Harm Reduction, Part Nine: Psychedelics and Benefit Maximization

 Here's the continuation of my psychedelics discussion. In the first part, we reviewed the resurgence of psychedelic research and how to support those having challenging experiences.

As mentioned previously, you may be interested in not just preventing harm, but in getting the most out of your use of these powerful catalysts of consciousness.

BENEFIT MAXIMIZATION

The three critical elements to consider are your intention, how your intention shapes your preparation, and then integration of your experience into your everyday life.

Photo by Arno Gourdol

Let's start with your intention:
what is the purpose of your use?

Are you seeking spiritual enlightenment, and want to experience complete ego dissolution?

Do you have a therapeutic use, such as uncovering and working with the root of an emotional difficulty? 

Is your goal relational, such as enhancing intimacy and communication with your partner? If you're wanting to have a really amazing time while at an upcoming festival, your motive may be recreational.

Please note that none of these intentions are better than the others (and in fact, we often have a mixture of more than one). Your planning and methods will vary, however, depending on your objective, so awareness is important.
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Preparation for your journey is key, and is best understood through the lens of drug, set, and setting. (See Part Five ​in my harm reduction series for a more extensive discussion on this topic.)
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DRUG: One of the best ways to trip safely is to know what you are taking. If this is a substance that is new to you, please do some research on Erowid (or other sources of quality, unbiased information) so that you are familiar with the typical effects, dosage range, and duration. It may be wise to begin on the low end of the dosage range to see how you react to this new substance.

Another important factor is drug purity (for example: how much MDMA is actually in what you're taking?). Pill-testing information (for both MDMA and LSD) can be found at EcstasyData and DanceSafe.

Interactions are also extremely important; Zendo volunteers have shared that many of the folks who end up there for assistance have mixed multiple (often unknown) substances together. Again, if you are on any medications, please check in with a health care professional (and do your research) before using psychoactive drugs!

SET: Psychedelics are thought of as "non-specific amplifiers," meaning that they can greatly enhance the perception of whatever is already happening for you.

Consider your current state: did you just have a difficult breakup and haven't slept for three days? Worried about losing your job? That content will likely come up, so be ready for it. (This may be intentional for those using the medicine therapeutically, but can cause discomfort for those looking to use recreationally.)

Awareness of your own personal and family history of mental health is also very important, as those with psychotic or bipolar vulnerabilities may have adverse reactions to these substances.

SETTING: Psychedelics are unique in how they sensitize us so exquisitely to our environment, which means that our surroundings crucially shape our journey. Knowing that we will be in a highly suggestible state can help us decide where we want to be and who to have around.

Many choose to create rituals to begin and close their journeys, and surround themselves with stimulating artwork or meaningful objects. They plan special music playlists to help guide them through the experience. They trip outdoors in nature, or in private, safe accommodations without risk of interruption. 
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It is also helpful to be deliberate about who else will be involved in your experience. You may choose to be with a intimate partner, or a group of close friends; it can be helpful to make an agreement with everyone beforehand on how to handle difficult experiences. (If there isn't enough trust built to have such a conversation, you might think twice about tripping with these folks!)

There are longstanding traditions involving the use of a shaman, trip sitter, guide, therapist, coach, ground control, or otherwise sober person during these journeys. Many feel that they are able to let go and travel to much deeper places when a guide provides a stabilizing, grounding force. Plant medicine use in indigenous cultures tends to be highly ritualized and directed by an elder or shaman, which can help contain the powerful material that can arise.

If you are curious about using a sitter, I highly recommend James Fadiman's excellent book The Psychedelic Explorer's Guide, which describes in detail the best practices for guiding/being guided on safe, sacred entheogenic journeys. (Another great collection of resources about trip-sitting can be found here, and you can read the relevant chapters of Fadiman's book in this pdf.)

PUTTING IT ALL TOGETHER: let's say your intention is to enhance your enjoyment of a concert with friends. Great! In that case, you might choose a lower dose (i.e. a "museum dose") in order to best facilitate dancing and crowd navigation. You could check in with your friends to see if they will be similarly tripping (or to designate a sober trip-wrangler), and to make a safety plan for the evening. You might also want to be sure that your mental health feels optimal, with no acute stressors, as well as being well-rested and adequately fed before you begin. Make sure you have regular access to water at your event, and pay attention to temperature regulation. Don't operate a motor vehicle. Have fun!

However, if your intention is to address longstanding PTSD symptoms and facilitate the healing process, you may choose a much higher dose, and plan both preparatory and follow-up therapy sessions to lay the groundwork for the journey.

The standard setup used in therapy and research protocols involves the use of an eye-mask and  headphones, in order to encourage the voyager to do deep internal work, as well as the presence of two well-trained therapists/guides to facilitate the process safely, as seen here:
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Artwork Fair Use: By Matthew W. Johnson [CC BY-SA 3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

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Finally, let's now turn to the importance of integration.  These medicines can bring profound improvement to our lives when we bring the insights gained during the trip back into our everyday world.

A period of introspection following the journey is highly recommended, especially for those with therapeutic and spiritual aims, so giving adequate time for this unfolding is important. 

There are multiple ways to reflect on your session: journaling about your experience (especially while reviewing your initial intentions), speaking with someone you trust and who understands psychedelic use, creative expression, attending a local integration group, bodywork, meditation, yoga, or spending time in nature.

A growing number of therapists are now beginning to offer integration services, and I am happy to be one of them! You may contact me to find out more about how I work, and if I might be a good candidate for your support team.


That's all for now! I hope you enjoyed my tiny sample of this immense topic, and please let me know if you have any questions or want to discuss this matter more. Thanks for reading.
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Disclaimer: These substances remain illegal in many jurisdictions, and this site does not recommend the activities described here. This information is provided for educational purposes only, and to assist those who have already decided to use substances to do it in the safest and most beneficial manner possible. It is your responsibility to assume the risks associated with these activities. Please consult with a medical professional beforehand, especially if you have a preexisting physical or mental/emotional concerns, or are on medication. Psychedelic-assisted therapy is legal only in approved research settings, and I am unable to offer such services at this time.