How to Navigate Difficult Psychedelic Experiences

Sam Woolfe
10 min readApr 24, 2023

Challenging experiences are always a possibility when using psychedelics. These may occur after a string of several positive and glowing experiences, but they can occur the first time as well. Essentially, the risk of them increases when there is a lack of attention paid to set and setting — that is, everything you bring to the experience in terms of your mindset (current mood, personality, mental health, beliefs, attitudes, etc.) and environmental factors (solo vs in a group, inside vs outside, city vs nature, people you encounter, weather, music, sounds, decor, etc.).

However, challenging experiences can occur even when you try to respect set and setting as much as possible. Taking too high a dose (by mistake or not being prepared for it), having difficult psychological material arise, or wanting the trip to end can all lead to emotional distress and overwhelm. Regardless of why a challenging psychedelic experience comes about, it’s crucial to understand how to deal with it when it does. There are many effective techniques for navigating states of fear, anxiety, panic, and overwhelm during a psychedelic experience. Each one may suit a particular situation but not another, while in other contexts, some can be utilised together.

Slow, Deep Breathing

Diaphragmatic breathing (also called ‘abdominal breathing’ or ‘belly breathing’) is a deep breathing exercise that fully engages the diaphragm and encourages full oxygen exchange (the beneficial trade of incoming oxygen for outgoing carbon dioxide). This type of breathing slows the heartbeat and can lower or stabilise blood pressure. But it can also reduce stress levels (by lowering cortisol) and negative affect, or feelings of emotional distress. It is therefore recommended to engage in this type of breathing if experiencing emotional difficulties during a psychedelic experience. Here’s how:

  1. Lie on your back on a flat surface (or in bed) with your knees bent. You can put a pillow under your head and knees if you like.
  2. Place one hand on your upper chest and the other on your belly (just below your rib cage).
  3. Breathe in slowly through your nose, letting the air in deeply, towards your lower belly. Keep your hand on your chest still (the other one on your belly should rise). As you breathe out, feel your belly lower.
  4. Repeat this process a few more times until you notice your mental state change. Continue to repeat if you feel you need to.

It can be especially helpful — when practising deep breathing — to use visualisation at the same time. As you breathe in, imagine that the air is filled with a sense of peace and calm. Try to feel it throughout your body. Then, as you exhale, imagine that the air leaves with your stress and tension. You can also say in your mind, as you breathe in, I breathe in peace and calm, and as you breathe out, I breathe out stress and tension. Continue until you notice yourself experiencing a state of physical and mental comfort.

Mindfulness/Non-Resistance/Acceptance

Mindfulness involves the idea that non-resistance or non-attachment is an antidote to emotional suffering. When we experience negative emotional states or situations that cause these states of mind to arise, we typically — not always, it should be stated — are able to adopt an attitude of mindful non-resistance or non-aversion. This means fully experiencing the negative emotional state or situation causing that distress without resisting it. In the context of psychedelics, this could mean not wishing a particular perceptual, cognitive, somatic, or emotional experience to end because we deem it disturbing or overwhelming.

Remaining mindful during a challenging psychedelic journey means focusing on our moment-to-moment experience in a watchful but detached and non-reactive way — this means not becoming attached to the wish for the experience to be positive or for any quality to disappear. By letting the experience simply arise and pass, without any judgement or evaluation, we can resolve, reduce, or shorten our emotional distress.

Central to mindfulness is the attitude of accepting our thoughts and feelings, and this attitude is a key component of many psychotherapeutic approaches — including cognitive behavioural therapy (CBT) and acceptance and commitment therapy (ACT); the latter influencing Rosalind Watts’ ACE (Accept, Connect, Embody) model for psychedelic therapy — because they are effective at alleviating mental distress. This useful attitude of acceptance is also encapsulated by certain maxims that psychonauts and psychedelic therapists recommend when experiencing difficulties in a psychedelic state. These include “surrender”, “let go”, “go with it”, “be with it”, “relax into it”, and “this is OK to experience”.

