Who SHOULDN’T use psychedelics?

There’s so much hype out there right now around psychedelics that it’s easy to think they’re a cure-all for everybody. But as I have tried to make clear in the disclaimers of my series on psychedelic integration, these substances can also have real downsides, and it always is important to consult with your physician before embarking on this kind of journey to minimize the possibility of negative interaction effects with other medications or underlying health conditions.

In this post I want to lay out some of the common contraindications - though, again, this post does not substitute for a consultation with your medical doctor. It is also important to note that the research on this aspect of psychedelics is still in its infancy, and rapidly evolving, so the information presented here may be out of date by the time you are considering using these substances - another reason to please consult with a physician before taking a trip.

If you are on any serotonin-enhancing medications, then you need to be very careful with psychedelics, as the combination can produce a toxic and potentially fatal level of serotonin in your brain, a condition known as Serotonin Syndrome. This includes the MAOI and very common SSRI (Prozac, Zoloft, Paxil, Celexa, Lexapro, and others) classes of antidepressants, lithium, and antipsychotics. If you are using any other medications, then, again, it is very important to consult with your physician.

Psychologically, if you or your family have a history of psychosis or bipolar 1 disorder, then psychedelics are probably not a great fit. This includes schizophrenia, schizoaffective personality, or any other disorder with psychotic symptoms. Also, if you have ever had a psychotic episode following a previous psychedelic experience, then that is likely a contraindication.

In addition, if you have a history of severe trauma and haven’t yet developed tools to help you stay regulated while exploring the memories of your traumatic experiences, then it is a good idea to stay away from psychedelics until you have developed those skills and can make sure you are in a space where there is the strong support you might need to stay safe. These substances often drop people right back into those experiences - which can be a really helpful thing, but only if you are prepared to ride those rapids. If you need help developing these skills then reach out to a trauma-informed therapist who can help you.

Physically, anybody with high blood pressure or other heart conditions are not good candidates, as many psychedelics can raise your heart rate. This is also true of people who are pregnant, or have glaucoma.

And once again, if you have any questions about whether these substances are suitable for you, then please consult with your physician. We want you to stay safe through these experiences!

Psychedelic Integration, part 4 - Narrating Your Experience

DISCLAIMER - Psychedelics are still largely illegal in the United States. I am not a medical doctor and cannot recommend any types of medication. This post is not intended to encourage anyone to engage in illegal activities or consume illicit substances, and I cannot provide the substances themselves or any help in obtaining them. The decision to try such substances should only be made with careful consideration and in consultation with your physician, as there can be an array of complications including negative interactions with other psychotropic medications. But if you are considering using these substances in your own healing work, then you should have scientifically accurate information about them, and about how to get the most from these types of experiences.

You’ve planned your journey and prepped your body-mind. You’ve set your intention. And you’ve gone and had the experience. Now the real heart of the integration process starts. And the first step here is just recalling and documenting your experience. These kinds of journeys can be intricate, multi-dimensional, and often have multiple phases where very distinct kinds of things are happening.

So it’s a good idea, as soon after the trip is done as you are able, to write down as much as you can remember about what happened. Give yourself some time to do this - depending on the substance these experiences can be quite prolonged, and as you write you will probably start to remember other parts of what happened. I would suggest also capturing as much of your in-the-moment reaction as you can recall. That is, if a part of your trip left you feeling scared and thinking about that time you got left at the mall then make note of that in your trip log.

Also, it can be extremely helpful to be tracking what your experience is like during the process of writing. If you are putting words to particular parts of the journey and you find yourself elated, or uneasy, or distracted, you should make a note of that. If you start experiencing sensations in your body as you write - tensions, tingles, movement impulses, dry mouth, and so forth - that is also worth recording. Same thing with memories or images that show up. All of these associations are information that will be valuable to you as you start to integrate the experience into your day to day life.

In fact, by telling the story this way you are already beginning to integrate what happened, and starting to weave a narrative around the experience and how it relates to your day-to-day life and personal history. Narrative is a powerful tool that our minds use to make sense of the world, as well as to create a consistent picture of ourselves. Without a sense of narrative you just have a random jumble of happenings, like a poorly scripted movie that is difficult to follow because there’s no throughline to hold it together. 

But narrative is discovered and deepened through the telling and re-telling of events, coupled with the emotional, somatic, and imagistic aspects of experience. So by writing out the story in this way, even if it feels like a jumble at the time, you are starting to pull those altered-state experiences into the stories that shape your day-to-day world. And this process is EXACTLY what we mean by integration.

Once you’ve done this, you can start to reflect on the kinds of changes you might need to make in your life, which is what we’ll talk about in the next entry in this series!

