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Comment by sharkweek | Hacker News Reader

I would love to try a psychedelic trip with a trained therapist guiding me toward facing my fears.

I’m generally a pretty anxious person (diagnosed with OCD, managed with ERP therapy), and I feel pretty confident that it would force me to face that part of me. I have no doubt that it’d be a beneficial experience.

Buuuuut... part of me is super nervous about what I might also find. It’s like part of my mind wants to explore it, and the other part doesn’t, which creates a lot of inner conflict. I honestly don’t know what I’m supposed to do with two parts of my brain fighting with itself.

Side note: How To Change Your Mind by Michael Pollan is a fantastic book and worth a read.

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You are right to be cautious. Don't let people oversell the benefits and minimize the risk. Yes, Johns Hopkins and some other places have early promising results, but these subjects were given counseling before, during, and after their trip. I'm sure for some people a lightbulb goes off and suddenly they can see the problems in their life which had been invisible to them and the benefit is immediate. Most of the time the message isn't so clear, and the benefit comes from actual hard work and changes that come as the result of your insights.

For example, I know I'm getting older, time is limited, and I'm mortal. Taking LSD and looking in the mirror and really seeing myself more objectively, all the wrinkles and saggy skin, the meat of my body hanging off my bones, makes my aging far more tangible and immediate than I can normally conjure. The trick is afterward maintaining that feeling and using it to make decisions about health, prioritizing things that are important, and dropping things that won't matter to me in 20 years.

If I had anxiety issues or deep trauma to work through, I'd absolutely want to use psychedelics in concert with a trained professional to minimize the risk of having things go wrong and to get help in figuring out what the trip meant to me (or "integrating" in the parlance).

Thanks for the thoughtful comment.

There was a part in Pollan's book where he talks about how an experienced guide will remind you to face the things in your trip that are scaring you. And that running away is what turns a trip into a bad one.

My personality would naturally want to run away, where perhaps the point of the "scary thing" is to face it and deal with it in a suggestible state of consciousness. As an example, I have a lot of health-related OCD triggers. Perhaps it would be a positive experience to "see" these things during a trip and recognize that 1) I have no true control over them 2) sitting around and worrying about them won't do me any good.

I know that those two things are true, but my brain is pretty hard-wired to worry about whatever the current flavor of the week is.

ERP therapy has been great in sort of numbing the associated anxiety, but I'd love to push it a step further.

At the risk of overselling the benefits and downplaying the risk, I'll say this: even the trips I've had that were hell in the moment have (at least seemed to) teach me something about myself, and I don't regret them in the least. This isn't to say that a bad trip is something to be sought after, and you should definitely read up on set and setting before tripping (I would recommend being outdoors in the country on private land with good friends, daylight, and a source of upbeat instrumental music), but if it happens, just let go of all control, lay back, and remember that what feels like an eternity in the moment will be over before you know it. If you follow best practices, you'll probably have a wonderful time. If you don't have a wonderful time, you might still find it a useful experience.

Edit: oh, and bring some paint. Even if you aren't normally visually artistic, some paint and a canvas -- even a piece of plywood -- is an incredible thing to have while you're tripping.

The best advice I ever got about drugs was this: “Whatever happens, just remember it’s only the drugs. It’s all gonna be over tomorrow”

Has really helped me any time I start overanalyzing what’s going on and how I’m feeling. Psychedelics or otherwise. It’s just the drugs, it will pass.

OK, I wasn't going to share this again. But now I must.

So I'd introduced a friend to LSD. They liked it a lot, and wanted to trip again the next day. I advised against it, because tolerance would reduce effects.

But no, it had to be. So we took maybe twice as much, and it was still disappointing. And then, being a total dumbass, I suggested that we smoke some marijuana.

Now my friend was impressed. Indeed, they were totally panicked, and convinced that it would never end. Because their short-term memory had become maybe 30 seconds.

So I spent the next three hours saying "It’s just the drugs, it will pass."

I've experienced that exact bad trip, at it was horrible enough that I have never done psychedelics since. The one time in my life I thought I was dead. Not worth the risk to try again.

Plenty of other drugs that have real benefits without as much potential for a bad trip. MDMA is much more my speed.

MDMA is fun but you psilocybin has the potential to teach you so much more.

MDMA is a lovely drug, but has it's own risks. I honestly don't think I would have gotten into programming if a friend hadn't suggested it while I was under the effects of MDMA (he had suggested it many times before without me taking the suggestion seriously, but I ordered a copy of Think Python the next day). I'm very thankful for the impact that drug has had on my life. The friend who prompted me to start programming had two months of severe anxiety after that bean drop. He had previously taken MDA about a week prior, which is something of an analog; my understanding is that they both dump your built-up serotonin, and if you dump too much serotonin at once you can have a rough time of life once the bliss wears off. Also, the literature seems to be mixed concerning the neurotoxicity of MDMA IIRC.

It may not always pass. Sometimes you get DPDR and you’re trapped in an endless hell from which few escape. Be careful out there.

Just to add my own experience. I am an experienced user of psychedelics with a lot of trips under my belt. The last time I took LSD I wound up thinking that my existence on earth was part of a universe that I myself had generated as the totality of subjective consciousness and thought I had control over it.