Reframing

If you feel overcome by fear and overwhelm during a psychedelic experience, this can be accompanied by thoughts that only feed that fear and overwhelm: This is too much, I can’t handle this, I don’t want this, I want this to stop, I’m losing control, I’m losing my mind, will this ever end? To combat this thought process, which only serves to increase emotional distress, it can be helpful to engage in cognitive reframing: this means changing the way you look at something, thereby changing your experience of it. Cognitive reframing, otherwise known as cognitive restructuring, is a CBT technique that stops cognitive distortions, shifting our perspective away from negative or flawed thought patterns towards more positive and realistic ones.

The exact type of cognitive reframing you do may depend on the kind of experience you’re having and what feels right at the time. Some types of reframing may feel authentic and relevant to the situation, whereas others might feel the opposite. In any case, here are some possible phrases that can help to reframe difficult moments or phases of a psychedelic trip in more positive terms:

Why should I let this disturb me?

This attitude helps to challenge the idea that any material that arises should overwhelm us; with this attitude in mind, we can instead say to ourselves, let’s just see how this unfolds.

What is this trying to show me?

Being curious instead of aversive can help you relax and introspect, perhaps helping you unearth something personally meaningful.

This is a test

By framing a difficult psychedelic experience as a challenge to overcome, and which can be overcome with a certain attitude, we can view these intense states of mind as a sort of training ground that will lead to a more fulfilling psychedelic experience as well as benefits in our sober life. For example, a distressing psychedelic experience may invite us to apply the Nietzschean attitude of life affirmation: an attitude of embrace, or yes-saying.

This is useful

Related to the last point, we can see challenging psychedelic experiences are useful, rather than just useless forms of emotional suffering. Perhaps some visionary, emotional, cognitive, or somatic experiences are instructive, telling us aspects of ourselves or our lives we’ve ignored, or what needs to be healed. This isn’t always the case, of course. Disturbing visuals — like seeing gruesome faces or creatures — may simply come from us feeling fearful and under threat. But even these effects could still be reframed as useful if you think to yourself, look how my reality is shaped by my thoughts and feelings.

This is necessary

When we want our psychedelic experiences to be only positive, it can be an unwelcome shock when we find ourselves disturbed, confused, panicking, and lacking control. Nonetheless, negative experiences can be just as valuable — and sometimes more valuable — than positive states of mind. Following on from the last point, what is disturbing intensifies when it is deemed ‘wrong’, ‘unnecessary, ‘useless’, ‘pointless’, and so on and so forth. By reframing some experiences (this won’t be true in all cases) as necessary (this is what I need at this moment, this is what I need at this stage in my life), we can respect and value a challenging experience rather than reject and disvalue it.

You’ve got this

Emotional distress is intensified during a psychedelic experience when we tell ourselves we can’t handle what is happening. We can relieve or reduce this distress by invoking the opposite thought and attitude: I can handle this. By saying to yourself something like, You’ve got this, you become your own ally in the turbulent moment you find yourself in. This is a way of supporting yourself and increasing feelings of resiliency, which itself can be a profoundly meaningful moment, capable of informing the rest of your life and all the difficult situations you will inevitably encounter. Difficult psychedelic experiences — not always, but often — invite us to consider whether we can locate and apply our inner reserves of strength.

Self-Compassion and Kindness

When we experience emotional suffering, this is a call to extend compassion to ourselves. It can be difficult to feel compassion in very intense, negative psychedelic states, because you may instead be consumed by thoughts and wishes for the experience to end. This reaction is actually a neighbour to compassion because, like compassion, it includes the desire for our suffering to end. But unlike compassion or kindness, it lacks warmth and self-soothing; and rather than quell our distress, it magnifies it.

When we are compassionate and kind towards ourselves, we can recognise the hardship and suffering we’re going through and be filled with the desire for it to end, stemming from self-worth and love — inherently caring about our well-being — rather than reacting from a place of fear and panic. Sometimes, during a challenging psychedelic experience, we may also block self-compassion because we are being hard on ourselves (I’ve messed up, this is all my fault, I’m such an idiot, I’ve broken my brain).

