The recent interest in psychedelics is both hopeful and worrying at the same time. On the one hand, it might mean that the masses are starting to understand the need for cognitive liberty, on the other, it might just be another hype – a thing you put on your bucket list because all the cool people do it. We live in a century of experiences and psychedelics guarantee an experience that is unforgettable and life-changing. However, the experience might be memorable for various reasons, and some of them might not appeal to you. Not everyone has an enlightening, mystical and blissful trip and having one does not guarantee an improvement of your mental health. Some people face their demons or unlock emotions that were suppressed for a reason and without proper psychological help the psychedelic experience might be damaging.
You might have read a few articles in the mainstream media about the benefits of psychedelics, or Michael Pollan’s recent book [1], or you have this over-excited friend who just came back from the Ayahuasca retreat in Peru, and now you are wondering, maybe I should try it too. Regardless of what sparked an interest in these substances for you, you should adequately inform yourself because psychedelics offer a deep dive into your subconsciousness and you might not be ready for this.
Do not get me wrong, I love psychedelics, and they helped me to deal with depression and social anxiety. They also lead me to a few psychotic episodes and a period of depersonalization, both of which I exited as a stronger person due to my comprehension of human psychology and neuroscience. I know people who were not so fortunate, however, who either slipped back to depression or live happily encompassed in the delusional world they have created to deal with emotions they had unlocked and cannot handle.
The information that I provide here is hardly talked about in the media or even inside the psychedelic community. There is a bias among the users towards angelising psychedelics as a wondrous solution to human mental problems. Even those, whose opinions should be more objective, who do scientific research on these mind-altering plants and chemicals, focus mostly on the positive effects. The psychedelic community wants these substances to be at least decriminalised and we push for governments to acknowledge each person’s right for cognitive liberty. We fear that if the negative side of the psychedelic use will be exposed, we will return to the seventies when these substances were made illegal and scientific research was banned.
In my view having an honest discussion on the effects is the key to acceptance by society and is part of the harm reduction approach that might be needed in times of the rising popularity of psychedelics. Many people nowadays cannot cope with themselves and are desperate to try anything that brings a promise of relief. These people are ready to risk a lot to try psychedelics which have been portrayed in some media as a magic pill for the mental health struggles.
If you hope for turning life around with the use of psychedelics or you are just curious about the experience, you should familiarise yourself with the risks to avoid hurting yourself. This article will provide you with information needed for deliberating on whether you could take a psychedelic. It will offer preparation tips and some solutions to situations in which things did not go as you planned and you struggle with integrating the experience into everyday life.
If you already did some research on the internet, you are probably familiar with some safety precautions. Nearly every article mentions the importance of the set and setting. Ingesting psychedelics in a calm, safe environment, surrounded by people you can trust is a necessary measure you should always take to make sure that you will be fine. Other crucial things you should know are being in a relatively good mental and physical health condition. Also, certain types of medication are contraindications for taking psychedelics. You can read more about these issues here, here and here. I will not elaborate on these basic safety precautions as they were discussed numerous times and there is no need to repeat all of this information.

Trauma
Let’s start with the most critical issue, the issue of trauma. You might have a severe trauma(s), PTSD or complex PTSD and not even know about it. There are many reasons why you might not be aware of such a serious problem. One of the main ones is the misconception of what trauma means. Many people think that trauma is a violent or terrible single or repeated event which leaves one in long-term mental distress afterwards. This is not always the case, however. Emotional abuse or neglect can also be classified as trauma-inducing and can lead to Post-Traumatic Stress Disorder (PTSD) or if the abuse continued for a prolonged period to complex PTSD. What might play a significant role here is your perception of responsibility for the events that happened in your past. For example, some people grow up in violent, physically abusive families and are less traumatised than the ones from seemingly normal families. It is easier to distance yourself from a crazy environment and blame your carers for the events than when the distinction is less clear. Many carers are blaming a child for the situation in the family, and some people carry this blame and responsibility into adulthood, in many cases without realisation. A similar situation could have happened when your carers due to their unresolved issues tried to support their insecurities by telling you that you do not deserve much or just gave you conditional love and only praised you for achievements. In our times this story is part of many people’s past, and hence we have a global mental health crisis.