Psychedelic Integration, part 3 - Knowing less, not more

DISCLAIMER - Psychedelics are still largely illegal in the United States. I am not a medical doctor and cannot recommend any types of medication. This post is not encouraging anyone to engage in illegal activities or consume illicit substances, and I cannot provide the substances themselves or any help in obtaining them. The decision to try such substances should only be made with careful consideration and in consultation with your physician, as there can be an array of complications including negative interactions with other psychotropic medications. But if you are considering using these substances in your own healing work, then you should have scientifically accurate information about them, and about how to get the most from these types of experiences.

Before we dig into integration any more, I want to make an important part of my perspective explicit - if you’re doing psychedelics (or any other personal growth path) right, then you will come away knowing less, not more.

I’ll say that again. If you’re doing psychedelics right, then you will come away knowing less rather than more.

What do I mean by this? Surely you’re pursuing this path because you want to learn new things about yourself, right? To become more clear on the direction and intent of your life? To get clearer on all those hidden nooks and crannies of yourself? Of course, and chances are you will come away with all sorts of insights. That is, of course, very valuable, and not to be discounted.

But the real change happens in the growing comfort with NOT-knowing. Truth time here - all your concepts, all your dearly-held beliefs about yourself and others and the world at large, they’re all just illusions. They’re all chimera that help you organize yourself and the world into perceptible forms, but they don’t have much substance beyond that. Many of them are really helpful illusions, especially the shared ones that help us move through the social worlds that we all inhabit. But they’re still illusions. And the real growth, especially the spiritual growth, comes from being able to let go of the illusions and just see the messy formless reality of things as they are in this moment.

The forms we project onto the world become so deeply embedded in our minds that they serve to shape our very perception of reality. Once we are wedded to particular ideas about the world’s forms, we see everything in terms of those ideas. (see my post about narratives for more). And indeed, this is a good thing! It’s part of how the brain operates so efficiently, by using these base-level assumptions about reality to be able to quickly suss up situations and move through them. As a way of moving through day-to-day life, perceiving self and the world as undifferentiated, formless mass isn’t very conducive to survival.

But there are also times when we want to step out of our habitual perceptions, dissolve our ideas about reality, and make space to see ourselves and our worlds in new ways. This need is why meditation practices are so immensely useful - you are regularly practicing stepping outside of your conceptual mind and seeing the world as it is, rather than as your concepts have conditioned you to see it. And in often coming back to that space you are giving your concepts a chance to evolve in response to deep reality, rather than just allowing your old conceptual frameworks to become more and more rigid and self-referential (and indeed, in our modern world, to then shape reality in accordance with them rather than the other way around).

This is the effect psychedelics have as well, but on overdrive. Which is where both their power and much of their danger comes from. In this spirit, a trick of these big growth paths, and especially of psychedelic journeying, is therefore to take your experience seriously, without taking it as gospel. It can be really tempting to treat your experience as “now I’m REALLY experiencing reality!” 

But psychedelic journeys, and the perceptions experienced in them, are as much chimera as all other perceptions. Like dreams, they can tell you a lot about yourself, but they tend to conform to and follow deep and often unconscious psychic structures, often relics of how you learned to approach the world in early childhood, encoded in implicit body memory. And THAT means that, like all your other concepts, they should not be taken as truth, but as a pattern in the sand that can tell you something about the shape of the earth beneath it.

If you haven’t experienced this, then I imagine this post might sound like gibberish. And that’s okay. Just file it away, and keep it in mind as you proceed on your path. Maybe it will speak to you at some point. Or maybe not. Regardless, I wish you luck on your path, and please reach out if you need support around these processes!

Psychedelic Integration, part 2 - Preparation

DISCLAIMER - Psychedelics are still largely illegal in the United States. I am not a medical doctor and cannot recommend any types of medication. This post is not encouraging anyone to engage in illegal activities or consume illicit substances, and I cannot provide the substances themselves or any help in obtaining them. The decision to try such substances should only be made with careful consideration and in consultation with your physician, as there can be an array of complications including negative interactions with other psychotropic medications. But if you are considering using these substances in your own healing work, then you should have scientifically accurate information about them, and about how to get the most from these types of experiences.

It may be counter-intuitive, but the integration process actually works best when it starts BEFORE whatever experience it is that you are going into. The biggest determinants of a psychedelic experience are your mind set and the setting you are doing the trip in (you will hear this referred to as “set and setting”), and therefore putting focus on and making decisions about both of those is the first step towards successful integration. This part of the process is often called preparation, but it is important to recognize it as the very first step of integration, as the decisions you are making here will affect all of the later work.

