This study (n=19) used semi-structured interviews to explore the psychedelic experience through the lens of self-care, a concept within the domain of health and well-being. Most participants reported using psychedelics with self-care intentions in ceremonial, recreational, or private settings. Self-perception and existential meaningfulness were identified as the main mechanisms of self-care.
Abstract
“This article explores the psychedelic experience from the users’ point of view and through the lens of self-care, a concept within the domain of health and well-being. In a time of renewed interest in psychedelic-assisted psychotherapy, we aim to contribute to a better understanding of these substances by exploring their role in different settings. A phenomenological approach was used in this study. We conducted semi-structured interviews with 19 psychedelic users and inquired about the relationship between their experiences and self-care. Analysis of the interview data was based on inductive content analysis. Most participants reported using psychedelics with self-care intentions in ceremonial, recreational, or private settings. Self-perception and existential meaningfulness were identified as the main mechanisms of self-care. Participants also mentioned difficult experiences and adversities that impair self-care. The results suggest that for some people, the use of psychedelics may be experienced as part of a self-care process and may improve self-care abilities in naturalistic settings.”
Authors: Carla M. Soares, Angela Leite & Marin Pinto
Summary
This article explores the psychedelic experience from the point of view of the users and through the lens of self-care. It suggests that for some people, the use of psychedelics may be experienced as part of a self-care process.
ARTICLE HISTORY
Psychedelics; hallucinogens; self-care; qualitative research
Introduction
There are many clinical trials on psychedelics, including those for chronic posttraumatic stress disorder, treatment-resistant depression, substance addictions, obsessive-compulsive disorder, anxiety associated with life-threatening diseases, and social anxiety in autistic adults. These studies suggest that psychedelics may have therapeutic effects.
Self-care is a process that adapts to changing needs, values, and experiences, and aims to promote healthy functioning in physical, professional, relational and emotional dimensions. It is performed through idiosyncratic strategies that might enhance self-esteem.
Methods
We used a phenomenological epistemology to guide our research design, and a snowball strategy to recruit participants. Four participants were selected from the first author’s informal social network, and nine more participants responded to advertisement on its online group.
Nineteen participants were included in this study. In-person interviews were conducted in places chosen by the participants, and informed consent was obtained from all participants.
The first part of the interview elicited a free-ranging discussion with minimal intervention of the interviewer. The second part guided participants’ reflections in terms of self-care, starting with their definitions of the concept and ending with how these experiences affected their life trajectory.
Interviews were recorded, transcribed, and analyzed using NVivo software. The data were inductively analyzed using Bardin’s (1977) theory of themes and inductive categorization, and the trustworthiness of the findings was enhanced using the COREQ checklist.
Results
From the content analysis, four themes emerged: (1) psychedelic self-care; (2) psychedelic states; (3) mechanisms of self-care emerging from psychedelic experiences; and (4) challenges and difficult experiences.
Psychedelic Self-Care
Participants’ definitions of self-care identified several underlying mechanisms, including self-perception, self-awareness, self-knowledge, self-analysis, self-worth, self-agency and healthy functioning and well-being.
14 participants reported having used psychedelics with self-care intentions, and the same number mentioned experiences in which they found self-care by serendipity. The most common settings for self-care experiences were ceremonial, followed by recreational settings, especially Boom Festival.
Participants mentioned mood, the people present during the experience, and the chosen places when using psychedelics for self-care. Some mentioned a positive mood change after using psychedelics in a negative mood, while others described an intensification of the adverse emotions and feelings.
Psychedelic states
Participants mentioned several effects experienced during psychedelic states, including affect alterations, perceptual alterations, volition alterations, intensity, out-of-body and near-death experiences, unity and ego dissolution, aesthetic appreciation, and ineffability.