Some people block recollection of abuse and suppress emotions that were associated with these events by either creating a hole in the memory or running away from themselves. We can witness this by observing a growing number of people addicted to any types of distractions, like social media, workaholism, alcohol abuse, etc. For these reasons psychedelics might not be something that you are looking for, because they might force you to be entirely with yourself, especially in a ceremonial or one-to-one setting. There is nowhere you can hide from your repressed feelings in such a setting. Going through such an experience might be harrowing and might send you into a worse emotional state than before taking the substance, especially if you take them with a person that has limited knowledge of human psychology. Unfortunately, because psychedelics are an unregulated substance, there is no code of conduct around who can be a facilitator and there is a growing number of self-proclaimed shamans or therapists. Ideas that these people spread might not only be damaging to your mental health but your life in general. You might get influenced by them and make drastic changes that will not be beneficial for you.
Another issue that is hardly touched on in the descriptions of the psychedelic substances is that the strength of the psychedelic might be correlated with the severity of trauma. It is possible that stronger psychedelics enable you to face deeper, less remembered traumas from even your birth or very early childhood. Currently, there is no research on this topic, and this is speculative, but many people in the field observed this relation. Stan Grof, for example, believed that very high doses of psychedelics could enable people to face prenatal traumas [2]. There is a lot of anecdotal evidence from Ayahuasca drinkers that this is the case. Ayahuasca is becoming more and more popular, and for many people, it is the first contact with psychedelics. The experience is very intense, and many people who have not even had one therapy session are not prepared for such an emotional rollercoaster. If you have not dealt with less severe traumas, you are probably not equipped to face the ones that are much deeper and more painful. To make it worse, many centres claim that you need to drink this brew at least two days in a row! This is a recipe to put you in a prolonged depersonalised state – about which you can read a bit later in this article.
I believe that Ayahuasca is a wonderful tool and many people would struggle with healing some of their traumas in other ways or these other solutions would take years. What is essential, however, is that you enter the experience well prepared and that you are supported by someone who knows how to help you to integrate such intense journey into everyday life. In general, it is advisable to have a gentle start with psychedelics and maybe begin by microdosing and using less potent substances and then increase the strength when you feel comfortable with the low dose.

Depersonalization and HPPD
Another reason why you should not jump into deep waters and start with Ayahuasca or similarly strong psychedelic is a risk of depersonalization or Hallucinogen Persisting Perception Disorder. Depersonalization is a disorder that is characterised by feelings of disconnection from one’s body and thoughts. In some cases, people who suffer from this problem feel like reality is a dream. This dissociative disorder can be caused by a traumatic event but also by the use of a psychedelic. There is no know explanation for why these substances might cause depersonalization. Neurologically, psychedelics seem to de-synchronise the brain [3], so possibly the substance-induced depersonalization is an interruption of the stabilisation mechanism. My speculation is that it is linked to the coping mechanisms one developed in childhood. Some people who grew up in the abusive environment learned to use “freeze” response to dissociate themselves from the stressful surroundings. The “freeze” response happens when our automatic system decides that no fight or flight from the situation is possible and shuts off our perception of reality to make the traumatic event more bearable. Many people for example, completely black out during severe physical injury. For some, the “freeze” response might be pleasant and exhibit itself in the form of lucid dream-like state. Majority of people suppress this response when they grow up, and it is possible that psychedelics are a sort of reminder of that state. Perhaps, in those whose normal life is too stressful, psychedelic experience leads to de-activation of the “freeze” response and their autonomic system prefers to stay in the dissociated state in which there is no override of the stress responses and hence less energy needed for maintaining existence. Research still needs to be done to explore those potential explanations.
If you feel like you entered depersonalised state after ingesting a psychedelic, the most important thing is to stop taking any dissociating substance (hallucinogens, cannabis, etc.) until you go back to normal and resolve the psychological problem that lead you to the inability to stabilise your mental state. It is also advisable to create a routine, start exercising and eat healthy food to enable a new steady mindset. Everything that is grounding helps you to exit the dissociated state. In severe cases, it is recommended to contact a mental health professional that is familiar with the topic.
