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The current trend in psychedelic folk knowledge is away from the good trip/bad trip dichotomy and towards "challenges" or "challenging experiences." IE trips that force you to reckon with some particular fear, past experience, core part of your worldview etc but provide (or demand) an opportunity for growth or fuller self-knowledge through it.

I've found this valuable in that it encourages full & nonjudgmental engagement with the "bad" experiences, focused on gaining something meaningful from them. Though it risks dismissing the potentially harmful effects of these experience. Or even worse, considering people who do have bad trips to be merely too weak or unenlightened to have chosen to avoid the experience.

But anyway I suspect the author is aware of this view, having used the phrase "challenging trips" in almost exactly the same sense.

> The current trend in psychedelic folk knowledge is away from the good trip/bad trip dichotomy

Wow, maybe "folk knowledge" is dumb. A real bad trip is not any kind of "challenging experience"; it's maybe 8 hours of completely senseless horror, a meaningless nightmare. And it doesn't really matter much whether it's 10 minutes or 10 days; if you have no sense of time, you're contemplating eternity.

Bad LSD is still a thing unfortunately. You can test a batch for purity now, though.

I think what Evans did actually violated set and setting, but it's possible this article is just poorly framed. He did enough LSD on his first trip in a packed club to experience depersonalization. To me a review of set and setting would've told me three of those things are a bad idea. He later then went to do a drug like Ayahuasca in a foreign country under a cultural practice he likely didn't appreciate. Again, things set and setting would tell me are likely not a good idea - at the very least that I should build up to. For the unfamiliar, I view both things he did like climbing Mt Hood and Mt Everest as an amateur with barely adequate gear.

I think he should continue to tell his stories, maybe even post them to Erowid or the Psychonaut wiki where there are similar warnings. That said, I'm not super convinced he's challenged the theory of set and setting.

His personal experience is not what that claim is based on, but rather the collected bad trips of hundreds of others, many of which were in a therapeutic setting.

Bad LSD being "a thing" and bad LSD being "a thing that causes bad trips" are very very different.

Among the things that people often sell as LSD, some have dangerously steep dose-response curves like 25I-NBOMe, some are pretty close analogues like AL-LAD.

None outright cause bad trips, and most or all of them are also sold with their proper labels and enjoyed by enthusiasts.

Yeah, I think I agree with you. In my head I hold space for the fact that bad trips can be resultant of three larger factors:

- Overstimulation and a lack of "preparedness" for that level. That touches on my Mt Hood example.

- Unmanaged triggers ahead of a psychedelic experience. You can feel this on something as simple as THC and certain terpenes.

- Contaminants that defeat the expectation of what the substance "should be" and are potentially unsafe.

That last part in the article about them being surprised that 8% of people in psychedelic clinical trials had difficulties is interesting to me. I think assuming that being in a therapist or clinician's office is a good 'set and setting' is sort of funny, because I can't imagine wanting to be in a clinical setting for a psychedelic experience. I'd likely want to leave and go wander in nature and they'd probably say no, too dangerous, put this blindfold and AirPods Max on. I'd do it for science, but it's not in my top 10 choices of location to do it in!

I think the article stated that 8% of the respondents who said they had a “bad trip” had their trip in a clinical trial. Not that 8% of clinical trials resulted in a bad trip.

That is what the article said, thank you for clarifying. This comment led me to read the article and try to find the data behind the study. Mainly I looked for this because the article doesn't say how this 8% compares on a normalized basis to other settings, but does make the claim that it provides evidence/proof that

> This [8%] finding challenges the “set and setting” hypothesis of psychedelics.

Edit 3: This claim was made by the article on nautil.us but was not made by the study, and indeed the Discussion in the study seems to be axiomatically accepting of the "set and setting hypothesis", and indeed the authors actually pull out quite a few statistics from previous studies which can only be viewed as supporting the "set and setting hypothesis". Some of those cited studies, such as Simonsson [1] would likely also be worth reviewing for anyone who finds interest in this one. I provided a link to Simonsson as it seems most directly relevant at first glance and I don't have time right now to review the other studies quoted, but the other studies cited shouldn't be overlooked by curious minds - they all seem quite relevant in their own way.

I've been unable to find a resource with more numbers, or ideally the underlying dataset itself to analyze on my own. If you or anyone else know where I can find more numbers from the n=(about 608) survey, I'd greatly appreciate a pointer to it.

Edit: Found the study[0]

Edit 2: The study does not have enough granular data for me to perform my own quantitative analysis. Of note though, 5.3% of participants took it in a clinical setting, but 8% of the people who "suffered afterward" had taken it in a clinical setting. This is elevated compared to what it would be with a uniform distribution but the study itself also says:

> "Experiencing a greater range of difficulties was predicted by being in an unguided setting at the time of the trip and having a more challenging trip. Duration of difficulties was predicted by the challengingness of the trip but no other factors emerged as significant. "

Taking this at face value, it would seem that an unguided setting is more strongly correlated to a "challenging trip" than a therapeutic setting. And "challenging trip" was shown to be the greatest, and one of the only, predictors of post-trip difficulties:

> To test this, linear regression analyses were conducted, firstly with range of difficulties as the DV and secondly with duration of difficulties as the DV. The overall regression model for the prediction of range of duration was significant (R2 = .04, F(4,519) = 4.97, p < .001). In terms of individual predictors, two emerged as significant; the challengingness of the trip (β = .17, p<0.001) and being in an unguided setting (β = .11, p = 0.008).

0: Study from the posted article: https://journals.plos.org/plosone/article?id=10.1371/journal...

1: Simonsson study: https://www.sciencedirect.com/science/article/pii/S016503272...