The experience of the self
Participants described several processes associated with self-perception when using psychedelics, including self-knowledge, self-awareness, and self-analysis. Nearly all reported improving self-knowledge and self-esteem, as well as realizing fears, doubts, uncertainties, emotional blocks, and learning tools to maintain harmony.
Some participants considered that psychedelic experiences allow self-care, while others mentioned that self-awareness is the first step to becoming more whole. Finally, some participants mentioned a process of self-analysis, which was the mechanism behind their recovery from addiction.
Half of the participants also associated self-care with experiencing self-esteem during and after psychedelic use. They described a sense of self-worth, self-love, self-confidence, and self-acceptance.
The existential experience
Almost all participants mentioned spiritual or transcendent dimensions, and some reported feelings of “anguish and meaninglessness” (P11). Some participants mentioned psychedelics as a kind of self-care to try to find themselves, and that’s their kind of God.
Almost all participants mentioned that psychedelics had influenced their worldviews, and that they had helped them to understand their purpose in life. They also said that psychedelics had helped them to rearrange their priorities and focus on the path.
Some participants reported changing their perspectives about death after an out-of-body experience or a psychedelic experience.
Other psychological mechanisms
All participants described the relationship between psychedelics and self-care in terms of other psychological mechanisms, such as perspective change, insightfulness, emotional expression, connection to other, empathy and conflict resolution.
Healthy functioning
Participants described psychedelic experiences as a “fresh start” or a “total reset”, and mentioned changes in eating habits, professional pathways, aesthetic sense, pro-environmental behaviors, religious orientations, personality characteristics and interpersonal relationships.
Interviewees shared the view that psychedelics had a beneficial impact on their well-being. These effects were associated with productivity and motivation, as well as the relief of stress, anxiety, or depressive symptoms.
Challenges and difficult experiences
Participants reported several impairments to well-being, including confusion, loss of self-control and resistance, negative affect, panic and paranoia, somatic reactions, and difficult comedowns. Participants mentioned different coping strategies for managing adverse effects, such as looking for social support or a safe environment, using relaxation techniques, deriving meaning from experience, or observing the emotion with a certain distance. Some participants also reported long-term difficulties, such as problems in integrating the experience, social isolation, and trauma.
Discussion
The main research question explored the users’ perspectives on the use of psychedelics and self-care, and the secondary research questions explored the dimensions, mechanisms and needs associated with self-care in the psychedelic experience.
Perceived mechanisms of self-care
Participants described psychedelic experiences as stimulating self-perception, which in turn led to an increase in self-care actions across several dimensions (physical, emotional, social, and spiritual). This finding is in line with previous studies reporting improved self-perception and a boost of self-worth during psychedelic-induced states.
Some participants associated psychedelic experiences with spiritual self-care, while others experienced changes in life values, worldviews and perspectives on death. These results support previous research with psychedelics in clinical and naturalistic settings.
Participants identified perspective change, insightfulness, emotional expression, connection to others, empathy, and conflict resolution as significant mechanisms of self-care.
Impairments to self-care
Psychedelic experiences can have adverse effects on self-care, particularly when used by vulnerable populations in non-controlled settings or when there is no support to integrate the experiences.
Users’ perspectives on using psychedelics in adverse moods are consistent with those of Mason, Dolder, and Kuypers (2020), who reported positive mood changes after using psychedelics in negative mood states.
Some difficult experiences were associated with increased self-care, resembling “healing crisis” (Brouwer & Carhart-Harris, 2021). This could be explained by the successful transposition of coping strategies onto other situations in daily life.
Study limitations
We used a phenomenological approach to gain access to participants’ experiences, and generated detailed descriptions about the phenomenon of psychedelic self-care. However, our study approach does not attempt to explore the underlying causes of reported experiences, and the results may not generalize to other samples.
This study suggests that self-care is an important topic in integrating psychedelic experiences, and post-experience interventions can promote healthy functioning and well-being.
Conclusion
Psychedelic use can be seen as a self-care process, which can influence health and well-being.