Exploring the Challenges of Psychedelic Integration

This column was written by Blossom’s founder Floris Wolswijk in cooperation, and co-published, with Lucid News.

Psychedelic experiences can often be life-changing and transformative. If used carefully, psychedelics can help shake old habits, find renewed meaning, and strengthen relationships. But these experiences can also be challenging to integrate into daily life. They can bring about feelings of anxiety, confusion, and existential crisis. 

To face this shadow side of psychedelics, I spoke with Anna Lutkajtis and Jules Evans about their recent research into the challenges of integrating psychedelic experiences. In a nutshell, they interviewed participants of a legal psilocybin retreat in The Netherlands and found that 30% had difficulties integrating the experience.

Throughout the interview process, nine of the 30 participants volunteered information about their challenges during the two to three weeks after the retreat. This information prompted Lutkajtis to collaborate with Evans, who started The Challenging Psychedelic Experiences Project, an ongoing research series on integration challenges of which their interview is the first study. 

I caught up with the researchers and asked them about the study and its broader implications, what this could mean for people who use psychedelics recreationally, and tips for those experiencing integration challenges.

Challenges in Integrating Psychedelic Experiences

What were you looking to find out when conducting this study? 

Lutkajtis: The study aimed to examine the phenomenology of the high-dose psilocybin occasioned ‘mystical-type’ experience. What do people experience when taking a high dose of psilocybin? What do they see? What types of narratives emerge? What kinds of insights occur? The study was a qualitative interview-based study aimed at discovering key themes related to the experience.

What do you make of the relative lack of reporting on challenging experiences?

Evans: There are several reasons why the challenges of integrating psychedelic experiences are only now being explored. The positive media coverage of psychedelics and their therapeutic potential has led to much excitement in the field. It’s been over 15 years since the first paper on the “psychedelic renaissance” was published. It makes sense that people are now starting to research the risks and challenges associated with psychedelic use.

In the past, the focus has been on getting psychedelics medically approved and legalized, and some may have feared that talking about the risks could harm these efforts. However, this shift towards researching the challenges and risks is a sign of the growing maturity of the psychedelic culture, as it’s normal for a medical treatment to have unexpected side effects.

It’s important to remember that while psychedelics can lead to incredible mystical experiences and psychotherapeutic breakthroughs, they also carry the risk of negative experiences. Psychedelics can sometimes lead to the most meaningful spiritual experience of your life, and they can also lead to the most difficult, challenging experience of your life.

Psychedelics as medicines is a relatively new field of scientific inquiry. A related area where much of this work has already happened is the field of meditation. Are there similarities or differences between the challenges one faces there and integrating psychedelic experiences?

Evans: The research on adverse experiences in meditation by Willoughby Britton has inspired us. The research on mindfulness seems to be ten years ahead of the research on psychedelics in terms of the number of studies produced. We are still gathering our research on the challenges people face when integrating psychedelic experiences.

However, we can see some patterns and similarities. For example, dissociation and depersonalization seem to be unexpected and unpleasant side effects for some who practice meditation and take psychedelics. A commonality makes sense as both aim to dissolve the ego.

Ecstatic and mystical experiences can occur during intense meditation and psychedelics, but they can also be quasi-psychotic. Occasionally people may experience spiritual emergencies or temporary psychotic reactions due to the powerful alteration of consciousness.

What else did participants report about their experiences? 
Lutkajtis: Interestingly, three participants in the study reported the resolution of significant health conditions (cluster headache, trigeminal neuralgia, depression), and these three people all experienced integration challenges, which suggests there could be an association between disease remission and integration challenges. We can’t say from this study whether this is a significant correlation or whether it is an anomaly – future research should examine this potential connection. 

Some evidence suggests that challenging experiences during and after a psychedelic session are more likely to occur if the individual has poor physical or mental health, and challenging experiences can sometimes be connected to breakthroughs in healing. These findings also align with the literature on spiritual emergency, which suggests that resolving such crises can ultimately lead to positive personal transformations.

Challenging Psychedelic Experiences Project

The study Anna and Jules conducted is the first to emerge from The Challenging Psychedelic Experiences Project. In a maturing field, it serves to look at the dark side and provide this perspective. Still, Jules is quick to highlight that the project isn’t anti-drugs. 

What is the story behind the project?

Evans: The origins of the Challenging Psychedelic Experiences project go back to 2021 when I wrote an article about the lack of research on bad trips and extended difficulties after taking psychedelics. There was little to no research on how to help people who experience these difficulties. I suggested that a small part of the billions of funding for psychedelic companies and research should go towards harm reduction and support services.

I then formed a team of leading psychologists and psychotherapists with experience in psychedelic research and difficult trips. We raised funding and started producing peer-reviewed, empirical research on this topic. Our goal was to support people with difficulties and steer the field toward taking the risks of psychedelics more seriously.

We have received a positive response so far. We want to encourage people to feel okay talking about their bad trips and not feel stigmatized. 

One project is an online survey asking people if they had difficulties after a psychedelic experience that lasted longer than a day. 

What can you tell us about the study’s findings so far? 

Evans: Over 600 responses have been received. Two-fifths of respondents reported difficulties lasting over a year, and one-fifth reported problems lasting over three years. We are now identifying common challenges and coping methods.

We will publish our findings in the spring, in a peer-reviewed journal, but from an initial analysis, anxiety and panic attacks seem to be the most common difficulties reported, followed by dissociation and feelings of confusion about what is real. People also report depersonalization and fear of permanent damage. Some people experience hellish bad trips and fear repeating them, even in the afterlife.

Starting in March, we will also do follow-up interviews to gather more information and publish those results in the autumn. The goal is to generate hypotheses for future research.

Practical Tips for Those Who Experience Challenges With Integration

What advice can you give the reader who might be struggling to integrate a psychedelic experience?

Evans: If someone is struggling to integrate a psychedelic experience, the best advice is to find support. Support can be in the form of an integration support group or a therapist specializing in psychedelic integration. Organizations such as MAPS or the Institute of Psychedelic Therapy have lists of therapists with experience in this area. Some cities also have psychedelic integration circles, and some may be available online.

It’s important to remember that people are not alone in their experiences. A recent survey showed that 12% of people sought support for psychological difficulties after challenging ayahuasca experiences. Our research aims to gather information on what has been helpful for people in the past and share it with others.

A few therapy sessions or participating in peer integration circles can be helpful. The key is to reach out for support.