10 years ago a single psychedelic experience helped me overcome depression and anxiety.

But it wasn't my first experience. Or my second. Or even my fifth.

I went into all of these looking for relief. But – despite being blown away by the sheer novelty of what unfolded – I came out pretty much the same.

Looking back, i'm not surprised.

I’d read about the importance of preparation, and found some great resources that helped me navigate sticky situations.

But I missed some key steps, and didn't get any better until stumbling into them.

I've since learned these steps are supported by the latest research in psychedelic therapy.

Here's what I wish I knew when preparing for my first psychedelic experience, including 4 evidence-based tips for a more therapeutic trip.

Experience as medicine

The long-term impact of taking a psychedelic depends on your experience of it.

So what types of experiences are linked to feeling better?

Research shows that mystical-type experiences or emotional breakthroughs are both linked to better therapeutic outcomes. [1, 2, 3, 4, 5]

A mystical-type experience is marked by feeling:

• a sense of unity and interconnectedness that feels true and sacred

• strong positive emotions like love and peace

• an altered sense of space and time

• that it is difficult to describe the experience using words

An emotional breakthrough is marked by:

• feeling able to explore challenging emotions or memories you usually push aside

• getting closure on an emotional problem, personal conflict or trauma

• an experience of emotional release followed by a sense of relief

The trip that helped lift my depression and anxiety involved an emotional breakthrough. My next most impactful trip (3 years later) was more of a mystical-type experience.

These aren't mutually exclusive. You could experience each at different points in a trip, or elements of each at the same time. Or neither.

These also aren’t the only types of therapeutic experience.

But they help show how – more generally – you can get better as a result of both experiences of matters beyond the self (transpersonal) and about your life and relationships (personal).

Researchers have also studied challenging experiences which are marked by feelings like fear, insanity, paranoia and physical distress.

These feelings are likely to feature at some point in any trip. But they tend to dampen therapeutic outcomes if they dominate the duration of your trip without being resolved. [1, 2, 5, 6]

Set and setting

How can you boost your chance of having a therapeutic experience and minimise the chance of a challenging one?

First things first: the psychedelic experience is unpredictable. That said, it’s also highly influenced by context.

This means that while you’re never going to be in the driver’s seat, you can take certain steps to bias the steering.

The context in which you take a psychedelic can be summarised by set and setting.

• Set (or mindset) refers to psychological factors such as your mood and motivation for having the experience

• Setting refers to environmental factors such as your physical surroundings and the other people present.

This handy phrase was popularised by psychedelic researcher Timothy Leary in the early 1960s. But appreciation of the underlying concept stretches further back. [8]

Indigenous cultures who use psychedelics have preparation rituals like periods of solitude or dietary restriction. They also carefully control factors like sounds, scents and lighting during ceremonies.

In the 1950s, early practitioners of LSD psychotherapy also realised the impact of set and setting on outcomes for their patients. They arrived at practices which are still used in modern clinical trials like:

• extensive preparation sessions

• a “living room” aesthetic with artwork, soft lighting & comfortable seating

• the use of eyeshades and music

4 Pre-Flight Tips For A More Therapeutic Trip

Despite widespread recognition of the importance of set and setting, there aren’t many controlled studies of how to optimise it.

This is partly because psychedelic research has been difficult to carry out. Today, barriers are slowly falling.

Even so, it’s difficult to study set and setting due to the ethics of providing poor experiences to trial participants.

Fortunately, people use psychedelics in the wild with lots of variation in the factors that make up set and setting.

Even more fortunately, they’ve been signing up for studies where they report on their experiences.

This means we can learn about relationships between set and setting, the psychedelic experience, and long-term outcomes.

Based on this research, here are 4 steps to prepare for a trip to:

• boost your chance of having a therapeutic experience

• reduce your chance of having an unduly challenging experience

In future posts i’ll cover evidence-based tips for the experience itself (e.g. setting) and processing it afterwards (i.e. integration).

1. Know what to expect

You never know what you’re going to get with a psychedelic experience, but it helps to look at the menu.

If you know what’s on offer, then it’s easier to accept your particular experience as normal and nothing to be afraid of.