Thanks for digging these out. It definitely would be interesting to look at this dataset, because there are some parts of the study I wasn't expecting. For instance, the participants could report more than one substance during their experience -- I had assumed single drug use for the session -- where 10% indicated cannabis use. The only times I've seen people on psychedelics go from "everything is great" to "wow wtf is going on" has been after they smoked weed while a couple hours into an LSD trip.

They also didn't seem to have an option for alcohol use, which seems like an important factor if we're collecting data on mixed drug use. I'd even be interested in tobacco use, it's certainly a powerful drug and would likely be involved in most ayahuasca ceremonies.

Also was surprised that 26% of people had no idea what their dosage was. That seems really irresponsible.

Anyways, thanks again, interesting data and would love to be able to look at it more!

> Also was surprised that 26% of people had no idea what their dosage was. That seems really irresponsible.

I agree that it's irresponsible, but personally I was surprised it wasn't way higher. I have a 0.1mg resolution analytical balance and for my psychonaut acquaintances/friends I'm almost always the very first person to introduce them to consistently weighing their doses to help start building a sense of what's appropriate for them. Even for people who've been using them regularly for >10 years. And no one I know has ever quantitatively tested the purity+dose of their drugs either, which is relatively "easy" through http://energycontrol-international.org (a few do reagent testing to test for contaminants but it doesn't tell you much about % purity or dose)

Note also that with mushrooms, weighing the fresh or dried mushrooms gives you very little information on your psilocybin/psilocin dose, different strains can vary by two orders of magnitude and even within the same strain you might find the strongest sample has 5x the concentration of the weakest sample. https://www.copsychedeliccup.com/2023-psychedelic-cup-data

A 0.1mg-resolution balance would let you measure your dose to the nearest 100 microgrammes. That gives you just 3 gradations between no dose at all, and a fairly "standard" 300 mikes.

Yes it isn't appropriate for pure LSD but is fine for most other psychedelics, or dilute LSD of a known, tested, concentration. TFA is not limited to pure LSD.

Yeah you're right, my slight bias against the clinicalization of psychedelics probably slipped through there! Thanks.

I share your bias, although until we find a better way to pair therapists and patients in other settings, I am accepting of the clinical setting. I have always been pro-legalization and I personally enjoy mushrooms, MDMA, and weaker psychoactive compounds -- but I've always had a rational skepticism of overpowered medical claims, especially when it comes to popular, politicized topics like medical applications of recreational drugs.

The data and results for MDMA-assisted clinical therapy have blown me away. For example, a 2020 study[0] measured outcomes 12 months after the final MDMA-assisted therapy session and nearly half the participants ceased lifelong suicidal ideation for the full year following treatment.

I was willing to easily believe that MDMA-assisted clinical therapy reduced symptoms of PTSD but I was worried that the benefits would wear off quickly; it wasn't until just the past few years we started measuring outcomes >3 months past the completion of MDMA interventions. Seeing these strong long-term effects in has really made me a believer that there's value in the clinicalization of psychedelics, even if other guided settings might have even stronger results.

Moving over to pure conjecture, I also believe that the submission of MDMA for FDA approval (which, if granted, will force the DEA to reschedule MDMA), has been used as a lever to pressure the DEA to move on rescheduling THC/marijuana -- I believe the timing is mainly because it would be embarrassing if MDMA were moved off Schedule I before marijuana was. Obviously the broad public support for rescheduling of marijuana is a necessary prerequisite, but I don't believe it's the trigger for the specific timing. I also believe part of the timing is to generate positive press close to a presidential election. But I would be very happy to see these both rescheduled, regardless of the reasons.

I also desperately want better access for Americans to get their drugs tested, so that we can more easily shift cultural norms towards getting in the habit of knowing their dose, purity, and contaminants before taking recreational, psychedelic, or pharmaceutical drugs.

0: https://link.springer.com/article/10.1007/s00213-020-05548-2

Absolutely, I'm in the same camp as you it seems. It's important to study these things and make sure we can get psychedelics rescheduled. I'm also happy that people that aren't as weird as me can have therapeutic settings to help with lifelong issues they might otherwise completely avoid. Even if I might laugh and cringe a little inside when I see the yuppie corporate branding for things people have been taking for thousands of years and (for me) seem like no big deal at all. Or rather, a big deal that's not so much of a big deal.

I don't think you should assume what you experienced is the same thing that the author experienced. I have had both good and bad trips, ones that are like you described that lead me to imagine a world of possibilities after the trip and other ones that left me depersonalized. They definitely were not the same effect.

I do think it has a lot to do with the framework you enter with and how you understand what's happening, which I think is what OP was getting at. My most profound experience was a full depersonalization, which I never even began to consider was a bad thing at all, but maybe for someone else would be filled with panic and anxiety. So it's all dependent on your view, which is probably why Buddhism puts 'right view' (samyak-drishti) as the first of the eight-fold path (although I don't think the ordering really matters, it's just convention).

> A Buddhist teacher once explained to me that one of the expected effects of certain kinds of meditation was a growing sense that the world is insubstantial, as if it were made of tissue-paper that you could stick your finger through.

This is called "emptiness", and the second level "but actually it's all real too" is supposed to add up to something called "non-duality". Buddhists historically spend a lot of time arguing with each other about how exactly it works.

The practical upshot is supposed to be that you can look at a statement about yourself like "I have depression" and realize that it is empty of independent existence ie that you're the one doing it to yourself, and this may possibly make it go away.

If you do this too hard you then realize you don't exist and also go away.

> Anything can be changed.

Take that a step further; everything is change, quite literally.

Lauren Olamina is that u

Full quote for those unfamiliar because it's so good:

"All that you touch, You Change.

All that you Change, Changes you.

The only lasting truth is Change.

God is Change."