You can practise self-compassion when emotionally distressed in a number of ways. Self-soothing physical touch, such as placing your hand on your chest, is one way. Alongside this, or separate from it, you can repeat phrases that direct compassion and kindness towards yourself (many of which come from the compassion and loving-kindness meditations practised in Buddhism):

  • May I be free from suffering
  • May I be free from pain and sorrow
  • May I be free from harm
  • May I be safe and free from danger
  • May I be peaceful and at ease
  • May I be kind to myself
  • May I accept myself
  • May I be happy

You can use any variation of these you like, or any other phrase you come up with, so long as it embodies the intention of self-compassion and kindness. You can repeat these phrases silently in your head or out loud to yourself; with your eyes open or closed; and while sitting, lying down, or walking. You can choose a single one to repeat or a few to repeat in a cycle. Continue to repeat these positive phrases until you notice a welcome shift in your mood.

Alter the Setting

Changing aspects of your environment can go a long way in terms of alleviating distress during a psychedelic experience. Doing so may help get you out of unpleasant experiences like paranoia, thought loops, overthinking, disturbing visuals, restlessness, and emotional pain. You can try:

  • Changing the music
  • Going into a different room
  • Going somewhere quieter and more peaceful (this can be useful to keep in mind if feeling overstimulated at a festival or in an urban setting)
  • Going outside (if you’re not tripping too hard or, if you are, having a sober sitter accompany you. Walking in a natural setting is ideal in terms of trying to boost your mood and create some calm.
  • Sitting in a garden, park, or another natural surrounding (if a feasible option)
  • Spending some time alone (if being with fellow trippers feels overwhelming)
  • Spending time with others if you feel isolated (it’s crucial, however, that you surround yourself with trusted, loving, empathic, and non-judgemental people)
  • Seeking emotional support and comfort from a sober trip sitter
  • Drinking water (you may be dehydrated)
  • Eating some food (psychedelics can suppress appetite, and if you’ve taken a psychedelic on an empty stomach, then you may be experiencing low mood, lethargy, irritability, and discomfort because of low blood sugar levels). It’s best, however, to go with healthier food options that will give you energy, rather than junk food or food high in refined sugar, which can cause you to feel sluggish or make you crash later on.
  • Having a cold shower (since this can lessen anxiety and boost your mood).
  • Doing something physically active that grounds you, such as dancing to music and doing some yoga.
  • Doing something creative that keeps you focused on the present moment, such as drawing or playing music.
  • Distracting yourself by watching a film, documentary, cartoon, or series (make sure that it’s something that you would enjoy, though, and which is generally positive, calming, and pleasant. Nature documentaries tend to be a reliable choice).
  • Texting or calling a friend or loved one (this should be someone who you know will respond compassionately to you and who is aware of your psychedelic use and ideally knows that you are currently tripping. Not receiving a response or receiving judgement may make you feel more stuck and hopeless, so if you seek out support, make sure it’s from someone who is reliable and non-judgemental).
  • Contacting Fireside Project, which provides a hotline for those currently experiencing a challenging trip, or using Tripsit, which offers a live online support service in the form of a chat room.

Trip Killers

Bad trips can turn out to have an overall positive effect if they are worked through, or they can be turned into positive experiences by making sense of them. Nevertheless, there will be occasions when none of the above help, or they don’t help someone in distress enough. Some trips are so nightmarish that they can be traumatic, and potentially long-term negative effects on mental health could be avoided if the trip were cut short. But even if there is the possibility that other techniques not tried will be ameliorative, in a state of overwhelm and extreme distress, it is understandable that quick relief is sought.

The neurobiologist and pharmacologist Andrew Gallimore created an excellent Twitter thread on ‘trip killers’: pharmacological interventions that have been used to kill, or at least diminish, a psychedelic trip that feels unbearable. The most readily available and commonly used trip killers would be the benzodiazepines, such as Xanax and Valium. However, these are not without their risks, side effects, and contraindications. If using a trip killer, the utmost care and caution are necessary. You should make sure not to take too high a dose, not to mix them with alcohol, and not to drive or operate heavy machinery (not that you should consider doing so when tripping either).

It is best to consider trip killers a last resort, to be used when distress feels excessive and difficult to abate. Even having them available, however, can be enough to lessen distress since you can be safe in the knowledge that you can stop the trip or turn it around if you really need to, and so in the meantime, you can try other techniques to calm yourself down.

Originally published at https://www.samwoolfe.com on April 24, 2023.

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Sam Woolfe

I'm a freelance writer, blogger, and author with interests in philosophy, ethics, psychology, and mental health. Website: www.samwoolfe.com