"Bad trips" can have surprising benefits

Ciddy was anticipating a fun trip when he took LSD by himself. He had tried it before and had a transformational experience in which he felt his body ascend above the Earth’s atmosphere and witness the formation of a new universe over the course of what felt like thousands of years. 

Except, this time, the psychedelics subverted his expectations and instead presented him with a distressing memory he had repressed for years: In high school, he had felt so hopeless about the state of the world and his place in it that he had tried to kill himself. 

“At first, my mind tried to push back and avoid words like ‘suicide,’” Ciddy, who is using a pseudonym to protect his privacy, told Salon in a phone interview. However, he said he was grateful at the time to be able to recognize he was avoiding the topic and accept that in order to “confront the reality that was being presented.”

Psychedelics like LSD or psilocybin “magic mushrooms” have been shown to be very safe and effective in treating many conditions like depression. However, they can carry some risk: Certain people with a genetic predisposition to psychosis can increase the risk of that happening during a psychedelic trip, and a small percentage of people using psychedelics may be affected by hallucinogen persisting perception disorder, in which hallucinations not related to psychosis continue long after the trip.

These substances can also sometimes produce challenging experiences, sometimes referred to as a “bad trip,” which are relatively understudied and can lead to significant psychological distress, said Dr. David S. Mathai, a psychiatrist at Baylor College of Medicine.

“The early quantitative, industry-focused research is really studying these more as medicines that alleviate symptoms without considering some of the challenging experiences like ontological shock, shame or these different evaluations of self that become activated,” Mathai told Salon in a phone interview. “I think these need to be a part of how we think about the safety profile of psychedelics, and I don’t think they are to be taken lightly.”

It’s estimated that about 10% of users will at some point in their psychedelic career report a challenging psychedelic experience, which can affect them for weeks, months or even years afterward. These experiences may involve frightening and anxiety-ridden experiences like hallucinations, or things like the dissolution of the ego, which can be disorienting and lead to a feeling of dissociation with oneself.

“Ontological shock and existential crisis is one of the most prevalent symptoms and the most long-lasting,” said Dr. Dave Luke, a psychology professor at the University of Greenwich who works with the Challenging Psychedelic Experiences Project. “One of the biggest challenges we see is that the experience is so mind-blowing and metaphysically challenging to [people's] prior world view that it really destabilizes them for quite a long time.”

Although these experiences can lead to significant psychological distress, there are ways to minimize their effects. In many cases, people actually report that a so-called “bad trip,” ended up being beneficial for their healing, said Eirini Argyri, a PhD candidate at the University of Exeter who also works with the Challenging Psychedelic Experiences Project. 

Sometimes people experience anxiety, panic and feeling disconnected from their sense of self, but what makes it a "bad trip" depends on the individual's resources, support and integration of the experience, Argyri said.

“It can be that a bad trip is even considered traumatic but then the person finds that after months or even years, sometimes they manage to find some meaning and from going through these challenges, they transform the bad trip into a learning experience," Argyri told Salon in a video call. 

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These challenging experiences are more common when taking psychedelics alone or with friends, but challenging psychedelic experiences have also been reported in the clinically recommended setting with a psychiatrist present. In one study published in May, the most bad trips occurred with psilocybin and ayahuasca, although these substances are more commonly studied overall.

Still, substances that are smoked like 5-MeO-DMT (also known as toad venom) or salvia may also lead to a challenging experience because their effects happen so rapidly and feel overwhelming, said Dr. Andrea Jungaberle, a psychotherapist, anesthesiologist and emergency medicine physician at the OVID Clinic in Germany and co-founder of the MIND Foundation, an European non-profit promoting psychedelic research. On the other hand, these experiences are also shorter in length than something like LSD, which can last 12 hours or more. This could present different challenges due to how long the trip is, she explained.

In a 2016 study from John Hopkins University of about 2,000 people who reported a past negative experience when taking magic mushrooms, more than 10% said their worst “bad trip” had put themselves or others in harm’s way. The majority of participants also said the experience was one of the top 10 biggest challenges of their lives. Yet the majority also said those experiences were meaningful and worthwhile, with half of the people who said it was ultimately positive saying it was the single most valuable experience in their life.

Last month, Argyri co-authored a qualitative study of people who had gone through challenging experiences found some people gained more compassion for others in the process and wanted to give back after their experience.

Still, these experiences can be traumatizing or retraumatizing. In the qualitative study, more than half of the 26 participants either explicitly reported their experience as traumatic or described experiencing symptoms of post-traumatic stress disorder. Though it's not always the case, this can lead to suffering that can ultimately resolve in growth, Argyri said. 

"The kind of growth that people ultimately find can be beneficial,” she said. “It is very much akin to a kind of post-traumatic growth.”

In another 2022 study of about 600 people who had experienced a challenging psychedelic experience, problems persisted for over a year. And in some cases, people can react to these experiences in a similar way as they do to a traumatic event, with flashbacks, intrusive thoughts and emotional instability, Jungaberle said.

“People can perceive this as damaging, especially if it happens in a context where they didn’t expect anything like that to happen,” Jungaberle told Salon in a video call.

