This qualitative study (n=26) explored existential distress following psychedelic experiences, finding persistent preoccupation with sense-making and confusion about existence and purpose. Participants reported cognitive, emotional, social, bodily, and functional impacts. They managed distress through embodiment practices and social/cognitive normalization.
Abstract of Navigating Groundlessness: An interview study on dealing with ontological shock and existential distress following psychedelic experiences
“Psychedelic induced mystical experiences have been largely assumed to drive the therapeutic effects of these substances, which may in part be mediated by changes in metaphysical beliefs. However, there is growing evidence that psychedelic experiences can also trigger long lasting distress and studies of persisting difficulties suggest a high prevalence of ontological challenges (related to the way people understand reality and existence). We conducted semi-structured interviews with 26 people who reported experiencing existential distress following psychedelic experiences. We explored the phenomenology of participants’ difficulties and the ways they navigated them, including what they found helpful and unhelpful in their process. Thematic analysis revealed the kinds of distress that accompanied worldview and identity shifts: persistent preoccupation with making sense of the experience and confusion about their existence and purpose. Along with cognitive difficulties stemming from the ungrounding of their prior frameworks for understanding, participants’ ontologically challenging experiences also had significant emotional, social, bodily, and other functional impact. Participants primarily alleviated their distress through ‘grounding’ practices of embodiment, and the social and cognitive normalization of their experiences. Findings are discussed in the context of the growing field of psychedelic-related difficulties and the challenges of integration.”
Authors: Eirini K. Argyri, Jules Evans, David Luke, Pascal Michael, Katrina Michelle, Cyrus Rohani-Shukla, Shayam Suseelan, Ed Prideaux, Rosalind McAlpine, Ashleigh Murphy-Beiner & Oliver Robinson
Summary of Navigating Groundlessness: An interview study on dealing with ontological shock and existential distress following psychedelic experiences
Research has shown that psychedelic substances can cause profound shifts in metaphysical beliefs, such as a shift away from physicalism towards non-physicalist beliefs, and a shift in the attribution of consciousness to both living and non-living entities.
In contexts like the treatment of psychiatric comorbidities in late-stage cancer patients, existential and ontological shifts may be associated with reductions in existential distress and death anxiety, enhancing life meaning and purpose, and thereby mediating associated depression and anxiety.
A significant minority of psychedelic experiences may lead to long-term psychological distress, with 50% reporting protracted ontological challenges. This raises ethical dilemmas regarding the extent to which informed consent can be reliably given ahead of psychedelic use.
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https://dx.doi.org/10.2139/ssrn.4817368
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Argyri, E. K., Evans, J., Luke, D., Michael, P., Michelle, K., Rohani-Shukla, C., ... & Robinson, O. (2024). Navigating Groundlessness: An interview study on dealing with ontological shock and existential distress following psychedelic experiences. Available at SSRN 4817368.
Study details
Participants
26
Humans