The more you agree with the following statements, the more likely you are to have a mystical-type experience or emotional breakthrough, and the less likely you are to have a challenging experience. [7]

• I had done some of my own research into the effects of the psychedelic substance

• I understood that the experience could evoke a range of intense emotions, from bliss to horror

• I understood that events from my past could surface into the psychedelic experience

• I knew that my experience would be somewhat unpredictable

• I was aware that the psychedelic experience might change me in some way

I’d recommend checking out PsychonautWiki for an overview of the possible effects of your chosen psychedelic.

After that, you can dive into trip reports on Erowid to get a first-person sense of those effects. Read about challenging experiences as well as blissful ones.

2. Be ready to surrender

It’s one thing to know about the possible effects of a psychedelic. But it’s another thing to be ready for them.

Your best bet is preparing to surrender. The more you feel ready to surrender to whatever comes up during your experience:

• the more likely you are to have a mystical-type experience [4] or emotional breakthrough [2]

• the less likely you are to have a challenging experience [3].

Remember: the more you fight a psychedelic, the more it squeezes.

You can think of this a bit like exposure therapy for treating phobias.

If you run into a spider by chance, you become more afraid. But if you choose to face one voluntarily, you become braver.

Now swap this spider for a difficult memory, or for losing a sense of time, space or self.

Here’s some related advice given to participants in clinical trials at Johns Hopkins University:

3. Set a clear intention

Your reason for taking a psychedelic affects your experience.

If you’re motivated by therapy or personal growth, you’re more likely to have an emotional breakthrough [2]. If you have spiritual motivations, you’re more likely to have a mystical-type experience. [4]

That probably won’t surprise you. But what studies also show is that the clearer your intention is, the better. [3, 7]

This means you should go beyond a vague idea about seeking therapy, and take time to reflect on your reasons for taking a psychedelic.

For example, try writing about what you consider to be your main problems, and the questions you want to investigate during your trip. This exercise alone can improve your mental and physical health (more on that in future posts).

Of course, psychedelics don’t have to be so serious. They’re also fun, and it’s just as valuable to explore this.

But taking them for fun doesn’t seem to boost your chance of having a therapeutic experience [3]. So if that’s your goal, then it’s better to focus on it.

I’ve had great times giggling the night away with friends. But my most impactful experiences have all been focused on looking inwards in relative silence (whether alone, with a partner, or on retreat).

4. Get the timing right

So: you know what to expect, you’re ready to surrender, and you’ve set a clear intention.

Now it’s time to pick a date and time for your experience.

But don’t rush this step, as it’s just as important as the others.

You’re more likely to have a challenging experience if you take a psychedelic when:

• you’re in a bad mood [3, 6]

• you’re feeling preoccupied, rushed or busy [3, 4]

Being in a good mood sounds like a strange requirement if you’re trying to improve your mental health.

But you can think about this in terms of daily ups and downs around your longer-term wellbeing. You should avoid taking psychedelics on particularly bad days where you’re feeling strongly charged negative emotions.

Try to clear your schedule to allow time before and after the experience.

If you have lots of plans on the same day or following days, then thoughts about these might cloud your experience. I’ve never had a really insightful trip when trying to squeeze it in around other things going on in my life.

All the best for the week ahead,

Nick

References

1. Roseman et al. (2018). Quality of Acute Psychedelic Experience Predicts Therapeutic Efficacy of Psilocybin for Treatment-Resistant Depression.

2. Roseman et al. (2019). Emotional breakthrough and psychedelics: Validation of the Emotional Breakthrough Inventory.

3. Haijen et al. (2018). Predicting Responses to Psychedelics: A Prospective Study.

4. Russ et al. (2019). Replication and extension of a model predicting response to psilocybin.

5. Peill et al. (2022). Validation of the Psychological Insight Scale: A new scale to assess psychological insight following a psychedelic experience.

6. Carbonaro et al. (2016). Survey study of challenging experiences after ingesting psilocybin mushrooms: Acute and enduring positive and negative consequences.

7. McAlpine et al. (2023). Development and psychometric validation of a novel scale for measuring ‘psychedelic preparedness’

8. Hartogsohn (2017). Constructing drug effects: A history of set and setting.