In a fit of excitable mania I ran around my sitter's home and leapt off their second story balcony. I'm still recovering from a broken heel, fractured T10 and fractured collar bone.

I had spent weeks planning and determining how best to organise the experience. I am now confident that no matter how much you try to minimise negative outcomes, they _can_ happen. Though they're probably rare.

My point is, please just be very careful.

The point seems to be to take LSD at ground level with no sharp objects nearby.

Hah! I suspect though that had I not debilitated myself it could have been worse. Before I jumped I attempted to run out to the stairwell, which would have resulted in me alone and running around London. I'm just glad I didn't hurt anyone else in the process.

That's an interesting perspective, and I'm sorry to hear that this happened to you. I was under the impression that those "jumping out of a window" stories were urban legends. I've definitely had psychedelics affect my beliefs about the universe in crazy ways (I briefly believed in god during a mushroom trip), and seen it in other people (a friend who normally has very down-to-earth beliefs about the universe once believed he could communicate with me psychically), but never in any dangerous ways.

Thanks. I also thought that they were urban legends. I do still think it's rare enough to not worry too much about, but at the same time I think the common narrative among psychedelic proponents that "if anything, it makes you _more_ alert/aware/whatever" is unrealistic.

As a community, though, psychedelic users have a pragmatic mindset about preparation and are generally sensible.

There is no running away from the trip. I mean, it's all in your head, so what could "away" mean? Except for some haloperidol, perhaps. And that is something that professional guides might have available.

But mainly it's fear that causes bad trips. So it helps a lot to have someone around who can reassure you, if you start feeling afraid. I've known people who freaked, and called 911. And that didn't turn out well.

Also, in my experience, Psilocybe spp. are much gentler than LSD, even at doses with comparable hallucinogenic effects. There's more "body trip" than withg LSD. It's almost like "pleasantly drunk" or effects of muscle relaxants.

I would advise not looking in the mirror. I’m glad you found the experience valuable but this can send people into a spiral of imaginary illness.

This is a standard trick that acid freaks play on each other.

Once you see yourself in the mirror, it's very hard to stop looking. People sometimes get stuck there for hours.

Trained therapist? Nah. Good, trusted friend. Someone who will be willing to clean up embarrassing bodily functions for you type of friend.

You can't pay somebody to discover you, you're going to have to do that yourself. Having a companion is just to help keep things from getting messy.

Different roles. Having some good friends to help prop you up, tell you when you're being an ass, wipe your tears, etc - good and nec.

Definitely not the same as a trained therapist who actually knows how to hold the mirror for you to see yourself in a different way.

Everybody's different and perhaps having someone do that role is a good thing. I'm not so sure. If you set out to discover yourself with someone else, then thats what you get, yourself with someone else. When they leave are you still the same? We're social animals, expecting to interact with someone is a different state. (yeah I'm not expressing this well but its been nagging at me for hours so I'm trying)

Personally my favorite mushroom experiences involve a full moon spring night, a coon hound, and square miles of wild woods. That's the trip I recommend; but so few people are blessed with good coon hounds now.

Maybe not, but there are therapists who specialize in guided psychedelic trips who encourage exploration and fear facing. Seems like they'd know how to guide the discovery process.

We need scientific clinical trials conducted without any therapist intervention in order to understand what good these drugs do on their own. All the BS about talk-therapy being necessary for them to work is going to keep them out of the reach of most people. The reality is that psychedelics will quickly put psychiatrists out of business unless the public is convinced they can't take psychedelics safely without a shrink watching over them.

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The reality is that they’re currently out of reach for most people, and the only shot at increasing adoption comes with legally sanctioned institutions to help deploy them safely.

Not everyone has a good trusted friend who might be available for this.

There are a few therapy modalities that can help, check them out and see if any resonate with you: core transformation (my fave), feeding your demons (buddhist), internal family systems, focusing (eugene gendlin), coherence therapy. All are predicated around the same few core concepts of having different parts of yourself that view the world in different ways, acknowledging and accepting that each of those parts has some positive contribution to our well being even though they get into conflicts with each other about their proper 'domains' of applicability sometimes. In this case, it sounds like one part is worried that you'll label it as bad and try to change it without acknowledging the ways in which it might be protecting or helping you. If you read the wikipedia page on coherence therapy for instance you'll see the steps around needing to address those parts needs before they're willing to compromise.

Happy travels.

I'd be interested in some more reading on core transformation - do you happen to have any recommendations? Thanks!

the book by Connierae Andreas.

Be careful because psychedelics are all about letting go of control and that can be hard for control freaks.

I'm not saying you are a control freak but OCD leads me to believe you're not far removed.

I know that I am one, so speaking from personal experience psychedelics can be frightening to a person who must control everything. You just have to tell yourself that you've taken a drug and there is a halflife of every drug.

It can't make you do anything, it can only change your perspective of what you want to do.

Meditation can lead to similar insights over time, with practice. And because it doesn’t happen “all at once” (unless you jump into the deep end of a silent retreat or something) it might alleviate some of your anxiety.

The problem with make or break solutions is they sometimes break you. Instead, be patient and overcome your anxiety step by step.

As a step in that direction, have you considered propanalol with a trained therapist? It's non-narcotic

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