So, the first part of the integration process is simply deciding what the setting and structure of your journey will be - Which medicine or medicines will you be using? Are you tripping alone, in a group, or with a facilitator? Where will you do it? What kind of support resources - both during and after the experience - will you have available? Having answers to these questions will help you get the most out of the experience as it’s happening, and give you the most constructive material to go into integration with (though integration is also important if you’ve had a bad trip).

And then there is preparing your mindset. That means that in the lead up to your experience you are sitting with yourself. You are getting clear on where you feel static in your body and your mind, and where you feel settled. From that process, you are developing an intention for the work. The experience of your journey may or may not speak directly to this intention, but the process of developing one is extremely helpful in preparing the ground of your psyche to get the most out of this endeavor, and will be an anchor point to return to later in the integration process.

In the spirit of sitting with yourself, people generally get the most out of these experiences when they have built space in their schedule around the trip itself. In our overly busy lives there can be a tendency to want to squeeze these experiences in - work until 5 pm Friday, journey Saturday evening/Sunday morning, back to work on Monday. And while you can certainly get some insight out of that, you will get far more if you give yourself a day or so beforehand, and a day or so afterwards. In a future post we will talk about the intersection of meditation and psychedelics, but in this preparation period meditation can be an excellent way to get settled into yourself.

Since body and mind are really different aspects of the same thing (remember, mind is the experience of being a body in a world) preparing your mind also means preparing your body. This can include being very deliberate with your diet (this might mean fasting or restricting certain types of foods, or preparing your body through supplements), sleep, and sexual activity. And so forth.

And the clearer you can get on both your set and setting in the lead-up, the better chance you have to get the kind of clarity that can really be translated into actionable changes in your life. Which is ultimately where the healing happens.

And if you are looking for help in your own personal growth, whatever your path looks like, then please reach out!

Psychedelic Integration, Part 1 - Introduction

DISCLAIMER - Psychedelics are still largely illegal in the United States. I am not a medical doctor and cannot recommend any types of medication. This post is not encouraging anyone to engage in illegal activities or consume illicit substances, and I cannot provide the substances themselves or any help in obtaining them. The decision to try such substances should only be made with careful consideration and in consultation with your physician, as there can be an array of complications including negative interactions with other psychotropic medications. But if you are considering using these substances in your own healing work, then you should have scientifically accurate information about them, and about how to get the most from these types of experiences.

If you’ve been paying attention to the mental health space lately you’ve probably encountered talk of the psychedelic renaissance (for a good introduction to this topic, check out Michael Pollan’s highly accessible How to Change Your Mind). These substances - including everything from LSD and magic mushrooms to Ketamine and MDMA - have demonstrated a remarkable effectiveness in treating many conditions that have been largely impenetrable to other therapeutic modalities. These include anxiety, depression, PTSD, addiction, and existential crises.

But as miraculous as these substances are proving to be, they do not work in a vacuum. That is, most people can’t just drop in, take a dose, have the big experience, and walk away cured. Rather, these types of journeys have to be part of a larger process (I’m focusing on psychedelics here, but the same can be said of any big experiences - nature solos, meditation retreats, Inipis, etc.) that takes whatever insights or clarity are gained through these experiences and integrates them back into day-to-day life. Indeed, one of the biggest pitfalls of this avenue of personal development is having one of these experiences, feeling totally changed for a week or two or three, and then finding yourself slipping back into old patterns because you haven’t made the systemic changes in your life and relationships that would help solidify your gains.

We see this over and over again in psychotherapy - and particularly with psychedelics - that people can be in whatever setting they choose to do their work in - therapy room, meditation sangha, or whatever - and get a lot of insight in that space. But if that insight isn’t being translated into dynamic changes in people’s lives then nothing really gets better. Indeed, if you’re not making those changes then sometimes these experiences can actually make things worse, as you have a picture of how things COULD be but aren’t, and now you have to sit with the knowledge of that discrepancy.

Hence, integration. Many times this part of the process can be very frustrating to people interested in using these substances to hit the turbo button on personal growth, because it’s slow, painstaking, and requires a significant amount of discomfort. But if you’re interested in real growth rather than just cultivating novel experiences (nothing wrong with novel experiences, but let’s be honest about what it is!) then integration is where the real work of change happens. So you need to be asking yourself if you’re just interested in being a psychedelic tourist, taking an occasional vacation to an exotic locale and then returning to your life as is, OR are you interested in making real change in your life and wanting to use these substances in service of that change? Again, nothing wrong with either one, but if it’s real change you’re interested in, then integration is THE most important part of the process.

The posts in this series will explore different aspects of the integration process, and provide some prompts and encouragement along the way. And if you’re interested in finding help with this part of your journey then please reach out to me - I’m happy to provide one-on-one support around this and I also regularly offer integration groups, which can be a very effective tool for making sure you get the most out of your journey.