Another danger related to putting your mind in a dissociated state of psychedelic experience is Hallucinogen Persisting Perception Disorder (HPPD). HPPD and depersonalization often happen together. HPPD occurs when the visual processing does not stabilise back to normal vision after the psychedelic experience, and the problem persists for a long time. People who suffer from HPPD report seeing trails following a moving object, halos, auras, visual snow, etc.
Both depersonalization and HPPD are hardly reported by those who experience it [4]. The reason for this is that it is possible to lead a normal life with these disorders. Only, the ones who are severely distressed about the symptoms and as a consequence affected by high anxiety or depression, seek treatment. In most cases, the recovery happens on its own with time.
It seems like, therefore, that both depersonalization and HPPD are not much to worry about. From my observations of the psychedelic community, however, it looks like the problem might not be so trivial. One of the issues of this subculture is a prevailing belief in the existence of another parallel reality. Many members of the psychedelic community believe in spirits, ghosts, entities, aliens, etc. Numerous people are convinced that they have some special super powers or have the ability to travel in other dimensions. In my opinion, these beliefs stem from the experience which was not fully integrated and led the mind to struggle with coming back to the optimal state adjusted to everyday existence in the society. Many psychonauts enter the psychedelic state with no psychological preparation and as a result struggle with embracing their emotions and feelings. To avoid overflow of sensitive material and sometimes responsibility for their own acts they externalise uncomfortable feelings by creating a fantasy world. Humans have a very delicate psyche protected by many safety mechanisms, known in the therapy field as defensiveness. Majority of therapies focus at the beginning on breaking this defensive behaviour by supporting patient’s self-worth, confidence and feelings of being supported. If the patient does not feel safe during the treatment, he/she will perceive an attempt to point to their self-sabotaging patterns as an attack on their personality and will stop to cooperate.
Psychedelics may open materials that a user is not ready to digest which might initiate defence reaction to subconscious information that emerged during the experience. Because there is no therapist onto whom the person could project the suppressed emotions – the only way to proceed is to either create an alternate identity (e.g. entity) or create some form of explanation that is unconnected to everyday reality (e.g. being a shaman). This compensation has to be sustained for as long as the material is too painful to process consciously. Therefore, for many, it means being stuck in a dissociated state which affects focus, attention, memory, decision-making process and even bodily functions. In extreme cases, it might lead to severe depression, high anxiety, egomania or narcissistic behaviours.
As I already mentioned, all actions that keep you grounded can prevent or bring you back from the dissociated state. For some, grounding is easier said than done, however. It is theorised that body sensations are a precursor of emotions [5] and that body stores trauma [6, 7]. In some cases, grounding, or going back into the body means experiencing feelings that were suppressed for years and might lead to anxiety attacks. Somatic therapy or hypnosis might be the best solution for you if you have persisting depersonalization or HPPD. The somatic therapist might help you to release trauma from your body while providing mental support at the same time. In case of hypnosis, the therapist might help you to find a reason for being stuck in dissociated state and remove that trauma.

References:
[1] M. Pollan (2018) How to Change Your Mind. What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence
[2] Grof, Stanislav (1976). Realms of the Unconscious: Observations from LSD Research. New York: Viking Press
[3] S. D. Muthukumaraswamy, R. L. Carhart-Harris, R. J. Moran, M. J. Brookes, T. M. Williams, D. Errtizoe, B. Sessa, A. Papadopoulos, M. Bolstridge, K. D. Singh, A. Feilding, K. J. Friston & D. J. Nutt (2013) Broadband Cortical Desynchronization Underlies the Human Psychedelic State. Journal of Neuroscience, 33 (38), p. 15171-15183 doi
[4] M.J. Baggott, J. R. Coyle, E. Erowid, F. Erowid, L.C. Robertson (2011) Abnormal visual experiences in individuals with histories of hallucinogen use: A web-based questionnaire. Drug Alcohol Dependency 114, p. 61–67.
[5] A. Damasio (2012) Self Comes to Mind: Constructing the Conscious Brain
[6] B. van der Kolk (2015) The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
[7] A. Lowen (2012) Fear of Life