid to connection, trust, communication, boundaries and patterns between the two people. Sometimes it is important for both participants to focus primarily on their inner world. At other times, however, a shared moment, touch within clear boundaries, eye contact or a brief conversation can be particularly valuable.

With this form of therapy, extra preparation is important, as the dynamics between two people can have a significant impact on the session. The therapist therefore monitors not only individual safety, but also relational safety.

After the peak: landing, resting and coming back

After the most intense phase, the effect gradually wears off. This is often referred to as the ‘landing’ phase. The person begins to return to their normal state of consciousness and is better able to speak, move, eat and reflect. This phase is important, as any insights or emotions may still feel fragile and raw.

A good support worker does not rush into analysis at this stage. First, a moment of calm is needed. Water, tea, a light snack, silence, music, a blanket or simply being there can be more important than talking straight away. Later on, there may be an opportunity to briefly discuss what someone has been through.

Integration: from experience to everyday life

The session itself is not the end point. Integration is the process by which a person applies what they have learnt to their everyday life. This may involve choices, relationships, boundaries, self-care, lifestyle, finding meaning, behavioural patterns or how a person deals with their emotions.

During integration, we assess which insights are useful and which still need time to develop. Not everything that feels profound during a psychedelic experience needs to be taken literally. Effective integration helps us to find meaning without jumping to conclusions.

Integration forms part of the holistic approach to trip therapy. A session is seen as part of a broader process in which the body, mind, emotions, lifestyle, environment and personal development are all interconnected.

In summary

During a psychedelic therapy session So there isn’t just one standard approach. With microdosing, the emphasis is on subtle support and reflection. With psycholytic therapy, there is more interaction and dialogue whilst in a mild to moderate psychedelic state. With macro-dosing, the emphasis is more often on a deep inner experience with safe guidance. In psychedelic-assisted psychotherapy, a psychotherapeutic treatment model takes centre stage. In group sessions, ceremonies and retreats, the group setting also plays an important role.

At Triptherapie, trip therapy is viewed as a holistic approach in which psychedelics are carefully administered in combination with therapeutic support, preparation, a safe setting and integration. The substance itself is not the whole story. The quality of the process surrounding it largely determines how safe, meaningful and applicable the experience can be.