However, in the 2022 study, these difficulties lasted a shorter time if participants reported being more aware of the dose of the psychedelics they were taking, and fewer difficulties were reported among people who took them under a guided setting. 

Sometimes repressed memories can return during a psychedelic experience, and this can be overwhelming, Jungaberle said. However, resisting anxieties or difficult experiences can make the experience more distressing than letting them come up and observing them without judgment, she explained.

“I sometimes liken it to the experience of watching a muddy puddle,” Jungaberle told Salon in a video call. “Whatever bubbles up will bubble up, and if difficult things need to be processed, I think the surest way into a difficult experience is avoidance.”

Sometimes, thought loops that occur during the challenging psychedelic experience can take root in a person’s mind. In the study published in May, people reported having “no-exit” thought patterns that they have “fried their brain” or done something that can’t be undone, especially with these ontological experiences of “losing oneself."

“If they don't have the right kind of social environment to start to untangle what has actually happened, that belief that emerges during the experience can keep them stuck into thinking they've really done something,” Argyri explained. “Guilt and shame can be associated with that and can exacerbate their anxiety and all sorts of other difficulties around that.”

Guilt and shame can make these experiences difficult to verbalize or talk about, Mathai said. In a study Mathai co-authored that was published in February of about 680 adults who planned to use psilocybin outside of the clinic, nearly 70% said they felt shame or guilt during their experience. Those who could work through those feelings reported improved psychological well-being after the experience.

“We did find that the group with the highest ratings of well-being... actually was the group that had challenging experiences that they felt like they were able to work through in a very constructive way,” Mathai said. "The ratings for that group were higher than a group that didn't have significant experiences of shame or guilt at all."

However, close to 30% of people in the study experienced more shame after the experience. Shame is a self-conscious emotion, meaning it has a lot to do with how we see ourselves. It may come up in psychedelic experiences because these substances uniquely affect how we relate to ourselves, Mathai said. Loosening these rigid ideas about our identities can be painful, but also helpful, he explained.

“One way I think of that [is related to there being] these really entrenched ideas about identity that have been resistant to change,” Mathai told Salon in a phone interview. “There is an opportunity for that rigidity to soften and for there to be new ideas about the self, but sometimes that involves what has been described in psychedelic literature as this sort of confrontation with self in ways that can be painful.”

Ultimately, psychotherapy is about this same confrontation with self, although if these confrontations come on too strongly with psychedelics it may be too overwhelming to process, he said. 

Still, part of that guilt and shame may stem from the legality of psychedelics, which are banned in most places. In Argyri's qualitative paper published last month, about one-fifth of participants said that legalizing or decriminalizing psychedelics would have reduced the stress and anxiety they felt about their situation. 

Ciddy has tried LSD and psilocybin several times and experienced a few of what he would consider bad or negative trips. The first time he tried psilocybin, he became paranoid that his friend had called the police to tell them he was taking an illegal substance. 

“I saw these cop cars going by and I was like 'Oh my God, they’re going to arrest me because I’m doing this illegal Schedule I narcotic,'” he said.

Relatively little literature exists citing “bad trips” within Indigenous communities, where substances like psilocybin, ibogaine and ayahuasca have been traditionally used for hundreds, if not thousands of years. 

If a “bad trip” is a Western phenomenon, it could be because leaders in the Indigenous community who administer these substances undergo extensive training to help guide people through them, and many Indigenous communities in general have these substances deeply embedded in their society. It may also be that “good trips” do not exist along with “bad” ones because this binary way of thinking is also Western.

These communities support the person going through the experience, which is seen as a part of a ritual process, infused with meaning, that can support the growth of the individual, Argyri said. In Western cultures, that is lacking, she added.

“If you experience talking to trees or other entities, it is so out of the ordinary and often pathologized … that people might be afraid to talk about these experiences and become stigmatized," Argyri said.

Still, in addition to taking psychedelics in a supportive setting, it’s also important to be in a headspace where you are mentally prepared to take them, Argyri said. Allowing time to process the experience afterward is also important to reduce the likelihood of a negative experience, she explained.

Nevertheless, “bad trips” can still occur, even if a person has set up everything they can for it to not happen, Luke said. 

“People do have bad trips for all kinds of reasons and it is not necessarily about having resistance or anything like that,” he added. “Normalizing bad trips is important … and generally we need better education around this.”

For this reason, many practitioners are advocating for a harm reduction approach to psychedelics that focuses on meeting people where they are and minimizing risk.

"It is important not to put the responsibility on the individual for doing something wrong if they find themselves struggling," Argyri said. "What's more important than the difficulties arising is supporting people feeling stuck in the aftermath to help them see that there is a way through."

For Ciddy, confronting the repressed memory of his suicide attempt in high school was just the beginning of his healing process. It took many months for him to be able to verbalize the realization he had. But he decided to start going to therapy, where he was able to sort through all of the thought patterns and childhood experiences that led to that experience.

“With some of my negative and positive experiences with LSD, I was able to bring certain things to the forefront and work on them in the ways that I knew how,” he said. “But it was only when I went to therapy that I was able to integrate it in a way that was a little bit less intense and make everyday changes.”